Prostate Cancer is the most common nonskin cancer and the second leading cause of cancer related death among men in the Unites States. Systematic Transrectal Ultrasound guided biopsy is the standard approach for diagnosis of Prostate Cancer. However, this technique has limitations because of its inability to accurately visualize and localize prostate cancer for targeting. The systematic biopsy has been criticized for over detection of low grade Prostate Cancers that have virtually no risk of metastasis. This is associated with substantial overtreatment and considerable morbidity. At the same time, potentially lethal tumors are missed.
MRI of the prostate is more reliable and able to localize significant prostate cancer. The technology of MRI has allowed us to identify suspicious areas that require a needle biopsy. MRI of the prostate utilizes state of the art MRI technology as well as a radiologist skilled in reading these images. The radiologist marks suspicious areas seen in the prostate gland. In an outpatient setting, under local sedation, an ultrasound probe is inserted into the rectum. The entire prostate gland is now imaged utilizing real time sonography and the fusion software overlays the MRI image accordingly, giving a detailed 3-D ultrasound/MRI view. This fused image is now utilized to guide the biopsy needles precisely to the suspicious MRI lesion. This is more precise then just randomly performing biopsies hoping to find something. Fusion Prostate Biopsy has been compared to GPS. The destination is reached utilizing directional software rather than driving blindly without directions. Fusion guided prostate biopsy is likely to result in fewer and more accurate prostate biopsies than the present use of systematic biopsies with ultrasound guidance alone. Nonetheless, this will find tumors we need to treat while overlooking those we do not need to worry about.
Dr. Solomon is a Diplomat of the American Board of Urology, a Fellow of the American College of Surgeons, a member of the American Urology Association and American Association of Clinical Urologists. Locally he is a proud sponsor of OPERATION 300, the Boys and Girls Club, PATCHES, and Make a Wish. He is also the team Urologist for the St. Lucie Mets.
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