Targeted biopsy of suspected prostate cancer (PCa) lesions, identified using magnetic resonance-ultrasound (MR-US) fusion, increases PCa detection and detects aggressive tumors that may be missed by conventional biopsy, according to a study published in The Journal of Urology (2012;189:86-92).

Geoffrey A. Sonn, MD, of the University of California Los Angeles, and colleagues used MR-US fusion prostate biopsy in 171 men (median age, 65 years) undergoing biopsy as part of active surveillance (106 men) or due to increased PSA levels with a prior negative conventional biopsy (65 men). MR-US fusion prostate biopsy locates lesions by magnetic resonance imaging (MRI) and fuses it with real-time ultrasound to generate a three-dimensional prostate model to allow targeted sampling. The men also had conventional systematic biopsies taken.

The researchers identified PCa in 53% of men, of whom 38% had cancer with Gleason grade 7 or greater. Of these highly-aggressive cancers, 38% were detected only by targeted biopsy. Of the 16 men with the highest level of suspicion by MRI (image grade 5 target), 94% had PCa.

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“Prostate lesions identified on MRI can be accurately targeted with MR-US fusion biopsy in a clinic setting using local anesthesia,” Dr. Sonn and colleagues concluded. “Targeted prostate biopsy has the potential to improve the diagnosis of prostate cancer and may aid in the selection of patients for active surveillance and focal therapy.”