MRI Fusion TRUS Guided Trans-Perineal Targeted Biopsy
What is the MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy?
Prostate cancer continues to be a worldwide health problem and the second most common cancer in men. The new MRI Fusion TRUS guided trans-perineal targeted biopsy is performed trans-perineally, which offers accuracy up to 95% to 97%. MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy plays a significant role in prostate cancer by diagnosing it in the early stages.
Why it is done?
The patient who is suspected to have prostate cancer either by DRE (suspicion of prostate cancer on clinical examination) or by raised PSA (normal 0-4ng/dl) or those with strong family history of prostate cancer after the age of 45 years undergoes prostate biopsies to confirm the diagnosis.
What happens during the procedure?
During the procedure, the patient undergoes mpMRI and contouring of the lesions (suspicious of cancer) and prostate size are marked via a special software pack. Further the image is transferred to the special ultrasound done transrectally. The ultrasound probes assess the longitudinal and cross sectional images of the target lesions (suspicious lesions). Keeping the target in situ, a small bore needle is passed perineally via a grid (brachytherapy) for more accurate yield of tissue for examination. In this procedure, one can do sector biopsies and saturation biopsies depending on the size of the prostate and in addition target biopsies to accurately diagnose the lesion with minimal sampling.
What happens after the procedure?
The procedure is done under local or regional or general anaesthesia. It’s a day care procedure and has high specificity and sensitivity.
Apollo expertise in the procedure
India’s first prostate cancer diagnosis breakthrough – MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy was introduced by Apollo Hospitals, Seshadripuram, Bangalore. The Apollo Institute of Renal Sciences (AIRS) in Bangalore has successfully performed many procedures using MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy. Our experts have extensive training in performing this procedure, as this requires immense technical skills.
Why is MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy a superior technology?
For more than 25 years, PSA testing and transrectal ultra- sound guided prostate biopsy (TRUS-Bx) has been the primary diagnostic pathway for prostate cancer. In India (due to unavailability of the transrectal ultrasound), we still do finger guided biopsies which could miss nearly 50% of early prostate cancer.
Furthermore, transrectal (passing needle via rectal approach) biopsies are met with high incidence of infection (17%) and sepsis especially in those with diabetes and immunocompromised.
The current innovation, MR fusion – Trans perineal biopsy prevents the above caveat and helps in the early diagnosis and treatment and drastically reduces the infection rate to <1% or no infection.
Who will be benefitted with this?
- Patient with suspicion of prostate cancer.
- Patient with wavering PSA (varying high level PSA) which is very common among Indian patients.
- Failure of conventional biopsy.
- Earlier negative TRUS biopsy report with persistently elevated PSA.
- Diabetic and elderly patients.
- Disease of the anus/ rectum.
- Low grade early prostate cancer patients who are considered for active surveillance.
Is the MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy safe?
The MRI Fusion TRUS guided Trans-Perineal Targeted Biopsy provides high specificity and sensitivity, prevents unnecessary biopsies, does not require the patients to be on pre-operational antibiotics or have any bowel preparations and most importantly, there is no risk of infection when the procedure is done through the perineal region. Thus, this makes the entire procedure safer.
UPDATED ON 15/11/2023