What is MRI with Transrectal Ultrasound Fusion-Guided Prostate Biopsy

Prostate cancer has a new standard of care in MRI-guided fusion biopsy with transrectal ultrasound. While a prostate biopsy has been the only way to get a definitive diagnosis of prostate cancer, it has only been working if cancer cells are identified in the sample tissue. But in some cases, such as when the tumor occurs at the top surface of the prostate or other unusual locations, a biopsy may not give a correct diagnosis. For instance, the standard TRUS (transrectal ultrasound) guided biopsy in which tissue samples are collected from the prostate in a systematic pattern gives a negative result with tumors located in unusual areas of the prostate. About 15-20 percent of tumor locations can be missed by the biopsy needle.

What makes the MRI-ultrasound fusion biopsy more definitive?

The MRI-ultrasound fusion approach is an improvement on the traditional 12-core TRUS, which involved taking biopsies from twelve prostate areas where the cancer is considered more likely to occur. With the TRUS biopsy, about 70 percent of men who have a negative biopsy result are not essentially free of the cancer. The MRI-ultrasound fusion technology blends the superior imaging capability of the high-definition multi-parametric (mp) MRI with real-time ultrasound imaging. There is better visualization of the suspicious areas of the prostate where the cancer may occur that may not be visible on ultrasound alone. The fusion-guided biopsy detects almost twice as many prostate cancers in all stages as the standard TRUS biopsy.

The ability of MRI-ultrasound fusion-guided biopsy to create a three-dimensional (3D) map of the prostate ensures that doctors are able to see the targeted areas of the prostate better and perform more precise biopsies. The technology uses a machine known as UroNav developed by Invivo, which is supplied with sophisticated software to produce super-detailed MRI images and fuse them with the ultrasound images generated by a transrectal probe administered on the patient in an outpatient setting. The resulting images enable the examining physician to direct biopsy needles with pinpoint accuracy and to easily access any lesions or suspicious areas revealed by MRI. The technology allows the urologist to hit the target spot more accurately and improves cancer detection rate. In fact, it is primarily used for men who have an ongoing suspicion of prostate cancer, such as those with consistently elevated PSA, but whose TRUS biopsy results are repeatedly negative.

Fewer biopsies, more accurate detection

The fusion-guided biopsy is a very targeted approach in which biopsies are performed only in highly suspicious areas of the prostate appearing in the MRI image. As a result, significantly fewer biopsies are done with the MRI-ultrasound fusion than with the traditional TRUS technique, minimizing the adverse effects that often accompany repeat biopsies. Multiple prostate biopsies can lead to complications such as bleeding, infection, urinary retention problems, sepsis or even death.

In spite of fewer biopsies, the MRI fusion approach increases the rate of detection of aggressive prostate cancer. The extensive MRI images obtained before the biopsy helps highlight both high-risk and intermediate-risk cancers often missed by traditional TRUS biopsy. With MRI-ultrasound fusion, the likelihood of detecting cancer increases as the grade of the tumor increases. The use of MRI fusion biopsy helps to avoid metastatic disease by finding cancer before it spreads to other areas of the body.

Improved cancer differentiation

Through MRI fusion, doctors are able to more accurately differentiate cancers that require treatment from the ones that should undergo watchful waiting (active surveillance). Fusion technology is able to show higher-risk cancers and does not highlight the insignificant low-grade tumors, making it less likely for urologic oncologists to over-treat indolent and low-grade cancers. A number of prostate cancers are low-grade, non-aggressive and do not cause problems at all and treating them through chemotherapy, radiotherapy or surgery can impair the quality of life or even cause death. MRI fusion effectively saves patients from the adverse effects of treating low-grade tumors. Fusion technology eliminates up to 50 percent of prostate cancer treatments that are unnecessarily administered on low-grade cancers.

At Advanced Urology Institute, we have adopted the MRI-ultrasound fusion biopsy and changed the way we screen, evaluate and diagnose prostate cancer. It has become our standard for detecting prostate cancer and we believe in the next few years it will be the gold standard for detecting the cancer. We are proud that it offers a higher detection rate, superior accuracy and reduces the rate of repeat biopsies — making our practice one of the best places for detection and monitoring of the cancer. It helps us deliver the best treatment outcomes for our patients.

If you think you are at high risk of prostate cancer or already have started experiencing some symptoms, let us show you how the precision of our high-definition MRI fusion machine, the expertise of our skilled physicians in MRI fusion biopsy and the know-how of our radiologists proficient in multi-parametric MRI imaging can help you. For more information on the treatment and diagnosis of prostate cancer, visit the “Advanced Urology Institute” site.

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What is the Da Vinci Surgical System?

What is the da Vinci Surical System?

The Da Vinci Surgical System is a robotic surgical device that includes a patient cart, surgical instruments and a surgeon’s console. The patient cart contains four robotic arms, each of which holds a different instruments such as a scalpel, scissors, or electrocauterizer. One of the robotic arms holds an endoscopic camera that allows the surgeon to have a direct and magnified view of the operation as it is performed.

How does the Da Vinci Surgical System work?

Any surgery using the da Vinci Surgical System can be performed while the surgeon sits at the console viewing the operation in 3-D image. There are two hand-held robotic arms and two foot pedals that allow the surgical instruments to be properly maneuvered. The advanced technology integrated into the da Vinci System translates the surgeon’s natural movements into more defined movements that allow for the smallest and most precise incisions to be made.

Benefits of the da Vinci Surgical System

Optimized Safety – The da Vinci System includes safety features that help reduce the risk of common human errors. While the machine is considered a “robot,” it is not functional on its own and requires that a surgeon be at the controls.

Less Time Consuming – In laparoscopy procedures, the surgeon is required to look up at a special video monitor in order to view the entire surgical procedure. The da Vinci System however, allows the surgeon to proceed with the surgery without ever having to look away.

Convenient – Unlike traditional surgical systems, the da Vinci Surgical System enables the surgeon to remain seated throughout the procedure while still having access to the instruments necessary to complete the surgery.

Minimally Invasive – The da Vinci Surgical System is much like conventional laparoscopy systems in the way that it is minimally invasive. One major difference is that the new and innovative system includes various features that allow the surgical procedures to be conducted with less time and effort.

The da Vinci Surgical System can be used for numerous procedures including; prostatectomy, vasectomy, and even complex surgeries requiring dissection or complete reconstruction. The most remarkable feature of the da Vinci System is that it enables patients to undergo surgery with a minimal amount of pain and blood loss, which allows for a faster recovery. Advanced Urology Specialists are skilled in the use of state of the art technology including the da Vinci Surgical System. For more information or to schedule an appointment, please go to our contact page.