Prostate biopsy is mandatory to make a definitive diagnosis of prostate cancer. In prostate biopsy, tissue samples are taken by imaging the prostate with the help of ultrasound and these samples are sent to pathology to determine whether they are cancerous or not.
In a classical ultrasound-guided prostate biopsy, although the shape and boundaries of the prostate can be seen with ultrasound, abnormalities in the prostate tissue and cancer-suspicious areas may not be visible, and tumor areas can be missed by 30% with this classical method.
Fusion biopsy, unlike classical ultrasound-guided prostate biopsy, uses images from Multiparametric MRI to identify suspicious lesions. These images are superimposed on images taken from ultrasound, allowing the detection of nodules or suspicious areas that cannot be seen with a classical ultrasound.
During fusion biopsy, images taken from Multiparametric MRI are combined in real time with images taken under live ultrasound guidance to create a 3D prostate image. Suspicious lesions on this 3D prostate are also seen in 3D. In this way, the physician can take a targeted, pinpoint biopsy of suspicious foci via a real-time 3D prostate image.
Minhaj et al., in their series of 1003 patients at the American National Cancer Institute between 2007 and 2014, found that fusion biopsy detected 30% more “high-risk cancers” than standard biopsy. In the same study, fusion biopsy detected 17% fewer “low-risk cancers” compared to standard biopsy.
In the study of Ahdoot et al., published in 2020, in a series of 2103 patients, it was revealed that fusion biopsy was 46% more successful than standard biopsy in detecting high-risk cancer.
According to the study published by Watson et al. in 2018, both fusion biopsy and standard biopsy were applied to 779 patients who had 1 or more previous biopsies and received negative results, and while fusion biopsy detected high-risk cancer in 26.3% of these patients, standard biopsy detected only 4.4%. was able to detect.
According to the results found by Arsov et al. in their series of 267 patients, statistically, in order to detect a high-risk cancer cell in a standard biopsy, it is necessary to take 3 times more needle samples than in a fusion biopsy.
As a result, it can be said that fusion biopsy has important advantages compared to standard biopsy, such as an increase in the diagnosis rate of clinically significant prostate cancer, the possibility of early diagnosis of the disease, fewer biopsy samples, and cost savings by preventing unnecessary “repeat” biopsies.
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