MRI-Guided Prostate Biopsy

Overview

What is the prostate?

The prostate gland is part of a man’s reproductive system that produces a fluid that is one of the components of semen.

What is a biopsy?

A biopsy is a procedure that removes a sample of tissue or cells for study and are most commonly used to look for cancer.

Prostate biopsies are done with a biopsy needle that can be positioned with the assistance of ultrasound images to get samples for testing.

Your doctor might decide you need a prostate biopsy based on the results of a blood test that measures your level of PSA (prostate-specific antigen). A high PSA result might point to cancer, but there are other things such as non-cancerous enlargement (BPH) or infection that cause PSA to rise. Tests that measure derivatives of PSA (fPSA, -2proPSA, hk2) such as OPKO 4k and Prostate Health Index may be more accurate than PSA in assessing your risk for having a cancer that needs treatment.

Test Details

What is an MRI-guided prostate biopsy?

MRI stands for magnetic resonance imaging, a test that creates a detailed image of an area inside the body. An MRI provides a more detailed image than the ultrasound procedure, and allows doctors to spot parts of the prostate that don’t look healthy and should be examined with a biopsy needle.

Doctors have started using ultrasound and MRI images together in what is known as a “fusion-guided biopsy.” An MRI is taken and the image is examined to identify areas that look suspicious. Later, the doctor who performs the biopsy uses an ultrasound probe along with special software to “fuse” the MRI and ultrasound images into one image that makes it easier to spot targets for the biopsy needles.

What are the advantages of an MRI-guided prostate biopsy?

Research has shown that using an MRI image to guide a biopsy improves detection of prostate tumors that require treatment, while finding fewer tumors that are called “biologically insignificant.” This means that they do not need any immediate treatment and are not likely to pose a threat to the patient. Because using an MRI image gives doctors better information and reduces the chance that a serious tumor will be missed, it should also mean that patients with blood-test results that suggest possible prostate cancer are less likely to need repeat biopsies because the first one may have produced a “false negative.”

What happens during an MRI-guided prostate biopsy?

These are done in the outpatient procedure area. Antibiotics will be given to reduce the risk of infection from the biopsy. Your doctor will be using the MRI and ultrasound images to watch where the biopsy needles are going. You may feel some discomfort or mild pain when the ultrasound probe is inserted into the rectum. Local anesthesia is used to ease the discomfort.

Results and Follow-Up

What happens after an MRI-guided biopsy?

You may resume your normal activities and diet immediately. You may be sore for a few days, and you also may see small amounts of blood in your urine, stool, and semen. However, these symptoms usually last only a few days. A high fever or flu-like symptoms within a few days of the biopsy should cause you to seek attention in a local emergency room to get treated for an infection.

Last reviewed by a Cleveland Clinic medical professional on 11/03/2016.

References

  • RadiologyInfo.org. Accessed 11/9/2016Ultrasound- and MRI-guided prostate biopsy (http://www.radiologyinfo.org/en/info.cfm?pg=prostate-biopsy)
  • American Cancer Society. Accessed 11/9/2016Tests for prostate cancer (http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-diagnosis)
  • Urology Care Foundation. Accessed 11/9/2016What is a biopsy? (http://www.urologyhealth.org/urologic-conditions/biopsy)

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