Does a multi-parametric MRI offer improvements over a TRUS biopsy?

Does a multi-parametric MRI offer improvements over a TRUS biopsy?

Radiologist Robert Princenthal Transcript

Title: Does a multiparametric MRI offer improvements over a TRUS biopsy?

Multi-parametric prostate MR is a relatively new sophisticated way to map and identify potential tumor spots in the prostate gland. The way that we do prostate MR is we look at the anatomy of the gland with anatomic imaging, and then we combine that with functional imaging. The benefit of prostate MR is that we can be extremely specific to identify which men would be the best candidate for active surveillance. The men for active surveillance should have a low volume, low grade disease and make sure that there’s no errors or a higher grade tumor that’s not been sampled. All of those things we can answer with quality prostate MR imaging. If you rely on the data from a TRUS biopsy you don’t know what you don’t know, and frequently men have a quarter of their tumor sampled with a needle. And right next to it would be a larger volume higher grade tumor that would preclude them from being properly managed in active surveillance. So they’re at high risk for treatment failure. In other words they’re going to progress and maybe have late stage disease when they should have been managed differently. Other men are being recommended for surgery who would have been better candidates for surveillance monitoring. The surgeon might say well we don’t know what we missed, and I think we should put your tumor in a jar. If you have a good pre-operative map of the prostate mr, we can answer all of those questions so a patient can sit down with their doctor with accurate data and make the best possible treatment decisions for that man.

Closing Title: Multiparametric MRI improves accuracy of diagnosis and staging

Radiologist Robert Princenthal describes how a multi-parametric MRI leads to a targeted biopsy, fewer needles and more accurate diagnosis.
Robert Princenthal
Radiologist

Dr. Princenthal is a board-certified radiologist with over 25 years of expertise in diagnostic medical imaging. He has read and evaluated more than 3,000 prostate MRI studies. He attended medical school at Penn State College of Medicine. His internship was completed at Hartford Hospital in Harford, Connecticut. A diagnostic radiology residency was completed at Yale University School of Medicine at New Haven Hospital and a fellowship in interventional radiology at the University of California, San Diego. 
Video reviewed and approved by Dr. Princenthal, August 1, 2015