MRI-Ultrasound-Guided Biopsies Diagnose More High-Risk Prostate Cancers.

Prostate biopsies that combine MRI technology with ultrasound appear to give men better information regarding the seriousness of their cancer, a new study suggests.  The new technology, which uses MRI scans to help doctors biopsy very specific portions of the prostate, diagnosed 30 percent more high-risk cancers than standard prostate biopsies in men suspected of prostate cancer, as reported by the senior author, Dr. Peter Pinto, head of the prostate cancer section at the U.S. National Cancer Institute’s Center for Cancer Research in Bethesda, MD.  These MRI-targeted biopsies also were better at weeding out low-risk prostate cancers that would not lead to a man’s death, diagnosing 17 percent fewer low-grade tumors than standard biopsy. In a targeted biopsy, MRIs of the suspected cancer are fused with real-time ultrasound images, creating a map of the prostate that enables doctors to pinpoint and test suspicious areas.  To test the effectiveness of MRI-targeted biopsy, researchers examined just over 1,000 men who were suspected of prostate cancer because of an abnormal blood screening or rectal exam.  The researchers performed both an MRI-targeted and a standard biopsy on all of the men, and then compared results.  Both targeted and standard biopsy diagnosed a similar number of cancer cases, and 69 percent of the time both types of biopsy came to exact agreement regarding a patient’s risk of death due to prostate cancer.  However, the two approaches differed in that targeted biopsy found 30 percent more high-risk cancers, and 17 percent fewer low-risk cancers, the type of cancer where this person certainly would have lived their whole life and died of something else.  An MRI is great for guiding doctors to serious cancers, but is not able to detect lesions smaller than 5 millimeters.  While this MRI – ultrasound technique is being widely publicized in medical circles, questions remain.  For example, would the new technology, which requires an MRI for each suspected case of prostate cancer and new equipment to fuse the MRI with an ultrasound scan, be worth the extra expense?  Dr. Pinto believes the new technology might actually save money in the long run, by reducing over-treatment.  See the following link for additional details.