MRI-guided Prostate Biopsy
More safety in the diagnosis of prostate cancer through MRI (3-Tesla)-based biopsy
A quantum leap in the diagnosis of prostate carcinoma is brought about by the so-called MRI-supported biopsy. For this purpose, the West German Prostate Center in cooperation with the Radiology Department of KLINIK am RING uses the most modern imaging method available today and combines it for prostate biopsy. While most facilities have magnetic resonance tomographs with a field strength of 1.5 Tesla, the KLINIK at the RING offers one of the most modern, high-resolution MRIs, the 3-Tesla-MRI. This enables the detection of prostate carcinomas with a significantly higher sensitivity and specificity than is possible with the standard transrectal ultrasound (TRUS). MRI-assisted biopsy is a useful and important extension of the diagnostic spectrum, especially for patients whose PSA values continue to increase despite negative biopsy and for whom the suspicion of cancer persists.
Prior to the actual biopsy, the patient's prostate is first examined in an MRI. In this process, a kind of "map" is created in which areas suspected of being tumor are marked, on which the urologists orientate themselves precisely when removing tissue. The actual biopsy then takes place in a second step under the control of a high-resolution transrectal ultrasound. The combination of both diagnostic procedures increases the hit rate and can save the patient from further biopsies. As recent studies have shown, the detection rate of prostate carcinoma in a biopsy supported by a 3 Tesla-MRI is 41 percent after tissue removal, significantly higher than 10 to 20 percent in a biopsy under transrectal ultrasound.
A further advantage: The exact determination of both the localisation and the aggressiveness of the individual tumour centres in the prostate allows the treatment to be very targeted. Especially for modern therapies such as brachytherapy, in which the entire prostate is not removed but irradiated with pinpoint accuracy, the MRI-supported biopsy provides valuable information.