What is an MRI-guided prostate biopsy?
An MRI-guided prostate biopsy helps healthcare providers diagnose, stage and treat prostate cancer. Providers use MRI and ultrasound-guided technology to take tissue samples (biopsy) from your prostate gland. A medical specialist called a pathologist uses a high-powered microscope to examine the tissue samples for cancer cells.
What is the prostate?
Your prostate is a walnut-sized gland that’s part of the male reproductive and urinary system. It sits in front of your bladder. This gland makes seminal fluid that mixes with sperm when you ejaculate. The fluid keeps sperm healthy and viable for conception and pregnancy.
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The urethra runs through the center of your prostate gland. This tube is part of your urinary system. It carries urine from your bladder through your penis and out of your body when you pee. It also carries seminal fluid and sperm during ejaculation.
What are the two routes that prostate biopsies can be performed?
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There are different ways to perform the actual biopsy. Your provider will discuss the options with you and select the best approach for your specific condition. Biopsy options include:
- Transrectal biopsy: Your provider removes the tissue sample through your rectum, the last part of your large intestine (colon).
- Transperineal biopsy: Your provider removes the tissue sample through your perineum, the area of skin between your anus and scrotum.
What is a multiparametric MRI-guided prostate biopsy?
Healthcare providers also use MRI technology and needle biopsies to perform:
- Multiparametric MRI (mpMRI): Your provider compares results from a standard MRI to a newer MRI method. An mpMRI is highly sensitive and can identify cancerous areas better than a standard MRI. But providers can’t rule out prostate cancer with mpMRI alone. A prostate biopsy is still usually necessary.
- Fusion-guided prostate biopsy: This test combines or “fuses” MRI and transrectal ultrasound (TRUS) technology. You get an MRI first to help your provider identify any suspicious areas on your prostate gland. During the actual biopsy, your provider uses a prostate ultrasound probe and advanced software to combine the MRI and ultrasound images. This fused image helps your provider more precisely sample tissue from the identified problem areas.
What does an MRI-guided prostate biopsy diagnose?
An MRI-guided prostate biopsy helps healthcare providers diagnose:
- Prostate cancer and its grade (aggressiveness).
- Recurrent prostate cancer (cancer that comes back after treatment).
How else do healthcare providers use MRI-guided prostate biopsies?
If you have prostate cancer, the biopsy results help your healthcare provider develop the most effective treatment plan.
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The test can also help your provider diagnose or rule out noncancerous (benign) conditions that cause signs or symptoms similar to prostate cancer, like an elevated PSA blood test. These conditions include:
- Enlarged prostate (benign prostatic enlargement/hyperplasia or BPE/BPH).
- Prostatitis (infection, inflammation and pain in the prostate gland).
Who needs an MRI-guided prostate biopsy?
Your healthcare provider may perform an MRI-guided prostate biopsy if a blood test shows elevated PSA (prostate-specific antigen) levels. You may also need this type of biopsy if your provider feels a bump or hard area on the prostate gland during a digital rectal exam (DRE) or if you have a suspicious MRI. These changes can be signs of prostate cancer or a noncancerous problem.
You may also need an MRI-guided prostate biopsy if:
- An ultrasound-guided prostate biopsy doesn’t detect cancer, but your PSA levels continue to rise.
- You have a diagnosis of prostate cancer and your provider is using active surveillance to monitor it.
- You have a diagnosis of prostate cancer and are considering focal treatments.
What are the benefits of an MRI-guided biopsy?
Compared to ultrasound technology, an MRI provides clearer, more detailed images of the prostate gland. It can better identify potentially cancerous areas that require sampling with a biopsy and, possibly, treatment. An mpMRI may reduce the number of biopsies you get and has better success at detecting prostate cancer than a standard MRI.
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