High-tech prostate scan may boost cancer detection

August 16, 2013 by Dennis Thompson, Healthday Reporter
High-tech prostate scan may boost cancer detection
Combo of ultrasound and MRI zeroes in on tumors, helping some men avoid biopsy, experts say.

(HealthDay)—An innovative fusion of MRI and ultrasound might be a better way to detect and assess prostate cancer, while helping men avoid unnecessary biopsies, researchers say.

The technology blends real-time imaging from both MRI and ultrasound devices, allowing doctors to more accurately direct the that draws cell samples from suspected tumors.

"This approach does detect cancers that can go missed by standard biopsy," said Dr. Art Rastinehad, assistant professor of urology and radiology and director of Interventional Urologic Oncology at Hofstra University-North Shore LIJ School of Medicine in Hempstead, N.Y.

In particular, the MRI/ultrasound fusion technique can guide physicians to tumors at normally neglected regions of the prostate gland.

"There are two screens in front of you, and the MRI is capable of pointing out areas that might contain cancer," explained Dr. Scott Eggener, associate professor of surgery and director of translational and outcomes research in the University of Chicago Medical Center's urology section. "Using the two screens, you can more intelligently direct your biopsy needles toward those areas."

The technology is part of an overall approach to first use MRI scans to best determine which men need to undergo prostate biopsy, and then use the MRI/ultrasound fusion to perform the most efficient biopsy possible.

Right now, doctors typically rely on blood tests to look for elevated levels of prostate-specific antigen, or PSA. A man with an elevated PSA is often urged to undergo a biopsy, most often conducted using a needle guided by ultrasound that draws cell samples from the prostate.

However, these biopsies only sample a small portion of the prostate, leaving the rest of the gland unchecked. Such can easily miss tumors, experts say.

Under the new approach, a man with elevated PSA levels would first undergo an MRI that would provide a visual scan of the entire prostate, Rastinehad explained. If potentially cancerous areas are found on the prostate, then the man would undergo a biopsy.

Studies have found that using an initial MRI scan to figure out who needs a biopsy can reduce the overall number of biopsies by about a third, according to a review of the data published this summer in the journal European Urology.

"We are working toward a goal that if you have a PSA that is elevated, you would instead get an MRI," Rastinehad said. For some patients, that may mean that "you may never need a biopsy," he said.

MRI also would be used during the biopsy itself. In that scenario, an electro-magnetic field generator is placed over the patient's hip, creating real-time MRI images that are combined with ultrasound readings to guide the needle biopsy. Images from the earlier MRI screening can then be overlaid with the real-time images to provide visible "targets" for the doctor to biopsy.

Studies have found that MRI-targeted biopsies are better at both detecting prostate tumors and determining which tumors are more advanced, Rastinehad said.

The technology helped detect advanced in Robert Herr, a Long Island, N.Y., resident who had high PSA levels but underwent a biopsy a couple of years ago that detected no cancer.

"Then the PSA elevated again and my urologist said, 'Why don't you go for this new MRI biopsy and see how it works out for you?'" said Herr, 66.

The fusion biopsy conducted in May ended up detecting high-grade prostate cancer near the top part of the prostate gland, an area normally not sampled in standard biopsy. Herr will begin radiation treatment in August.

"If I had gone for the regular again, it might not have shown up again and then I'm living with the cancer not knowing anything, and I don't think that's a good idea," Herr said. "To me, I don't think anybody wants to have cancer of any type, but if I have it I want to know about it and do whatever I need to do to treat it. To put your head in the sand, I don't think that's any kind of solution at all."

At this point the technology is both rare and expensive. Only five medical centers in the United States use MRI/ultrasound fusion , and the devices cost about $180,000, Rastinehad said.

The U.S. Food and Drug Administration approved the device, which was developed in collaboration with the U.S. National Institutes of Health, in April. It is being manufactured by Invivo, a division of Philips Healthcare. Rastinehad said he does not have a financial stake in the company.

While the technology is expensive, Rastinehad believes hospitals will end up saving money because they will be able to cut back on the amount of pathological examinations needed to assess suspected prostate cancer.

For his part, Eggener said the new MRI approach can help doctors meet the overall goal of finding serious cancers in a timely fashion.

"There are some early data to suggest it may be a better way of targeting cancers, finding more cancers and finding more meaningful cancers," Eggener said. "MRI is the best picture we can get of the . It's not perfect, but it is better than what we've had."

Explore further: GPS-like technology helps diagnose prostate tumors

More information: For more information on prostate cancer detection, visit the American Cancer Society.

Related Stories

GPS-like technology helps diagnose prostate tumors

May 3, 2013
The lead investigator of a way to obtain images of prostate tumors and accurately diagnose them said Thursday that the new technology is the medical equivalent of a global positioning system for the prostate gland.

Prostate cancer now detectable by imaging-guided biopsy

December 10, 2012
Ground-breaking research by a UCLA team of physicians and engineers demonstrates that prostate cancer can be diagnosed using image-guided targeted biopsy.

MRI helps identify patients with prostate cancer who may benefit from active surveillance

September 24, 2012
PSA screening has resulted in improved prostate cancer survival, but the high rate of diagnosis and treatment side effects raise concerns about overtreatment. In the quest to prevent overtreatment, "active surveillance" has ...

New technology fuses MRI, ultrasound to achieve targeted biopsy of prostate cancer

May 11, 2011
Targeted biopsy, a major advance in prostate cancer diagnostics, was detailed by a UCLA team in the current issue of Urologic Oncology. The new technology fuses MRI with real-time 3D ultrasound, providing an exacting method ...

Obese men at high risk for prostate cancer even after benign biopsy

April 23, 2013
Obese men were more likely to have precancerous lesions detected in their benign prostate biopsies compared with non-obese men, and were at a greater risk for subsequently developing prostate cancer, according to researchers ...

Recommended for you

Study provides insight into link between two rare tumor syndromes

August 22, 2017
UCLA researchers have discovered that timing is everything when it comes to preventing a specific gene mutation in mice from developing rare and fast-growing cancerous tumors, which also affects young children. This mutation ...

Retaining one normal BRCA gene in breast, ovarian cancers influences patient survival

August 22, 2017
Determining which cancer patients are likely to be resistant to initial treatment is a major research effort of oncologists and laboratory scientists. Now, ascertaining who might fall into that category may become a little ...

Study identifies miR122 target sites in liver cancer and links a gene to patient survival

August 22, 2017
A new study of a molecule that regulates liver-cell metabolism and suppresses liver-cancer development shows that the molecule interacts with thousands of genes in liver cells, and that when levels of the molecule go down, ...

Zebrafish larvae could be used as 'avatars' to optimize personalized treatment of cancer

August 21, 2017
Portuguese scientists have for the first time shown that the larvae of a tiny fish could one day become the preferred model for predicting, in advance, the response of human malignant tumors to the various therapeutic drugs ...

Scientists discover vitamin C regulates stem cell function, curbs leukemia development

August 21, 2017
Not much is known about stem cell metabolism, but a new study from the Children's Medical Center Research Institute at UT Southwestern (CRI) has found that stem cells take up unusually high levels of vitamin C, which then ...

Searching for the 'signature' causes of BRCAness in breast cancer

August 21, 2017
Breast cancer cells with defects in the DNA damage repair-genes BRCA1 and BRCA2 have a mutational signature (a pattern of base swaps—e.g., Ts for Gs, Cs for As—throughout a genome) known in cancer genomics as "Signature ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.