What is Fusion Biopsy? Dr. Edward KingWe asked Edward D. King, MD, vice-president of Ocala’s Advanced Urology Institute about this state-of-the-art new treatment for prostate patients.

Dr. King says, “Transrectal ultrasound—MRI prostate fusion biopsy is the new standard of care for the detection of prostate cancer. The only definitive diagnosis comes from biopsy, and these only work if cancer cells are detected. Until now, traditional approaches were notoriously hit or miss.

A PSA blood test as well as a digital rectal exam performed by a patient’s personal physician, feeling for any obvious prostate abnormalities such as areas if induration or nodularity are the first tests.

The Prostate-Specific Antigen is a protein produced by both healthy and malignant prostate glands and measures the amount of that protein in the blood. A PSA of 4.0 or less is considered “normal.” Test results above 4.0 may indicate prostate cancer. But even that can be inconclusive. Fully 10 percent of patients who present with prostate cancer have normal-ranged PSAs readings.

Next, using a transrectal ultrasound probe for guidance, a biopsy needle is inserted into the prostate and biopsies performed in a systematic pattern with the hope that tissue samples provide answers. Unfortunately, 15 to 20 percent of the areas of cancer can be missed.

Enter fusion biopsy

This cutting-edge technique combines the superior image results of a high-definition multi-parametric MRI—with real-time ultrasound images allowing for visualization of areas suspicious for cancer which would otherwise be invisible on ultrasound alone.

Sophisticated software in a machine called a UroNav by Invivo overlays the super-detailed MRI images, fuses them, with ultrasound images obtained from a trans-rectal probe administered in an outpatient setting. The result allows an examining physician to guide biopsy needles with pinpoint accuracy to access any suspicious areas or lesions revealed by MRI.

One reason it is not offered by most urology practices is cost. But the benefits — the higher detection rate of prostate cancers, lower incidence of repeat biopsies, superior accuracy — are fast making it the gold standard for the detection and monitoring of prostate cancer.

Dr. King recommends patients with prostate concerns consult a urologist immediately. If a biopsy is in order, find a clinic with a high-definition MRI and physicians skilled in fusion biopsy along with a radiologist experienced in multi-parametric MRI prostate imaging.