Targeted prostate biopsy improves cancer detection
Image-guided targeted biopsy can be used to detect prostate cancer, according to researchers at the University of California Los Angeles. Their findings recently were published online in the Journal of Urology.
The researchers reported that this new technique is more accurate than traditional "blind" biopsies currently used to diagnose prostate cancer.
"Early prostate cancer is difficult to image because of the limited contrast between normal and malignant tissues within the prostate," senior author Leonard Marks, a professor of urology and director of the UCLA Active Surveillance Program, said in an announcement. "Conventional biopsies are basically performed blindly, because we can't see what we're aiming for. Now, with this new method we have the potential to see the prostate cancer and aim for it in a much more refined and rational manner."
About 1 million prostate biopsies are performed each year on men with elevated PSA levels, with 240,000 resulting in a diagnosis of cancer. This means the remaining 75 percent are negative for cancer, although it's possible that these men still have malignant tumors missed by conventional biopsy.
In the study, the researchers evaluated prostate cancer detection rates in 171 men using MRI-ultrasound fusion biopsy. Before the biopsies, each patient underwent multiparametric imaging. Lesions on MRI were outlined in 3-D and assigned cancer suspicion levels by a uroradiologist. The MRI picture was fused with real-time 3-D ultrasound, which allowed the uroradiologist to see lesions during biopsy.
According to the study, the targeted biopsy was three times more likely to identify cancer than a systematic biopsy. Prostate cancer was found in 53 percent of the men biopsied, 38 percent of who had a Gleason grade 7 or great cancer. Of those men with the Gleason grade 7 or greater cancer, 38 percent had the cancer detected only with targeted biopsies.
"Targeted prostate biopsy has the potential to improve the diagnosis of prostate cancer and may aid in the selection of patients for active surveillance and focal therapy," the authors concluded.
Louis Potters, M.D., chair of radiation medicine at North Shore-LIJ Health System in New Hyde Park, N.Y., told HealthDay that the UCLA study "[evaluates] the next step in the evolution of prostate biopsy. It combines the state-of-the-art MRI which allows clinicians to see inside the prostate with incredible detail."
In the same article, Warren Bromberg, M.D., chief of urology at Northern Westchester Hospital in Mount Kisco, N.Y., said the technique allowed better visualization of tumors and that "adding the MRI to the ultrasound seems to allow preferential detection of the more life-threatening type of cancer [high-grade], which could reduce the chances that a man would undergo unnecessary treatment."