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Fewer Needles for MRI-Guided Cancer Biopsy

October 28, 2015

According to the American Cancer Society, the United States will diagnose 220,800 new cases of prostate cancer, with 27,540 deaths, in 2015 alone. The organization also points out that one man in seven will be diagnosed with prostate cancer during his lifetime, and one in 38 will die from the disease.

As in all cancers, early diagnosis is the best way to prevent the terrible prognosis that comes from waiting too late. For prostate cancer this entails taking a biopsy, which until now was a painful, needle-filled process.  

According to Dr. Dan Sperling, Medical Director of the Sperling Prostate Center, “Doctors take 12 or more random needle sticks because they don't know what they're aiming for. The prostate becomes a human pincushion. It can be painful and cause side effects. Prostate cancer is the only tumor malignancy diagnosed by blindly taking samples that can miss aggressive cancer, or oversample indolent disease. We have solved that problem.”

The problem has been solved by using real time MRI (magnetic resonance imaging) scans to show suspicious sites in the prostate, thereby avoiding the repeated prodding of the prostate.

This procedure makes it possible to place each needle precisely in any region the MRI has identified as being suspicious. The scan is a multiparametric MRI performed on a 3 Tesla (3T) magnet. The device produces high definition images of the prostate, along with unusual changes of the anatomy.

Image via Shutterstock

The MRI-guided biopsy can be carried out in one of two ways: endorectal or transperineal approach. They both use software to fuse the biopsy needle guides with the MR images to ensure the needles are placed with more accuracy.

When the procedure begins, a computer processes the signals from the device and generates images as slices of the prostate that can be viewed from many different angles. The radiologist can then interpret the images to find any abnormalities.

A procedure called MR spectroscopy can also be performed with the MRI to determine the chemical makeup of cells present in the prostate gland. By measuring the motion of water molecules (called water diffusion) and blood flow (called perfusion imaging) in the prostate, it can show the difference between normal and diseased tissue in the gland.

In addition to accurately diagnosing prostate cancer, the procedure also helps rule out cancer from benign prostatic hyperplasia or nodular enlargement of the prostate.   

Edited by Kyle Piscioniere

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