Fusion Biopsy

The diagnosis of prostate cancer (PCa) has been classically based on PSA values in blood tests and a digital rectal examination.

When any of these two parameters were abnormal, a random transrectal biopsy of the prostate was prescribed with 8 to 16 samples usually taken. Although the biopsy needle was guided by transrectal ultrasound, this biopsy was not specifically directed at certain suspicious areas.

This clinical practice, although extensively used throughout the world, has led to overdiagnosis and overtreatment and, since no real mapping of the prostate tumour affection was available, it was not possible to identify patients with non-aggressive tumours which, if left to their natural progression, would not put their lives at risk, and instead of being treated only required monitoring.

For this reason, the diagnostic procedure has been recently changed.

During a clinical situation of suspected PCa (elevated PSA), a multiparametric magnetic resonance imaging (mp-MRI) is carried out. This imaging test requires high-power resonance equipment, with a minimum of 1.5 Tesla, and highly specialised and trained radiologists to perform it and report.

mp-MRI provides very precise information on the PCa suspicious areas, which other imaging tests do not achieve.

At the same time, several studies have shown that the tumours detected are clinically significant.

Therefore, any tumour that is not detected with this technique is expected to be of a low-risk type. This avoids overdiagnosis and overtreatment.

Further examination will determine whether or not further action needs to be taken at any given time, taking into account the usually slow evolution of this type of tumour.

Fusion Biopsy

With the NMR information, thanks to an ultrasound machine equipped with special software, the NMR image can be merged with the ultrasound image and perform selective biopsies of the areas identified as susceptible to harbour tumours. This biopsy is carried out via the perineum, being safer, more accurate and less uncomfortable. Therefore, it is now possible to provide customised treatment with these two tools we offer: mp-NMR and Fusion Biopsy.

Advantages

  • More precise.
  • Safer.
  • Allows planning focal therapy.
  • Fewer complications: infection, hematochezia and others.

Disadvantages

  • More expensive.
  • Requires operating room.
  • Has to be performed by a very expert team.
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