What to know about a MRI fusion prostate biopsy

Written in association with: Mr Andrew Ballaro
Published:
Edited by: Conor Lynch

Here, leading London and Essex-based consultant urologist, Mr Andrew Ballaro, walks us through what an MRI fusion prostate biopsy procedure entails.

What is MRI fusion prostate biopsy and how does it work?

MRI fusion prostate biopsy is the most precise and minimally invasive method for taking small samples of the prostate to investigate MRI-detected abnormalities to determine whether prostate cancer is present. A prostate MRI scan is indicated if the PSA is raised, if there is a palpable abnormality on prostate examniation, or if a patient requests one and has had appropriate councelling.

 

If the MRI scan shows an abnormality in the prostate, the next step is to take a small sample, or biopsy, that can be analysed under the microscope to see if it is cancerous. The MRI fusión technique employs dedicated software that superimposes the prostate MRI scan with the área of concern marked, on to the real-time ultrasound image of the prostate that we take during the biopsy and this ensures that the biopsy needle is accutrately placed in the suspicious area of the prostate, and normal prostate is unharmed. 

 

How does MRI fusion biopsy compare to traditional prostate biopsy methods?

Traditional, or non-fusion, transperineal prostate biopsy techniques rely on clinician judgement to place the needle in the correct área of the prostate. This involves the clinician reading the MRI written report to determine the general área of the prostate that the posible tumour is in, then widely sampling this area of prostate hoping to hit thepossible tumour. 

 

This can be imprecise and a bit hit and miss- particularly when the suspicious area is small and the prostate is large. Using MRI fusión technology we can be sure that the posible tumour is sampled accurately and normal prostate is left alone.

 

What are the benefits of undergoing an MRI fusion prostate biopsy?

The benefits of MRI fusión biopsy vs traditional tmethods are its significantly increased accuracy of targeting the possibloe tumour, and minimising damage to normal prostate. This reduces complications such as pain, bruising, bleeding, infection and urinary retention. 

 

Are there any risks or side effects associated with MRI fusion prostate biopsy?

Risks are minimal. Some patients experience some blood in the urine and semen for a few days, and some mild bruising in the perineum.

 

What should I expect during and after an MRI fusion prostate biopsy procedure?

The procedure is quick and minimally invasive and involves passing a very thin biopsy needle into the prostate throught the skin between the scrotum and anus (perineum). It is a day case procedure which we like to do under a short general anaesthetic, although it can be done under local anaesthetic. Patients go home a few hours after the procedure with no discomfort, and results are avaialable within a week or so.

By Mr Andrew Ballaro
Urology

Mr Andrew Ballaro is a highly regarded consultant urologist in North London and Essex with over 15 years of experience. He specialises in the management of all urological problems including blood in urine, urinary infections, prostate pain syndromes, general prostate and bladder disease, and the diagnosis of urological cancers including the investigation of raised PSA with MRI Fusion prostate biopsy.

He has specialist surgical expertise in the management of kidney stone disease and benign prostate enlargement (BPE), and consistently publishes UK leading surgical outcomes for complex stone operations. He offers a choice of surgical procedures for benign prostatic enlargement tailored to the patient’s requirements including Holmium Laser prostatectomy (HOLEP) and is highly experienced in dealing with very large prostates and urinary retention, with every patient in a large series going home the day after surgery without a catheter.

Mr Ballaro takes satisfaction in providing second opinions, and is supported by a warm, skilled and responsive managerial team. Together they aim to provide the best possible outcome for each and every patient. Mr Ballaro's extensive training began after graduating from The Royal Free Hospital Medical School in London, and undertaking his surgical training at Oxford. He was awarded a fellowship from the Royal College of Surgeons of London and went on to complete higher urological training on the North London Training Scheme. This was followed by advanced training in complex stone surgery from national and international experts in his field.

Alongside his dedication to education, he is currently teaching trainees at the London Deanery, catering to various levels of expertise. Additionally, he has been honoured with a Hunterian Professorship from the Royal College of Surgeons of England, showcasing his commitment to scholarly pursuits. Holding a master’s degree in urology and an MD in clinical sciences from the Institute of Urology, Mr. Ballaro has extensively published research on bladder physiology and minimally invasive urological surgery. He is the co-author of the latest edition of the popular medical student textbook 'Lecture Notes in Urology'.

 

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