MRI Guided Biopsy for Prostate Cancer

What is a Biopsy, and How Effective Is It?

What Should I know?

A needle biopsy is the only method for diagnosing prostate cancer when it is suspected. However, the most common technique used, called transrectal ultrasound (TRUS)-guided biopsy, has some significant drawbacks that often result in inaccurate diagnoses.

For the past 20 years, TRUS biopsy has been employed to detect prostate cancer. It is considered a “blind” and random process because it cannot specifically identify certain tumors, particularly very small ones. Ultrasound imaging cannot pinpoint precise cancerous areas, making it ineffective in detecting tumors. Furthermore, TRUS biopsies typically focus on the outer regions of the prostate and often miss 30-40% of cancer located in the anterior, midline transition zone, or apex, a problem known as sampling error. To compensate for this, TRUS biopsies usually involve 12-14 needle samples, and in some cases, “saturation” biopsies use up to 24 needles. However, the more needles used, the higher the risk of discomfort, infection, and side effects such as urinary or sexual issues, while still failing to identify tumors. No other type of cancer is biopsied in such a manner.

MRI-Guided Biopsy

Advantages Over TRUS Biopsy

Image Quality

Our BlueLaser™ 3T mpMRI provides high-resolution, 3D images that clearly differentiate healthy from diseased tissue, allowing for precise localization of suspicious tumors. This advanced imaging technique offers a superior method for characterizing and targeting malignancies, particularly important when diagnosing smaller, lower-risk tumors.


Patient Comfort

MRI-Guided Biopsy, performed under local anesthesia, targets the exact area identified in the scan, making it more comfortable for patients compared to traditional TRUS biopsies. Additionally, this method significantly reduces the risks of infection and side effects.

Diagnostic Accuracy

An MRI-Guided Biopsy precisely targets the tissue identified in the MRI scan, ensuring that tissue samples are taken from the areas most likely to contain cancer. This targeted approach contrasts with the “blind” technique of a TRUS biopsy, offering greater confidence for both physicians and patients in the accuracy of the diagnosis.


Advanced Laboratory Analysis

Biopsy samples are analyzed in top-tier laboratories by expert pathologists. Depending on the patient’s individual risk factors, further analysis can include evaluating molecular markers and testing gene sequences for harmful mutations. If necessary, genomic testing is used for the most comprehensive results. These findings, when correlated with MRI images, provide a definitive confirmation of prostate cancer. If a tumor is identified as low- to moderate-risk, it may qualify for focal treatment.

“Fusion-Guided Biopsy”? Not the Same!

While some doctors use a fusion-guided biopsy and refer to it as an MRI-guided biopsy, this is misleading. Fusion uses previously captured MRI images that are “fused” with real-time ultrasound via software. However, this method compromises accuracy due to potential discrepancies in patient positioning or slight movement during live ultrasound, which can cause deviations from the original MRI scan. As a result, fusion-guided biopsies are less accurate than real-time MRI guidance, which is performed when the patient is inside the MRI scanner (in-bore). Though fusion improves upon TRUS alone, it is still less precise than real-time MRI-guided biopsies.


Questions Patients Ask

What is a Needle Biopsy and Why Do I Need One?

A needle biopsy is the only reliable method for diagnosing suspected prostate cancer. Thin, hollow needles are inserted into the prostate to gather tissue samples, which are then sent to a pathology lab for microscopic analysis. This examination determines: a) whether the cells are cancerous, b) the size of the tumor, and c) the aggressiveness of the cancer. Additionally, these samples can undergo genomic or molecular testing to assess whether the cancerous cells are particularly dangerous.

I’ve Had a Previous Negative Biopsy, but My PSA is Still High. I Don’t Want Another Biopsy. Any Suggestions?

We suggest scheduling a BlueLaser™ 3T mpMRI scan of the prostate. PSA levels are not exclusively indicative of prostate cancer; they can also be elevated due to noncancerous conditions such as inflammation, infection, or BPH. An MRI scan is the best next step to confirm or eliminate the possibility of prostate cancer. If a biopsy is needed, a BlueLaser™ 3T mpMRI-Guided Biopsy is less invasive and more precise than traditional TRUS or fusion-guided biopsies.


I’ve Had a Positive Biopsy. Can I Trust the Information from the Lab?

Standard TRUS biopsies are inaccurate in at least 30% of cases because ultrasound cannot distinguish between healthy and cancerous tissue. As a result, biopsy samples may not provide a complete or accurate diagnosis. At our Center, we offer BlueLaser™ 3T mpMRI-Guided Biopsy, which uses fewer needles precisely targeted at the tumor’s core. You can trust that our method delivers the most accurate results, particularly if you’re considering Active Surveillance or Focal Laser Ablation (FLA).


Can MRI Alone Diagnose My Prostate Cancer?

Studies have shown that today’s 3T multiparametric MRI can detect prostate cancer tumors. Our BlueLaser™ 3T mpMRI provides detailed imaging of suspicious areas, and certain imaging sequences can even help assess the aggressiveness of any cancer present. However, only laboratory analysis of biopsy samples can provide cellular and even molecular information about the tumor.