High-Tech Prostate Scan May Boost Cancer Detection
Combo of ultrasound and MRI zeroes in on tumors, helping some men avoid biopsy, experts say
"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 prostate cancer 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 biopsy 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 prostate biopsy, 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.