prostate mri biopsy

“Do I need a biopsy? Why?”

3T Multiparametric MRI – BlueLaser™ imaging detects prostate cancer with high accuracy. If this is true, why not simply proceed with treatment? The answer has to do with matching the treatment to the cancer. While the MRI images give important information about the probable aggression, only analysis of tissue samples can define the risk as low, intermediate, or high. Together with a patient’s age, PSA tests, and tumor stage, the biopsy adds the essential Gleason grade that indicates how dangerous the cells are. If needed, genomic or molecular analysis of the cancer cells taken by biopsy can determine appropriate treatment choices and how quickly to take action.

A prostate biopsy is necessary in order to choose from a range of treatment options.

  • Active surveillance (also called AS or observation) means holding off on treatment while following an established protocol of monitoring through blood/urine tests and imaging. It may also include lifestyle changes such as improved diet, exercise and stress management. No side effects.
  • Focal treatment (also called focal ablation) such as our BlueLaser™ Focal Laser Ablation uses extreme temperatures to destroy just the tumor plus a margin of safety. From there, a similar protocol to AS can be used to monitor for possible future cancer in the untreated part of the gland. Very low risk of side effects.
  • Whole gland treatment (also called radical treatment) is done either by surgery to remove the whole prostate (radical prostatectomy), some form of beam radiation or radioactive seed implants (brachytherapy), or whole-gland ablation. Moderate to high risk of side effects.

MRI-Guided Targeted Biopsy for Better Prostate Cancer Diagnosis

A key advantage 3T Multi-Parametric MRI – BlueLaser™ is detecting the location, size and shape of any suspicious area(s). If a biopsy is necessary to sample tissue, our 3T Multi-Parametric MRI – BlueLaser™ is used for precision guidance of biopsy needles targeted into the sites most likely to contain any aggressive prostate cancer. Only the minimum number of needles is used, yet this method gives the most accurate diagnosis. Compare this with the 12-14 needles used in a conventional ultrasound-guided biopsy. Ultrasound does not show tissue differences, so conventional biopsies are essentially “blind.” This results in over-detecting insignificant prostate cancer, or under-detecting dangerously aggressive prostate cancer. Our 3T mpMRI-guided biopsy makes it possible to match the treatment strategy, including Active Surveillance, with the disease.

In addition, tissue samples can be used for further molecular analysis if warranted. Certain biomarkers, if found, may indicate the presence of a more dangerous cell line which will determine treatment choices.

International research studies have shown mpMRI-guided targeted biopsy to outperform conventional ultrasound-guided (TRUS) biopsies while being less invasive and risky for the patient.

mpMRI-Guided Treatment Options

If prostate cancer is diagnosed as the result of a biopsy, Dr. Sperling can help the patient decide if he is a candidate for MRI-guided focal laser ablation. This targeted treatment for qualified patients offers excellent cancer control with minimal-to-no risk of urinary or sexual side effects.