Urologic cancers, like prostate cancer, can often be difficult to detect. We want to make sure we treat aggressive tumors; however, we also don't want our patients to needlessly undergo treatment or additional procedures if their cancer is slow-growing and not life-threatening. 

Penn Urology now has access to a new technology that assists in our efforts to detect and distinguish different types of prostate cancer. For the right patient, MRI-ultrasound fusion technology could be the most accurate and efficient way for us to biopsy the most suspicious areas in the prostate. It should help us minimize the over-treatment of non-aggressive cancers, while enhancing our ability to detect aggressive tumors.

The technology is still relatively new and outcomes continue to be studied – but these new, clearer images are a welcomed addition to Penn Medicine’s cancer-fighting toolbox.

How does an MRI-ultrasound fusion biopsy work?

First, the patient undergoes an MRI scan. After that scan, the radiologist reviews the images for areas that are suspicious for prostate cancer. Later, in our urology procedural suite, your urologist will perform the MRI-Ultrasound Fusion Biopsy.

During the biopsy, we insert an ultrasound probe into the patient’s rectum. As we move the ultrasound probe around the patient’s prostate, the fusion technology combines (or fuses) both the prior MRI images with the real-time ultrasound image. This fusion of images creates a clearer picture and hopefully more exact location of the suspicious area to biopsy. 

Then, the physician inserts the biopsy needle guided by these more precise images and takes the targeted biopsies. As with a ‘regular’ prostate biopsy, the tissue is sent to the lab where our genitourinary pathology experts review and determine if its cancerous.

When do we do fusion-guided biopsies?

The appropriate patient for a fusion biopsy is one who has had a recent MRI for the indication of suspected (or to rule out) prostate cancer. When the urologist and radiologist review the MRI images, they determine if they see there are areas that seem to be suspicious for cancer and, more so, if they are clear enough to fuse with an ultrasound for biopsy.

If the images are not specifically clear, that doesn’t mean that a biopsy may not be warranted or that cancer is not present, just that this technology isn’t the right choice for the patient.
 
If the images meet the criteria, we present the patient with the option for a fusion biopsy.

Learn more about how prostate cancer is diagnosed

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