3D MRI Prostate Scans and Prostate Mapping
Prostate Cancer Diagnosis – NEW 3D MRI Vs. Trus Biopsy
Over the past twenty years, physicians have been using TRUS (transrectal ultrasound) guided biopsy for diagnosing prostate malignancy based on what is called a “blind” procedure.
Ultrasound is not always able to distinguish some prostate tumors, especially ones that are very small, due to the soft tissue having poor resolution. Also, TRUS biopsies which are based on a grid (systematic) approach have a tendency to target the gland’s peripheral aspects and can miss as much as 30-40% of the prostate cancer that is located in the apex or midline, anterior transition zone. This is referred to as a sampling error. In order to overcome this problem, TRUS biopsies usually average 10-14 needles; while up to 24 needles are used for “saturation” biopsies. The more needles used, the higher the risk for sexual or urinary side effects, infection, and discomfort.
It is easy for a TRUS biopsy to miss early-stage, small tumors. These tumors are commonly at a risk level that may not necessarily be life-threatening for a patient. However, there are some aggressive prostate cancer cell lines. It can be difficult to determine if any action needs to be taken- and is so, exactly what, when precise information is not available.
Until recently, there were only two ways of obtaining an image of the prostate gland:
1. Ultrasound (without or with Doppler): Sound waves are used to obtain low-resolution images of the prostate gland. Ultrasound is unable to accurately distinguish between various tissue conditions occurring inside the prostate gland.
2. MRI with endorectal coil: Using an endorectal imaging coil uses less powerful magnets for improved resolution. It is encased inside an inflatable balloon that gets inserted in the rectum. This causes uncomfortable pressure for many patients and makes it hard for them to lie still. In addition, when pressure is placed on the rectal wall during imaging is can distort the prostate gland.
These technologies both have the problem of insufficient image quality that is needed for detecting tumors with a fairly good degree of accuracy. An accurate diagnosis is needed in order to provide patients with reliable and clear information. Also, if it is determined that the best action to take is prostate treatment, then the choice of treatment method will depend on many different factors, and in particular the specific nature of the prostate cancer that the biopsy identified.
NEW 3D Technology: A Better Solution That Provides Powerful Imaging Results
The most recent technology for both treating and detecting prostate tumors is called Multi-Parametric MRI. An endorectal coil is not used for 3D multi-parametric MRI scans of the prostate gland. It is a high definition, non-invasive, procedure that visually analyzes the entire prostate gland.
Our next generation high-resolution 3D images are able to do a better job of distinguishing between diseased and normal tissues in order to help pinpoint precisely possible cancerous cells inside the prostate. This results in being able to better characterize and identify prostate malignancy, which in today’s changing landscape of lower risk, smaller tumors is especially important.
Should a biopsy be required, an MRI-Guided Biopsy provides significant advantages when a patient needs to have a biopsy.
Since the MRI-Guided Biopsy targets the same tissues that the 3D Multi-Parametric MRI image reveals, patients tend to find it more comfortable compared to traditional TRUS biopsies. Side effects and risk of infections are significantly reduced by not sampling healthy tissue.
Accuracy Of Diagnosis
An MRI-Guided Biopsy is specifically targeted to certain tissues that the MRI imaging has revealed. Therefore, patients and physicians can be confident that the tissue samples are coming from locations that have been identified as having the most likely chance that they contain cancer. This results in it being a targeted approach compared to a TRUS biopsy, which takes a blind approach.
Questions Frequently Asked By Patients
Can my prostate cancer be diagnosed by an MRI alone?
A majority of experts are in agreement that imaging innovations, which include being able to enhance details like blood flow, water content and tissue density, can provide information that closely correlated with real prostate cancer slides that come from glands that have been surgically removed. There is a strong correspondence between pre-surgery sophisticated images of the location, shape, and size of the tumors with the slides, especially when an experienced radiologist interprets the images. The multiparametric MRI that we provide allows for greater analysis of areas in the gland that are suspicious. However, only lab analysis using a microscope can provide molecular or cellular information about actual tissue samples. It is our philosophy that the treatment should match the disease. Consultation with your physician is the best first step.