Prostate biopsy using image fusion is already a reality to reduce the number of unnecessary biopsies in prostate cancer diagnoses.
Prostate cancer is the most frequent tumour in males. Historically, digital rectal exams and PSA were used for diagnose. If nodules or indurations are found in the rectal exam or if the PSA level is too high for the patient’s age or the prostate size, a prostate biopsy needs to be done. The biopsy is usually performed using an ultrasound machine into the rectum.
However, transurethral ultrasound tests have inconveniences: we get to see few tumours with a bad quality. For that reason, we need to perform from eight to ten aleatory biopsies. A mapping of the prostatic gland is made to search for tumours.
These practices are making us diagnose insignificant or not aggressive tumours; leading into what we know as “overdiagnosing” and “overtreating”.
The specialized documented literature is starting to have solid evidence on how to avoid these biopsies by doing a magnetic ultrasound before the biopsy.
This radiologic technique detects tumours with clinical signification, that means, those tumours with possibilities to affect the patient’s life expectancy.
It also shows tumour injuries in the forward face of the prostate, which cannot be reached using a transrectal ultrasound and a classic biopsy.
Only in cases where the ultrasound shows any suspicious or malicious injury, we will perform a prostatic biopsy.It will be not performed as it used to be, but combining the ultrasound images and the samples collectedtransperineally, directed straight to the injuries we saw in the ultrasound.
Thanks to these techniques, we are reducing the number of biopsies and only detect tumours that need to be treated.
Our aim is always to provide the best, most effective results for the patient.