MR Fusion Prostate Biopsy
Prostate diseases, which are the most common disease group in men in the world, are seen more as prostate infections at young ages, but after the age of 50, they appear more as benign prostate enlargement (BPH) or prostate cancer (Pca).
With the rapid aging of the population, we are starting to see BPH and especially prostate cancer more frequently. Prostate cancer is currently the most common cancer in men, and it comes second after lung cancer in terms of death. Therefore, it becomes a very important social and medical problem in the aging society. After the age of 50, almost half of the men start voiding problems that affect their quality of life.
In the diagnosis of prostate cancer, digital prostate examination and measurement of PSA in the blood provide important clinical information. In doubtful cases, prostate biopsy is required to make a definitive diagnosis. Currently, prostate biopsy is performed through the breech as standard. 12 blind biopsies are performed from the prostate tissue with an ultrasound device inserted through the anus. In suspicious cases, if cancer is not detected, biopsies are repeated at least 3 times. Therefore, the complications of this procedure are increasing. In addition to the inadequacy in the diagnosis of cancer, patients have serious infection risk, bleeding and pain complaints because the breech canal is used. “Will you have a biopsy again?” for patients who underwent prostate biopsy in the standard way. When asked, more than half of the patients do not want to have a biopsy because of this.
The best imaging and treatment methods for prostate cancer are now provided with fusion systems. In targeted fusion prostate biopsies, the prostate structure of the patient is revealed with detailed MR. Suspicious areas in the prostate are clearly visible (Picture 1). Then, these images are transferred to the 3D (3D) Ultrasonography device with a special software. Following the marking of suspicious areas, real-time targeted biopsies are taken with specially designed biopsy apparatus. Marking suspicious areas minimizes the margin of error. Thus, biopsies to be taken from unnecessary areas are prevented. Biopsies from the targeted areas will provide a definitive diagnosis of the tumor, if any (Picture 2).
In prostate cancer, not every type of cancer carries the same life-threatening danger. Some slow-growing low-risk cancer types are followed for life without the need for any treatment, only by applying follow-up protocols. In addition, effective and rapid treatments are needed for fast-growing high-risk prostate cancer types. One of the most important steps that distinguishes these two large groups from each other is targeted fusion biopsy systems. With MR fusion biopsy systems, 30% higher risk prostate cancer is diagnosed while 17% unnecessary biopsies are avoided.
One of the most important advantages of the fusion biopsy system used in our hospital is that the breech canal is not used (Picture 3). Biopsies are taken by imaging the prostate directly over the skin. Therefore, infection, pain and bleeding complications seen in standard biopsies do not occur. In biopsy methods in which the rectal route is used, approximately 4% of patients require treatment that will require hospitalization due to infection.
- The most accurate method of diagnosis to date.
- Removing unnecessary areas from biopsy with targeted biopsies.
- Obtaining the real image of the prostate with MR and 3D US.
- The rate of side effects is very low since the breech route is not used compared to the standard method.
- Repeat biopsy rates are very low.
Picture 1: Prostate with 3D image.
Figure 2: Targeted fusion biopsies prevent unnecessary biopsies.
Figure 3: Comparison of standard Transrectal and Fusion Biopsy methods.