MAGNETIC RESONANCE IMAGING-ULTRASOUND FUSION-GUIDED PROSTATE BIOPSY

MAGNETNORESONANCNA-ULTRAZVOCNO FUZIJSKO VODENA BIOPSIJA PROSTATE

Abstract

Introduction: Prostate cancer is the most frequently diagnosed cancer in Slovenia. Initially, patients usually do not experience any symptoms. Early diagnosis is, therefore, of the utmost importance. Transrectal ultrasonography (TRUS)-guided biopsy is still the standard of care for diagnosis of prostate cancer. However, more accurate magnetic resonance imaging (MRI) – ultrasound (US) fusion guided biopsy based on multiparametric magnetic resonance imaging (mpMRI) is a currently rapidly evolving method.

Purpose: To present the new method called MRI-US fusion guided prostate biopsy, its technical background, clinical application, and to determine the accuracy of TRUS and MRIUS guided biopsy.

Methods: Descriptive method was used. A critical review of the literature published between 2012 and 2018 was made.

Results and Discussion: TRUS-guided biopsy is an invasive diagnostic method most frequently used for prostate biopsy. 8 to 12 samples of prostate tissue are taken without focusing on the specific lesions. Tumours of anterior part of the prostate are usually missed. MpMRI is the best method of visualising primary significant prostate cancer. MRI-US fusion-guided biopsy detects more clinically significant cancers using fewer biopsy cores compared to TRUS biopsy. This new method is slowly overtaking TRUS-guided biopsy not only due to its better diagnostic accuracy but also due to less complications and pain in comparison to TRUS-guided biopsy.

Conclusion: MRI-US fusion-guided prostate biopsy is an emerging new technique that offers solutions to current limitations of standard TRUS-guided biopsy. It enables more accurate diagnosis, better risk evaluation and consequently better treatment.