Taking the random out of biopsy sampling

2020

Challenge

Prostate cancer requires a biopsy to confirm the diagnosis. However, even with improvements in technology, current biopsy techniques remain challenging. In some cases, cancerous lesions may be missed, while in others, false positive results are obtained. Novel diagnostic tools are needed to perform more accurate biopsies and improve cancer detection rates.

Advance

A decade ago, IRP researchers Peter L. Choyke, M.D., Peter A. Pinto, M.D., Bradford Wood, M.D., and colleagues developed a minimally invasive biopsy procedure that combined magnetic resonance imaging (MRI) and ultrasound-guided prostate biopsy. This method detected cancer at a far higher rate than traditional biopsy techniques. More recently, their team built on this work by combining the MRI-targeted biopsy technique with a systematic biopsy in which many samples of tissue are removed from the prostate and examined under a microscope. A study of this combined approach in more than 2,000 patients found that it identified more cancers and provided more precise information about the characteristics of patients’ tumors.

Impact

Combined biopsy is currently the most effective predictive method to determine the true nature of a patient’s prostate cancer. The improved diagnostic accuracy resulting from combined biopsy reduces the risk of both overtreatment and undertreatment of the disease.

Publications

Ahdoot M, Wilbur AR, Reese SE, Lebastchi AH, Mehralivand S, Gomella PT, Bloom J, Gurram S, Siddiqui M, Pinsky P, Parnes H, Linehan WM, Merino M, Choyke PL, Shih JH, Turkbey B, Wood BJ, Pinto PA. (2020). MRI-targeted, systematic, and combined biopsy for prostate cancer diagnosis. N Engl J Med. 382(10):917-928. doi: 10.1056/NEJMoa1910038.

Turkbey B, Xu S, Kruecker J, Locklin J, Pang Y, Shah V, Bernardo M, Baccala A, Rastinehad A, Benjamin C, Merino MJ, Wood BJ, Choyke PL, Pinto PA. (2011). Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI. Cancer Imaging. 11(1);31-36. doi: 10.1102/1470-7330.2011.0007.