Advantages of an MRI-guided prostate biopsy?

My husband, who is 71, is set to undergo an MRI-guided prostate biopsy. He and I are wondering what to expect. His urologist, who very experienced with the procedure, and is also an advocate of active surveillance, believes the results are more accurate and provide a better guide for future treatments. Any advice or comments from this community would be appreciated. I have aPC, post on this site often, and want to give my partner support.

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  • Assuming I understand what your husband's doctor is saying, one way that an MRI can be used in a biopsy is a relatively new and quite advanced procedure in which an MRI is made first, then the patient gets a biopsy using the usual trans-rectal ultrasound (TRUS). A computer matches the MRI result with the ultrasound result in real-time so that the urologist sees integrated information from both scans while he is placing the biopsy needles. This is called an MRI/TRUS fusion biopsy. It is supposed to be the very best approach for finding tumors to be sampled by the urologist.

    If that's not available, it's also possible for the urologist to see separate images from a previous MRI and use his brain to combine the images with what he sees in the TRUS.

    In any case, use of an MRI along with the usual ultrasound gives a clearer image of where the abnormal spots are in the prostate, and that allows the urologist to plan his needle placement more knowledgeably than if he had to just place the needles in a pattern and hope he hit some of the cancer spots.

    They may do an "endorectal" MRI in which an antenna is pushed up the rectum and pressed against the prostate wall. It's uncomfortable and no fun, but it's not really painful. Whether they insert the antenna or not, your husband will then be slid into the tunnel for the MRI which can take many minutes.

    I think the use of the MRI is very much a good thing that will produce a more accurate, informative, and reliable biopsy.

    Best of luck.

    Alan

  • Alan, as usual you provide such up-to-date information on this topic. I will read your response to my husband tonight. He is quite anxious--obviously. He has had the MRI and will have the biopsy in two weeks. Many thanks. Ron

  • You can take my case as an example for what AlanMeyer ( an excellent mentor ) has advised you. In 2015 in a routine check up my PSA was 7.9. I had no urinary problems and my DRE was normal too. My urologist ordered a MRI which indicated some malignant development in my prostate gland. This was followed by a TRUS biopsy ( 12 core ). Now I say FORTUNATELY I was diagnosed with a very aggressive prostate cancer of Gleason 9. Immediately I followed an equally aggressive treatment regimen : Radical Retropubic Prostatectomy ( surgery ), IG IMRT ( image guided radiation therapy along with 2 years continuous ADT ( androgen deprivation theray ). I used Zoladex 10.8mg every 3 months + Bicalutamide 50mg daily during this therapy. Ever since my treatment my PSA has stabilized at 0.008. Don't feel you are UNFORTUNATE if you are properly diagnosed for prostate cancer. I was diagnosed for PCa at 69 just before my birth day. What a gift anyway!

    Best of luck to you and your husband.

    Sisira

  • Thanks, Sisira, for the added information. I will have my partner read it, too. Sounds like you are stable now after undergoing what can only be called a "hellish' series of treatments. Stay strong!

  • Whatever treatment which prevents a person from going to HELL I treat as HEAVENLY! Hope you will learn soon how to deal with Advanced Prostate Cancer. I wish your partner be pronounced truly NEGATIVE for PCa at the diagnosis. Good luck and God Bless you.

    Sisira

  • Thanks again, Sisira. I do appreciate that the time men on this site, such as yourself, take so much time to impart comfort and knowledge. You are a mentor in so many ways. God Bless you as well. I will send you word following my husband's biopsy.

  • Please do so. You are a dedicated and great partner your husband is certainly privileged to have! Should you enter a battle against PCa you will have the full support of our "war ship". There are several brave and brilliant captains who can give you enough arsenals to fight. Just retain your will power. Lets hear often about your progress. Its a pleasure to be in service whilst we fight our own battle.

    Sisira

  • Captain Sisira, the title suits you. I will keep in touch. I have many more questions. And I will share my experiences as I can.

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