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Fusion Biopsies Identify More High-Risk Prostate Cancer

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Prostate biopsies that include targeted magnetic resonance (MR)/ultrasound fusion detected a greater number of high-risk prostate cancers, and a lower number of low-risk prostate cancers compared to standard biopsies. These results were recently published in JAMA – The Journal of the American Medical Association.

High-risk prostate cancers refer to prostate cancer that is likely to spread and potentially become life-threatening. Low-risk prostate cancers refer to prostate cancers that exists, but remains unlikely to become life-threatening for quite some time, if ever during a man’s lifetime.

A tricky balance act exists in determining whether a man should undergo treatment for prostate cancer, if his cancer is not extensive and/or aggressive, or continue to be under observation to ensure the cancer remains localized.

Often, biopsies for prostate cancer are thought to be overutilized among men with low-risk prostate cancers, causing unnecessary procedures, costs, pain and anxiety. Therefore, researchers continue to evaluate novel ways in which to minimize unnecessary treatment and procedures while maximizing detection of potentially threatening cancers.

Researchers recently conducted a clinical trial evaluating a novel biopsy method which combined both targeted MR and ultrasound for the detection of potential areas of the prostate that indicate a need for a biopsy. These results were compared to standard biopsy procedures.

Targeted biopsies diagnosed 30% more high-risk prostate cancers compared with standard biopsies.
Targeted biopsies diagnosed 17% fewer low-risk prostate cancers compared with standard biopsies.
When biopsies from both targeted and standard approaches were combined, 22% more prostate cancers were detected than with either alone; however, 83% of these were low-risk cancers.
The researchers concluded that “Among men undergoing biopsy for suspected prostate cancer, targeted MR/ultrasound fusion biopsy, compared with standard extended-sextant ultrasound-guided biopsy, was associated with increased detection of high-risk prostate cancer and decreased detection of low-risk prostate cancer. Future studies will be needed to assess the ultimate clinical implications of targeted biopsy.”

Reference: Siddiqui M, Rais-Bahrami S, Turkbey B, et al. Comparison of MR/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer. Journal of the American Medical Association. 2015;313(4):390-397.