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Prostate Breakthrough Uses MRI, Ultrasound

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MRI and ultrasound combine for what seems to be a real breakthrough in the diagnosis of prostate cancer. A UCLA team of urologists, an engineer, and a radiologist report on their new technique in an article published online November 15 in The Journal of Urology.

The technique allows for precisely targeted biopsies in men suspected of having prostate cancer. Leonard S. Marks, MD, senior author of the study, explained:

Early prostate cancer is difficult to image because of the limited contrast between normal and malignant tissues within the prostate. Conventional biopsies are basically performed blindly, because we can’t see what we’re aiming for. Now, with this new method that fuses MRI and ultrasound, we have the potential to see the prostate cancer and aim for it in a much more refined and rational manner.

Dr. Marks is a professor of urology at UCLA and director of the UCLA Active Surveillance Program. He was quoted in a UCLA Health System news release (which also features video).

MRI can detect potential prostate tumors. But MRI machines aren’t exactly built to allow biopsies. Doctors therefore use ultrasound to guide biopsies. However, ultrasound doesn’t have sufficient resolution to show lesions. So doctors basically stab at the prostate, hoping they’re hitting the areas of concern that showed up on the MRI.

The new technique fuses the MRI image of the prostate with real-time, three-dimensional ultrasound, allowing precise biopsy targeting of the suspicious areas.

“The results have been very dramatic, and the rate of cancer detection in these targeted biopsies is very high,” Dr. Marks said. “We’re finding a lot of tumors that hadn’t been found before using conventional biopsies.”

The result might be more surgery or radiotherapy—but the technique could also lead to more “watchful waiting.” If a biopsy turns up only nonaggressive cancer, doctors and patients may opt to forgo treatment, confident that the biopsy hasn’t missed any more threatening tumors.

Related seminar: UCSF Abdominal and Pelvic Imaging: CT/MR/US


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