Fusion biopsy of the prostate is a new, modern and safe system for diagnosing prostate cancer. This is a technique that combines nuclear magnetic resonance imaging and ultrasound images into one image, giving it the name «Fusion». The method allows you to more accurately examine the prostate gland and detect cancer in the early stages.
What is the difference with a classic biopsy?
A prostate biopsy is the only method to prove or disprove the presence of cancer. Small particles of the prostate are taken using a special needle for further examination and detection of prostate cancer. The goal of every biopsy is to make it as accurate as possible so as not to miss the appearance of cancer. However, the classical method may give false negative results.
Classic prostate biopsy is performed only under ultrasound, i.e. We use the image from the ultrasound scanner to target and sample the suspected areas of the prostate. Unfortunately, the capabilities of ultrasound are limited, and it is often impossible to see prostate cancer with it. Nuclear magnetic resonance imaging is far superior to ultrasound and is the most accurate at identifying sites of suspected prostate cancer, but we cannot monitor the prostate while we are doing the biopsy. And the biggest advantage of fusion biopsy is that it combines the positive qualities of both methods. Using special software, ultrasound and pre-generated magnetic resonance images are combined, which allows, on the one hand, to see suspicious areas (with magnetic resonance), and secondly, to target them in real time (using ultrasound). Hence the name of the method — Fusion, which in English means fusion, i.e. merging two methods.
What are the benefits of fusion biopsy?
Materials are obtained from areas of the prostate gland where a tumor process is believed to have developed.
- The risk of missing a small tumor is minimized — this reduces the risk of false negative results.
- Reduced risk of infection because samples are taken perineally rather than through the colon (rectum).
- Reduces the risk of bleeding in patients with severe rotational and external hemorrhoids.
Which method should I focus on?
The risk of developing prostate cancer increases with age, and in the early stages the disease progresses with mild complaints or even no symptoms. It is advisable for all men over 50 years of age to undergo preventive examinations with a urologist so that the disease can be quickly identified and treated. However, this does not mean that every man should have a prostate biopsy. A biopsy is an invasive procedure that must be handled carefully, responsibly, and only under certain circumstances.
There are precise criteria that determine when a patient should be referred for a biopsy. Although it is a common procedure, a prostate biopsy is performed only when necessary and when all other diagnostic tests and treatments have been performed. Although prostate biopsy rarely causes complications such as infection, bleeding through the rectum, or blood in the urine, regardless of which prostate biopsy technique is used (fusion or standard technique). The decision is made by the urologist and the patient must be informed about his condition throughout the entire diagnostic process — what tests are needed, what treatment is needed and at what stage a prostate biopsy is performed.
On the other hand, fusion biopsy is an excellent and promising method, but in no case should we underestimate the classic ultrasound-guided biopsy, which is still the most commonly used and common method of proving prostate cancer.
Fusion biopsy may be useful in the following cases:
- In patients with an increase in PSA (prostate-specific antigen) levels and a negative previous biopsy;
- In patients with proven low-risk prostate cancer who are under active surveillance and require a biopsy;
- In patients whose biopsy shows cells that are not typical for cancer;
- In patients with elevated cancer markers.
Why do we need a prostate exam?
The prostate gland is located under the bladder and surrounds the urethra on all sides. With age, every man’s gland begins to grow, increase in size and begins to put pressure on the urethra.
There are complaints about urination:
- difficulty urinating,
- weak stream,
- frequent night urination, accompanied by a feeling of insufficient emptying of the bladder.
Fortunately, in most cases, this enlarged prostate is benign and not dangerous to patients. The so-called benign prostatic hyperplasia (prostate adenoma). Treatment methods for prostate adenoma are outlined here
On the other hand, prostate cancer develops in a similar way, and in many cases even begins completely without any complaints. Distinguishing between the two diseases — prostatic hyperplasia and prostate cancer — is difficult in many cases and requires the use of a wide range of diagnostic tools. Fortunately, advances in technology make it possible to detect prostate cancer in its early stages today, giving patients the chance for radical treatment.
Again the most important thing! Prostate fusion biopsy is a new and promising technique that combines the advantages of magnetic resonance imaging and prostate ultrasound. This allows for a safe and accurate diagnosis of prostate cancer.
There are several methods for fusion biopsy of the prostate:
- Transrectal (through the rectum) prostate biopsy. It is carried out using ultrasound fusion (TRUS) and magnetic resonance imaging (MRI). This method uses a special program. It combines two images (ultrasound and MRI) to provide the exact location of the area that needs to be pierced.
Risks of transrectal fusion biopsy of the prostate:
- Infection: With transrectal prostate biopsy, there is a risk of infection as the needle passes through the rectum. Patients may be advised to take antibiotics to reduce this risk.
- Bleeding: Sometimes after the procedure, the patient may experience bleeding from the rectum or bladder. This risk is usually low, but can be serious if bleeding continues.
- Pain: The procedure may cause some pain or discomfort in the rectal or bladder area. This risk can be reduced if the patient receives anesthesia before the procedure.
- Other standard risks inherent in any biopsy
2. Fusion biopsy of the prostate based on optical coherence tomography (OCT) and MRI. This method uses light technology to provide the exact location of the area that needs to be pierced.
3. Transperineal (through the skin in the perineal area) fusion biopsy of the prostate. Occurs using ultrasound fusion and MRI. This method is used when a more precise and deeper biopsy is required.
The risks of transperineal biopsy are lower compared to other methods. Since the puncture is carried out through the skin!! Accordingly, the patient is not prescribed antibiotics after the biopsy; hospitalization is not required, since there is no damage to the rectum as a result of punctures.
At the Urology Center Munich, we believe that every person deserves the best for their health. We offer our patients a variety of urological diagnostic procedures and have the most modern and accurate methods for diagnosing prostate problems.