What is an image fusion prostate biopsy and what is it used for?

Prostate cancer is the most common tumor in men, followed by colon and lung cancer. The risk of developing it increases with age, but there are also other risk factors such as black race and first-degree family history that increase the risk of developing prostate cancer.

In the initial stages, prostate tumors do not show any symptoms, so regular check-ups with the urology specialist are essential for the early detection of this type of tumor.

Screening is currently recommended from the age of 50 for the general population with no associated risk factors, from the age of 45 for patients with risk factors such as black race or a family history of first-degree prostate cancer, and from the age of 40 for men with an increased risk due to a family history of prostate cancer diagnosis at very early ages or carriers of genetic mutations that increase the risk.

What is image fusion prostate biopsy?

Image fusion-guided biopsy is a modality of prostate biopsy that uses a technology that allows the fusion of images from multiparametric magnetic resonance imaging of the prostate (mpMRI) and ultrasound in real time, obtaining three-dimensional images of the prostate that show us and accurately locate the suspicious area visualized in the mpMRI. This allows us to perform a very precise biopsy directed to the suspicious area, thus obtaining a more accurate diagnosis and with a lower risk of complications associated with the procedure.

What is image fusion prostate biopsy?

What is a prostate biopsy performed for?

Prostate biopsy is a minimally invasive diagnostic test performed for the detection of prostate cancer when there is a suspicion. The morphological and functional study of the prostate is previously performed with a prostatic multiparametric MRI and ultrasound.

When should a prostate biopsy be performed?

Prostate biopsy is performed when there is a suspicion that the patient may have prostate carcinoma. The study will be performed previously in the consultation room with an analysis of prostate specific antigen (PSA), a multiparametric prostatic MRI, a urological ultrasound and a digital rectal examination (helps us to confirm if abnormal nodules are palpated in the prostate).

Fusion biopsy procedure

There are two modalities of prostate biopsy, transrectal biopsy and transperineal biopsy. The former is usually reserved for cases in which it has not been possible to perform a multiparametric prostate MRI previously, the lesion is clearly palpable or image fusion does not provide any clear advantage. For all other cases the indication for prostate biopsy by image fusion is clear and provides significant advantages over standard transrectal prostate biopsy.

Prostatic multiparametric MRI classifies lesions according to the PIRADS scale ranging from 1 to 5 depending on the degree of suspicion (1 not suspicious and 5 very suspicious).

Fusion biopsy procedure

The image fusion biopsy is performed under sedation so the patient does not feel any discomfort during the procedure. The duration of the procedure is approximately 1 hour. Prostate biopsies are performed through the perineum to reduce the risk of infection after the procedure. Once completed, the patient will go to an area where he will recover from the sedation and once he is well and has urinated, he will be discharged home with antibiotics and painkillers. The anatomopathological results will be delivered in the consultation after a few days.

Preparation prior to prostate biopsy

Prior to the prostate biopsy it is necessary to make a preparation to reduce the risk of complications. Therefore, antibiotics are administered and a cleansing of the rectum with enemas is performed. The patient should come fasting for the test since it is performed under sedation.

Postoperative period after prostate biopsy by fusion

After the prostate biopsy is performed, it is recommended to rest for a few days and then you can resume your life normally. The test is generally very well tolerated and does not require prolonged analgesia after the test. The most frequent symptoms are discomfort in the perineal area and a slight hematic tinge in the urine. In case of fever or inability to urinate, the patient should go to the emergency room for evaluation.

Is it dangerous to have a prostate biopsy?

Like any test, prostate biopsy has its risks. The most important are infection, bleeding and urine retention, therefore, it is essential to prepare correctly for it and in case of any alarming symptoms, go to the emergency room to be evaluated.

When to perform prostate biopsy

Possible prostate biopsy results

Once the prostate fragments have been analyzed, a definitive anatomopathological result will be obtained which, in some cases, must be complemented with an immunohistochemical analysis in order to reach an accurate diagnosis. This result will be given in the consultation after a few days and the results will be explained in detail. These could confirm the presence of tumor cells or on the contrary rule out malignancy in the sample.

Perform a prostate fusion biopsy in Madrid

In the team of Ramirez Urology at the Hospital Ruber Internacional we have extensive experience in this type of procedures and we have the latest technology to perform them. The image fusion biopsy includes both the performance of the procedure and the stay in the day hospital and the complete anatomoatological analysis.