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