MRI guided prostate biopsy gaining acceptance among urologists

Dr. David Samadi provides his expert commentary on a recent national survey conducted among urologists regarding their opinions and efforts implementing MRI/US imaging into their practices.

The use of magnetic resonance imaging-ultrasound (MRI-US) guided prostate biopsy is proving to be gaining more favorable acceptance among urologists according to a national survey where the results were presented at the 2017 Genitourinary Cancers Symposium in Orlando, Florida.

“This survey is excellent news for all men who need a biopsy of the prostate in order to get the best ultrasound images possible,” stated Dr. Samadi. “MRI-US guided biopsy has the ability to fuse together real-time ultrasound images of the prostate allowing a more accurate and precise identification of suspicious lesions which may not have been found using traditional transrectal ultrasound.”

The survey was conducted in August-September 2016 where 291 urologists gave their views of MRI/US guide biopsy.  Out of the urologists surveyed, 86% stated they use MRI technology in their practices in some fashion from general MRI use, MRI/US guided prostate biopsy, MRI for active surveillance, and MRI for pre-prostatectomy imaging.  MRI-US guided prostate biopsy is used by 60% with 67% stating an increase in its use over the past 5 years.

“The use of MRI-US guided prostate biopsy is still relatively new for some urologists who may be hesitant in employing it but more and more urologists across the country are beginning to support the use of it and are actively using this technology in their practices,” said Dr. Samadi.

An overwhelming majority – 81% - of the urologists did agree that MRI-US guided prostate biopsy is useful for diagnosing prostate cancer.  Almost two-thirds of the urologists felt MRI-US guided prostate biopsy should be used more selectively like after a prior negative biopsy.  However, only 24% believed it should be used as a means of standard care in all prostate biopsies.

Another finding from the survey was depending on where the urologists were from that seemed to make a difference in their view of using MRI-US guided prostate biopsy.  Academic centers appear to have embraced the use of this technology the most with nearly three-quarters who use it, while only 38% of community-based urologists who do. Urologists living in the northeast had the highest use at 68% while those in the west had the lowest at 44%. 

“The main factor that stood out from the survey appearing to be preventing more urologists from using MRI-US guided prostate biopsy in their practices is the expense of it,” exclaimed Dr. Samadi.  “Sixty-nine percent of the urologists surveyed stated that the cost is prohibitive and that is why they are not using it at this time.”

Dr. Samadi went on to add, “I believe within time, MRI-US guided prostate biopsy will become more and more accepted among urologists.  This technology is too valuable in the fact that it has a better performance of avoiding detection of insignificant prostate cancer which reduces the possibility of oversampling potentially insignificant tumors.  It also requires fewer cores for successful tumor sampling which reduces patient discomfort.”

“We have to remember that this technology also plays an important role in evaluating low risk patients with active surveillance,” said Dr. Samadi. “This means it can identify more aggressive cancers needing to be removed quickly in order to spare a patient’s quality of life and prevent metastasis.  It really is the right technology we need at this time to provide men the best care we have to offer in aiding prostate health.”

Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.