Fusion Prostate Biopsy

Prostate cancer is the most frequent malignant tumor in men. An early and accurate diagnosis will provide the most appropriate treatment.

The diagnosis involves a clinical interview, digital rectal examination of the prostate, serum PSA levels (prostate specific antigen), ultrasonography and, recently, a prostate MRI (magnetic resonance imaging). This test is of utmost importance, as it reports the existence of suspicious areas and their features (number, size, location). Whenever the suspicion of cancer is high, a PROSTATE BIOPSY is mandatory. That implies to obtain small prostatic samples for an anatomopathologic analysis, whic will provide the definitive diagnosis (benign or malignant cells).

Typically this biopsy was performed “blindly” due to the low discrimination capacity of the ultrasound identifying suspicious areas within the prostate. We used to take samples trying to represent every prostatic area (mapping biopsies). There was a high percentage of “false negatives”, i.e., patients with a prostatic tumour not identified by the biopsies.

The Fusion Prostate Biopsy combines the images from the MRI and the ultrasound to create a detailed 3D image of the prostate. This makes it easier to reach the abnormal areas and obtain more precise and significant samples, thus optimizing the results. We decrese the false negative ratio and better characterize patient’s disease.

The procedure is performed at the operating room under sedation, lasting about 45 minutes and being discharged a few hours later.

The main advanteges of this fusion biopsy are:

-Higher rate of cancer detection compared to other types of biopsies, having therapeutic implications.

–It reduces possible complications, mainly infections, as it does not puncture through the rectum. Transperineal sampling also helps to reach all areas even in large prostates.

-Active surveillance: this strategy can be adopted in certain low risk tumours.

-Focal treatment: the aim is to destroy the lesion, avoiding a radical treatment in wich the entire gland is removed.

-It is possible to propose a HoLEP (Holmiun Laser Enucleation of the Prostate) in case of negative biopsy (no malignancy) and presence of obstructive symptoms.