Magnetic resonance imaging (MRI) is a promising tool for optimizing prostate cancer biopsy that appears to overcome the shortcomings of conventional systematic transrectal ultrasound (TRUS)-guided biopsy and also provides novel information for risk stratification that can guide the decision of whether to perform biopsy, according to Samir Taneja, MD.
Speaking at the Large Urology Group Practice Association annual meeting in Chicago, Dr. Taneja, of the NYU Langone Medical Center in New York, reviewed findings from studies conducted at his center evaluating MRI as a tool for guiding biopsy and biopsy decisions. The research included analyses of data collected in the first 605 men who underwent MRI-targeted biopsy and also a standard systematic 12-core biopsy.
Based on the results, Dr. Taneja proposed that MRI appears to offer four fundamental benefits.
First, in men who have never been biopsied before, an MRI-targeted approach appears to maintain similar rates of detection of clinically significant, high-grade cancer compared to standard TRUS-guided biopsy while reducing detection of clinically insignificant, low-grade cancer.
“Therefore, MRI-targeted biopsy in this population could reduce the problem of cancer over-detection and overtreatment,” said Dr. Taneja.
Second, in men with a previous negative biopsy, an MRI-targeted approach appears to allow increased detection of cancer and increased detection of high-grade cancer versus standard TRUS-guided biopsy.
“Not surprisingly, standard systematic biopsy is rarely informative in these men who had already had negative results with that technique, and our data suggest that such patients would not need to undergo a 12-core biopsy at all,” Dr. Taneja said.
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