MRI Fusion Biopsy and PSMA Scanning

Diagnostic techniques and management of prostate cancer have taken significant modern advances. Managing prostate cancer in the modern era has been made more effective due to the development of new imaging techniques. This allows for specific localisation of prostate cancers, allowing targeted biopsies and other appropriate treatments.

Multiparametric MRI

Multiparametric prostate MRI scanning has increased the diagnostic accuracy for the detection of prostate cancer and decreased the number of negative prostate biopsies. This technique is rapidly developing as a reliable, non-invasive means of monitoring men on active surveillance programs for low risk prostate cancers, which is where regular biopsies are examined to monitor tumour growth in case further action needs to be taken.

Multiparametric MRI

This technology provides high quality detailed images of the prostate and surrounding tissue. It is calibrated to detect only clinically significant cancers, therefore ensuring biopsies are only performed when they can be an effective treatment.

MRI Guided Prostate Biopsy

After identifying the area of concern using multi-parametric MRI, a targeted biopsy can be performed using MRI-guided biopsy techniques. This technique reduces the need for men to undergo multiple, random biopsies to find abnormal tissue. While MRI-guided biopsy increases diagnostic accuracy, it is an expensive, time consuming and uncomfortable procedure for patients as they are required to lie on the MRI table for extended periods.

Why should you choose an MRI?

  • Minimally invasive
  • High quality images
  • Fewer biopsies specimens required
  • Increased detection of clinically significant prostate cancers
  • Reduced need for biopsies for men undergoing active surveillance (regular monitoring)

MRI/Ultrasound Fusion Biopsy

An image scan of a MRI/Ultrasound Fusion Biopsy of a prostate

why-mri-for-prostate-diagnosisMRI Fusion Biopsy incorporates MRI and GPS technology to superimpose the MRI image over a dynamic ultrasound scan. The computerised coordination of the images allows for accurate targeting of the MRI detected lesions.  An MRI Fusion Guided Biopsy combines pictures from an MRI scan with an ultrasound to create a 3D image on the prostate that can be used to identify abnormal tissue and guide a biopsy needle to the affected area.

Sophisticated multi-parametric MRI diagnosis and fusion biopsy is a highly expert-dependent service that requires the collaboration of an experienced urologist and an MRI-trained radiologist. If you are concerned about your prostate health and would like a consultation with an experienced urologist, make an appointment with Dr Katelaris today.

PET Scan for Prostate Cancer

PSMA-PET-ScanningAnother significant advance in the staging of prostate cancer is PSMA-CT PET Scanning technology. Prostate cancers are often slow growing cancers and may not show up on a standard CT or Prostate PET scan.

A standard PET scan stands for Positron Emission Technology, and is an imaging method that tracks a radioactive liquid containing labelled sugar (tracker) through the patient’s bloodstream. As tumours require sugar and other substances to grow, they will attract the labelled sugar tracer, and the radioactivity can be detected and visualised. This method provides more information than a standard CT scan, and the PSMA PET Scan goes even further.

PSMA is a protein that is specifically located on the surface of prostate cells and can be targeted using a Gallium-68 radiolabel.  In the PSMA PET CT Scan, the radiolabel emits light on the PET-CT scan and shows the location of any prostate cancer cells in the body.  This new and exciting technology is used to evaluate men with high blood levels of PSA (Phosphate Specific Antigen) after definitive radiation therapy or radical prostatectomy surgery. In certain men, this scanning technology identifies the presence of discrete prostate cancer cells, allowing them to be targeted by stereotactic radiation therapy in an attempt to definitively eradicate recurrence.

A image scan of a Multiparametric prostate MRI of a prostate

Targeting prostate-specific cell markers allows detection of prostate can-cer cells on PET-CT scanning.

References: 

  1. ICON Cancer Centre: https://iconcancercentre.com.au/what-is-a-psma-pet-scan/
  2. National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5458645/
  3. National Cancer Institute: https://www.cancer.gov/news-events/cancer-currents-blog/2020/prostate-cancer-psma-pet-ct-metastasis
  4. JAMA Network: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775220#:~:text=Results%20of%20MRI%2Dguided%20biopsy,100%25%20for%20pCR%20definition%201.
  5. National Cancer Institute: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/fusion-biopsy
  6. National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3581822/
  7. University of Iowa: https://uihc.org/health-topics/mriultrasound-fusion-guided-biopsy-prostate-cancer