Breakthrough Using MRI Scans Spotting Prostate Cancer Over Invasive Biopsies – Dr. David Samadi

Men who are being tested for prostate cancer may be spared the need for invasive biopsies in the future. Researchers unveiled the latest findings published in the medical journal The Lancet showing that a multi-parametric MRI can pick up 93% of aggressive prostate cancer compared with only 48% when done with a biopsy.

“This research is some of the best news to come along in a while for prostate cancer,” said Dr. David Samadi. “Anytime there are more invasive procedures such as a biopsy using needles involved in detecting prostate cancer, it is always a concern for the man having the procedure done. There are concerns of pain, infection and bleeding that can be distressing to a man. In addition, a biopsy is not as accurate in diagnosing prostate cancer which can lead to false positives when the cancer is too slow-growing to be harmless or not even present.”

Typically, diagnosing solid cancer tumors will use imaging such as an MRI to identify if a patient needs a biopsy. Prostate cancer is different in that men who are found to have an elevated serum prostate specific antigen (PSA) will be offered a transrectal ultrasound-guided biopsy (TRUS) rather than using an imaging tool. The biopsy is considered invasive as it uses twelve needles to take samples from various points on the prostate gland. Each year more than 100,000 men undergo this procedure and it has the potential to lead to side effects of bleeding, pain, infection, and possible erectile dysfunction. For some men, they can also suffer a life-threatening bloodstream infection called sepsis as a result of the standard TRUS-biopsy.

This new research recruited 576 men between 2012 and 2015 of whom all underwent both an MRI and TRUS-biopsy or TPM-biopsy (template prostate mapping biopsy). On TPM-biopsy, 408 of the 576 men had cancer with 230 of 576 patients who were clinically significant. For clinically significant cancer, the MRI imaging was more sensitive (93%) than TRUS-biopsy (48%). The study also showed that more than a quarter (27%) of all men with suspected cancer could avoid a biopsy altogether.

When using a biopsy to detect prostate cancer, there can be inaccuracies as the tissue samples are taken at random

“When using a biopsy to detect prostate cancer, there can be inaccuracies as the tissue samples are taken at random,” explained Dr. Samadi. “This leaves a greater chance for missing aggressive cancers if they are there. Prostate cancer can either be aggressive and fast-growing or more of a harmless form that is exceedingly slow-growing with the man more likely to die of something else. What I want to avoid is making a man go through an unnecessary biopsy that has potential side effects when he could simply have a much less invasive MRI scan.”

Some hospitals already offering a multi-parametric MRI before doing an biopsy but the number of healthcare facilities using them is limited at this time. Many different kinds of cancer are diagnosed with the use of MRI’s making them in high demand for various cancers with a need for specialized training of radiologists to interpret the scans.

“I’m hoping that the need for conducting an invasive needle biopsy for diagnosing prostate cancer can be reduced greatly in the future,” stated Dr. Samadi. “This finding is an exciting step forward in making the discovery and diagnosis of prostate cancer easier, more accurate and less invasive. I want men to not be afraid of the diagnostic process. Men still need to be checked regularly and to recognize symptoms of prostate cancer. If they have a family history or are having any symptoms, they should contact their healthcare provider right away. The sooner prostate cancer is discovered, the higher the survival rate.”

Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.