Cutting Edge

Title
A better way to look for prostate cancer: MRI ultrasound fusion biopsy
Date
01/17/2017
Article

There’s only one kind of cancer that is not detected from something you can see or feel, and that’s prostate cancer. A blood test, called the prostate-specific antigen (PSA), identifies nearly 90 percent of prostate cancers – the second leading cause of cancer deaths among men. But once cancer’s suspected, finding its
exact location in the walnut-sized prostate gland can be a challenge.

“Unlike other cancers, you don’t see a lesion with prostate cancer,” said Samuel Deem, DO, CAMC Urology. “So when we try to find abnormal tissue, we literally must do a blind biopsy.”

Until now.

Fusion is a process that blends ultrasound and magnetic resonance imaging (MRI) technologies to create a detailed, 360-degree map of the prostate that helps doctors “see” prostate cancer like never before.

CAMC’s 3 Tesla (3T) MRI scanner uses a more technologically advanced magnet that quickly and safely produces high-resolution images of the prostate. Once trouble spots are identified, Deem uses an advanced image-guided stereotactic biopsy system called UroNav to get tissue samples directly from the suspicious areas
.
“This technology advances prostate cancer detection to the same level as every other cancer,” said Deem, who is one of few urologists in the country who is specially-trained to perform prostate fusion biopsy.

Deem recently treated a patient who had an alarmingly high PSA, yet multiple biopsies had all come back negative for cancer.

“The patient had had three biopsies over the course of four to five years, and even though the results indicated no cancer, his PSA kept going up significantly,” Deem said. That’s when the patient’s doctor referred him to Deem, who is fellowship trained in minimally-invasive urologic cancer procedures. “When I saw this patient, he
had just had his third negative prostate biopsy, but his PSA was extremely high,” Deem said.

Deem recommended that the patient have MRI ultrasound fusion biopsy that revealed cancer in an area of the prostate that is not typically biopsied, which is how it had been repeatedly missed.

“The cancer was in a very difficult location, but based on the MRI, it was an easy diagnosis. We were able to successfully biopsy the lesion, and the patient underwent radiation for the cancer.” Deem said fewer and more accurate biopsies are good news for patients.

“If you’ve been through a biopsy and you’re told you have to have another one, it’s pretty discouraging,” Deem said. “But when I can say, ‘You’ve had this biopsy, but now we see a lesion on the MRI, so now we’re going to biopsy just that spot,’ that makes a big difference because we know we’re going to get the specific area
of concern.”

Men who have had a negative prostate biopsy but their PSA continues to rise, or men with a clinical concern for prostate cancer, such as difficulty voiding, voiding symptoms, pain in the perineum or blood in the urine, may be a candidate for MRI ultrasound fusion biopsy.

For more information,call CAMC Urology at (304) 388-1900.