Urologists Support Targeted Biopsy

Urologists in the United States are increasingly using magnetic resonance imaging-ultrasound (MRI-US) guided prostate biopsy, and the majority of them believe the technology is valuable for prostate cancer (PCa) diagnosis, according to national survey results presented at the 2017 Genitourinary Cancers Symposium in Orlando, Florida.

“While the technology of MRI-US guided prostate biopsy is relatively new, the data suggest urologists support its use and are making efforts to introduce targeted MRI-US guided biopsy into their practice,” M. Minhaj Siddiqui, MD, director of Urologic Oncology at the University of Maryland School of Medicine in Baltimore told Renal & Urology News.

Of 291 urologists surveyed in August-September 2016, 86% use MRI technology in some way in their practices. General MRI use, MRI/US guided prostate biopsy, MRI for active surveillance, and MRI for pre-prostatectomy imaging varied by practice type. Sixty percent employ MRI-US guided prostate biopsy, and 67% report increased use over the past 5 years.

As many as 81% of urologists agree that MRI-US guided prostate biopsy is useful for PCa diagnosis. Most originally received their training in general urology (60%) or urologic oncology (22%).

Research is still revealing the best uses of targeted biopsy, but 24% of urologists believe enough evidence has accumulated to make it standard of care in all prostate biopsies. Nearly two-thirds, however, favor more selective use, such as after a prior negative biopsy.  

Regional and practice setting differences do exist, the researchers noted. About three-quarters of academic centers embraced targeted biopsy (72%), whereas just 38% of community-based urologists did. Practitioners in the northeast reported the highest use at 68% and those in the west the lowest at 44%. Urologists responding to the survey practiced in various settings across the US.

Despite its merits, MRI-US guidance technology technology is expensive. Among urologists who have not implemented it, 69% say the cost is prohibitive.

1. Tooker G, Pinto PA, Siddiqui MM. National survey of practice patterns employing MRI-guided prostate biopsy for diagnosis of prostate cancer. Data presented in poster format at the 2017 Genitourinary Cancers Symposium in Orlando, Florida, February 16-18, 2017. Poster Session B (Board #A12). Abstract: 104.