MRI Can Rule Out Need for Biopsy in Men with High PSA

Excerpt:

“One in four men presenting with elevated prostate-specific antigen (PSA) may be able to safely avoid prostate biopsy if they have triage testing with multi-parametric magnetic resonance imaging (MP-MRI) first, researchers said.

“The use of MP-MRI might also improve the detection of clinically significant cancer compared with transrectal ultrasound-guided prostate biopsy (TRUS-biopsy) and reduce over-diagnosis of clinically insignificant prostate cancer, the multicenter, paired-cohort, confirmatory PROMIS (PROstate MR Imaging Study) showed.”

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One in Four Men with Suspected Prostate Cancer Could Avoid Unnecessary Biopsy If Given an MRI Scan First

Excerpt:

“Giving men with suspected prostate cancer an MRI scan could improve diagnosis and save those who do not have aggressive cancers from having an unnecessary biopsy, according to a study published in The Lancet.

“The study estimates that adding the extra test could help one in four (27%) men avoid an unnecessary biopsy and reduce the number of men who are over-diagnosed – diagnosed with a cancer that does not go on to cause any harm during their lifetime – by 5%.”

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Increasing the Odds of Prostate Cancer Detection

Excerpt:

“For three years, Andrew Harder wondered if he had prostate cancer. In 2009, he had routine blood work that revealed an elevated prostate-specific antigen (PSA) level. When PSA is above 4 nanograms per milliliter of blood, it can be one of the first signs of a prostate tumor. Harder’s PSA was 9.

“By the time Harder saw a urologist, it had skyrocketed to 20. His doctor recommended the traditional next step: a transrectal ultrasound (TRUS) biopsy, which involves taking random tissue samples from 12 cross sections of the prostate.

“Over the course of two years, Harder, 60, an MRI technologist, would have three TRUS biopsies. They were all inconclusive.”

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New Image Analytics May Offer Quick Guidance for Breast Cancer Treatment

“For women with the most common type of breast cancer, a new way to analyze magnetic resonance images (MRI) data appears to reliably distinguish between patients who would need only hormonal treatment and those who also need chemotherapy, researchers from Case Western Reserve University report.

“The analysis may provide women diagnosed with estrogen positive-receptor (ER-positive)  answers far faster than current tests and, due to its expected low cost, open the door to this kind of testing worldwide.

“The research is published in the journal Nature Scientific Reports.”


MRI-Ultrasound Fusion Improves Prostate Biopsy Cancer Detection

“Magnetic resonance imaging-ultrasound fusion targeted prostate biopsy (MRF-TB) improves detection and risk stratification of high-grade disease and limits detection of clinically insignificant prostate cancer, according to a study published in the December issue of the The Journal of Urology.

“Neil Mendhiratta, from the New York University Langone Medical Center in New York City, and colleagues reported clinical outcomes for 452 consecutive men presenting for primary . Participants underwent prebiopsy multiparametric magnetic resonance imaging followed by MRF-TB and systematic biopsy.”


MRI Tied to More Aggressive Breast Cancer Treatment

“The use of preoperative magnetic resonance imaging (pMRI) in women with newly diagnosed breast cancer has increased by eightfold during the past 10 years in Canada’s most populous province and is associated with significant increases in adverse downstream consequences, including more mastectomies, a population-based study indicates.

“The research was published online September 24 in JAMA Oncology.

“Angel Arnaout, MD, University of Ottawa, in Ontario, and colleagues found that 14.8% of a cohort of 53,015 women treated with newly diagnosed breast cancer between 2003 and 2012 had undergone pMRI in the province of Ontario.

“A total of 65% of the cohort underwent breast-conserving surgery.”


Study Suggests Dense Breast Tissue Isn’t Always a High Cancer Risk

“A new study offers help to patients and doctors who are trying to deal with mammogram results that many women consider troubling and confusing: the finding of ‘dense’ breast tissue.

“Not only is breast density linked to an increased risk of cancer, it also makes cancer harder to detect because dense tissue can hide tumors from X-rays. But the new research indicates that not all women with dense breasts are at very high risk.

“Patient advocates urge women with dense breasts to ask doctors about extra tests like ultrasound or an M.R.I. to check for tumors that mammography might have missed. Studies have found that those exams can improve detection of tumors over mammography alone in dense breasts.

“Pressed by advocacy groups, 22 states have passed laws requiring that breast density be reported to mammography patients, and similar federal legislation has been introduced in the House and the Senate.”


UCSF-led Study Shows Oncotype DX and MRI May Provide Independent Information in Favorable Risk Prostate Cancer

“Genomic Health, Inc. (Nasdaq: GHDX) today announced results from a study led by the University of California, San Francisco (UCSF) showing a broad distribution of Oncotype DX® Genomic Prostate Score (GPS) results among prostate MRI findings, suggesting that these two technologies may provide non-overlapping clinical information in men with localized prostate cancer.

” ‘For the first time, we looked at the association between information provided by a genomic assay and a prostate MRI to better understand the value these two technologies bring to clinical practice,’ said Michael Leapman, M.D., lead investigator from UCSF. ‘These new data show that, in some patients, further risk stratification may be possible, and tools such as GPS may add important biological information to more precisely assess the aggressiveness of a patient’s cancer.’

“In this study, researchers conducted a retrospective evaluation of the statistical association between the Oncotype DX GPS results and contributing gene groups with baseline endorectal MRI in 100 patients with clinically localized prostate cancer. The results showed a large variation of GPS results across MRI findings, demonstrating that Oncotype DX and MRI offer non-overlapping clinical insights in patients with early-stage prostate cancer.”


Prostate Cancer: Biopsy Strategies Assessed (CME/CE)

“Biopsy guided by a fusion of magnetic resonance imaging (MRI) and ultrasound (US) improves detection of aggressive prostate cancer compared with mapping or targeting alone and systematic 12-core biopsy.

“Among the first 1,000 men to undergo MRI-fusion biopsy of the prostate at the University of California Los Angeles (UCLA), the presence of a grade 5 region of interest on fusion biopsy was the strongest predictor of high-grade prostate cancer. ‘Patients who had a grade 5 lesion compared to those who had no suspicious lesions had 23 times the odds of having Gleason ≥7 cancer,’ said Christopher Filson, MD, at UCLA.

“In a separate series of men presenting for prostate biopsy at New York University (NYU), MRI-targeted biopsy increased the detection of Gleason ≥7 prostate cancer by 23% compared with systematic biopsy while decreasing the detection of Gleason 6 disease by 26%.

“These data were presented during a press briefing at the annual meeting of the American Urological Association.