“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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“A targeted magnetic resonance (MR)/ultrasound fusion–guided biopsy technique produced better results than a standard biopsy in the detection of high-risk prostate cancer. This new technique also diagnosed fewer cases of low-risk prostate cancer. The results of this prospective study were published in JAMA.
“The standard core needle biopsy technique is invasive, involving the removal of prostate tissue with a thin needle, which is then analyzed by a pathologist to detect abnormal, malignant cells.
“The newer biopsy approach was better able to differentiate between low-risk and intermediate- and high-risk prostate tumors compared with either the standard core needle biopsy or the two techniques used together.
“ ‘This study demonstrated that targeted biopsy could significantly change the distribution of risk in men newly diagnosed with prostate cancer toward diagnosis of more highrisk disease,’ said the study authors in their discussion. Still, this study is preliminary, and further studies that can link diagnosis with disease recurrence and prostate cancer mortality are needed.”
“If results of a prostate-specific antigen test or digital rectal exam are positive, the next port of call is normally a prostate biopsy to confirm whether cancer is present. In a new study published in JAMA, researchers claim a targeted biopsy method is much more accurate in detecting high-risk prostate cancers than the standard biopsy technique.
“The standard method of prostate biopsy, also referred to as a core needle biopsy, involves a doctor removing samples of tissue from the prostate using a thin, hollow needle. The samples are then sent to a pathologist who views them under a microscope and assesses them for cell abnormalities that indicate cancer.
“But the research team, led by Dr. Mohammad Minhaj Siddiqui of the University of Maryland School of Medicine – who was a fellow at the National Institutes of Health at the time of study – says the technique used in their study involves a combination of ultrasound and magnetic resonance imaging (MRI), which they say can effectively differentiate high-risk prostate cancers from those that are low risk.
” ‘There is a concern that we overdiagnose and overtreat low-risk cancers that are unlikely to be terminal, and this technology enables us to make a more reliable diagnosis than the current standard practice,’ says Dr. Siddiqui.”
“The latest advancement in prostate cancer detection is magnetic resonance imaging and ultrasound fusion-guided biopsy, which offers benefits for both patient and physician.
“The only place in the Southeast offering the MRI-US image fusion technique is at the University of Alabama at Birmingham Program for Personalized Prostate Cancer Care.
“It is estimated that 2014 will see more than 240,000 new cases of prostate cancer, and more than 29,000 deaths from the disease, according to the National Cancer Institute.
“Jeffrey Nix, M.D., along with colleague Soroush Rais-Bahrami, M.D., both assistant professors in the UAB Department of Urology, studied the MRI-US image fusion as fellows at the NCI. Nix and Rais-Bahrami are two of a select few urologists in the United States trained to utilize this technology; together they have five years’ experience using this approach.
“Nix and Rais-Bahrami say this new technology offers a ttargeted biopsy,’ which refers to direct tissue sampling of suspicious areas seen on MRI as opposed to the traditional method of random, systematic sampling that is essentially performed ‘blindly’ in different ‘ZIP code’ regions of the prostate.”