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Prostate fusion biopsy is a type of prostate biopsy that uses pictures made by MRI and ultrasound during the procedure. A prostate biopsy removes tissue from the prostate for testing in a lab. It's used to diagnose prostate cancer.
Most prostate biopsies use transrectal ultrasound (TRUS) to guide the needle that takes tissue samples. TRUS is an ultrasound exam that uses a device inserted into the rectum to make pictures. A fusion biopsy also uses images from MRI scans, which are taken before the procedure.
For a fusion biopsy, a computer matches the MRI scans with TRUS images so the healthcare professional who does the procedure can see both kinds of images at the same time. This is called image fusion.
Prostate MRI scans are good at finding areas of concern that are more likely to contain cancer. TRUS is good at showing real-time pictures of the prostate. Together, the fused images help guide the biopsy needle to areas of concern to take samples. Targeting the biopsy in this way raises the chances that the procedure will detect prostate cancer that needs treatment.
In addition to targeting areas of concern found with MRI scans, a fusion biopsy usually also takes samples from all over the prostate. This helps check for any cancer that wasn't detected on MRI scans.
لماذا يتم ذلك؟
Prostate fusion biopsy takes tissue samples from the prostate to look for signs of prostate cancer. Reasons for a fusion biopsy include:
- A prostate-specific antigen (PSA) test shows a PSA level that's higher than expected.
- A digital rectal exam finds a concerning bump or lump on the prostate.
- A prostate MRI scan shows an area of concern that's likely to be cancer.
- A previous prostate biopsy did not find cancer, but the healthcare team is still concerned cancer may be present.
- Monitoring prostate cancer during active surveillance.
Prostate fusion biopsy is a newer approach to prostate biopsy. Studies show it's more likely to detect prostate cancer that needs treatment than a standard biopsy with transrectal ultrasound only.
Fusion biopsy may be most helpful after a standard biopsy doesn't find any cancer. If the healthcare team is still concerned cancer may be present, MRI fusion biopsy may increase the chance of detecting cancer.
المخاطر
Prostate fusion biopsy is a safe procedure. Like any procedure, it has some risks and side effects. Fusion biopsy side effects are similar to those that may happen with a standard prostate biopsy that uses ultrasound guidance.
Risks and side effects include:
- Bleeding at the biopsy site. Some bleeding from the rectum or the perineum is common after a prostate biopsy.
- Bloody semen. It's common to notice red or rust coloring in your semen after a prostate biopsy. This indicates the presence of blood. It may persist for a few weeks.
- Bloody urine. Urine may look pink or red when it contains blood. This usually goes away in a week or two.
- Difficulty urinating. Prostate biopsy can sometimes cause difficulty urinating after the procedure. Call your healthcare team if this happens. Rarely, a temporary urinary catheter is needed.
- Discomfort during the procedure. A prostate biopsy can cause discomfort, but it shouldn't hurt. Some people start to sweat or feel dizzy during the procedure. Tell the healthcare professional who does the procedure if you have these symptoms or feel a lot of discomfort.
- Infection. Rarely, a prostate biopsy can cause an infection. Call your healthcare team if you have a fever or chills after your biopsy.
- Pain. A prostate biopsy may cause pain and discomfort for a few days. Your healthcare team may suggest pain medicine that you can buy without a prescription to help with this.
Some people worry that a biopsy may cause prostate cancer to spread. There have been rare reports of cancer cells spreading along the path of the biopsy needle. The risk of this is very low.
كيف تستعد؟
To prepare for prostate fusion biopsy, you'll have a prostate MRI scan. Then you'll follow your healthcare team's instructions to prepare for the biopsy procedure.
Have a prostate MRI scan
Before the biopsy, you will have a prostate MRI scan. The MRI scan helps show any areas of concern that could be cancer. Your healthcare team will give you instructions for preparing for the scan.
MRI machines use a magnetic field and computer-generated radio waves to make pictures. Tell your healthcare team if you have any metal in your body, as this can interfere with the scan.
Prepare for biopsy
To prepare for the biopsy procedure, your healthcare team may ask you to:
- Adjust some medicines that you take. Tell your care team about the medicines you take, including any that you can buy without a prescription. Also tell your care team about any supplements you take. Your healthcare team may tell you to adjust your medicines before your procedure. Follow these instructions.
- Prepare for sedation. You may receive medicine to help you relax during the procedure. Ask your healthcare team if this is planned for your biopsy. If so, you may need to stop eating and drinking before your procedure. Make plans for someone to drive you to and from your appointment. Not everyone needs sedation for this procedure.
- Take antibiotics. Your healthcare team might prescribe antibiotics to prevent infection. You typically take this medicine at home before the biopsy. Sometimes the care team gives the antibiotics before the biopsy starts. Follow any instructions from your care team.
- Test for urinary tract infection. Your healthcare team may test your urine for signs of infection. If you have an infection, you may need treatment before the biopsy.
- Use an enema. An enema flushes waste from the rectum with water or a solution. Your care team might ask you to use an enema at home before your procedure if you're having a transrectal biopsy. In this kind of prostate biopsy, a needle goes through the rectum to take tissue from the prostate.
Follow any other instructions you get from your healthcare team.
ما يمكن أن تتوقعه
During prostate fusion biopsy, a healthcare professional removes samples of tissue from the prostate using a needle. The health professional watches real-time ultrasound images to guide the needle. The ultrasound images are fused with images from MRI scans. This helps the health professional who does the biopsy find and take samples from any areas of concern that were found on the MRI scans.
Prostate fusion biopsy often takes less than an hour. It can happen in a healthcare professional's office or in a hospital procedure room. Most people go home after the biopsy and don't stay in the hospital.
Before the procedure
Before the prostate fusion biopsy, you may change into a gown or robe. Sometimes the healthcare team uses sedation during the procedure. If you'll have this, your healthcare team will put a thin tube into a vein in your arm or hand. The tube gives the medicine that helps you relax. Some people fall asleep.
Most prostate biopsies don't use sedation. Instead, the healthcare team puts numbing medicine in the area of the prostate to reduce discomfort during the procedure.
A member of your healthcare team positions you on a table in the procedure room. How you're positioned depends on how the biopsy is done.
- Transrectal biopsy. During a transrectal biopsy, a needle goes through the wall of the rectum to take tissue samples. For this procedure, you may lie on your side with your knees bent.
- Transperineal biopsy. During a transperineal biopsy, a needle goes through the skin between the scrotum and the anus to reach the prostate. This area of skin is called the perineum. For this procedure, you may lie on your back. Your legs may be placed in stirrups.
A healthcare professional may do a digital rectal exam (DRE) to feel the prostate for any lumps that should be biopsied. During a DRE, a healthcare professional inserts a gloved, lubricated finger into the rectum to examine the area.
During the procedure
During prostate fusion biopsy, a healthcare professional inserts an ultrasound device into the rectum. The device, called a transducer, is about the width of a finger. It sends out sound waves that bounce off structures inside the body to make pictures. Doing an ultrasound in this way is called transrectal ultrasound (TRUS).
TRUS typically doesn't hurt, but it may cause some discomfort. If there is a lot of discomfort, numbing medicine can be applied to help with this. Some people start to sweat and feel dizzy when the transducer goes into the rectum. Speak up if you start to feel these symptoms.
TRUS makes black and white pictures of the prostate that the healthcare team watches on a monitor. For fusion biopsy, the monitor also shows findings from your prostate MRI scans at the same time. A healthcare professional uses the images to guide a needle to take tissue samples.
How the samples are collected depends on the kind of biopsy you're having.
- Transrectal biopsy. If you're having a transrectal biopsy, a healthcare professional puts a biopsy needle through the wall of the rectum and into the prostate. You may feel stinging or burning each time the needle takes a sample.
- Transperineal biopsy. If you're having a transperineal biopsy, a healthcare professional puts a biopsy needle through the perineum to get the tissue samples. You may feel a flicking sensation as this happens, but it typically doesn't cause much discomfort. The healthcare team uses medicine to numb the area, including the skin on the perineum.
Fusion biopsy takes several samples from the prostate. It may involve taking a few samples from around each area of concern. Then, several more samples are taken from around the prostate. Taking samples from all over the prostate lowers the risk that an area of cancer might be missed.
After the procedure
After prostate fusion biopsy, the healthcare professional removes the TRUS transducer from the rectum. It's typical to have some bleeding from the rectum or perineum after the procedure. Your healthcare team may give you a pad to wear in case of bleeding.
Plan to rest after your biopsy. As you recover, return to your usual activities as you feel up to it. Most people can return to their usual activities about 24 hours after the biopsy.
If you had medicine to help you relax during the biopsy, then someone you know needs to drive you home. For the first 24 hours after being sedated, it's common to have memory lapses, slowed reaction time and impaired judgment. Do not drive, return to work or do anything strenuous during this time.
Contact your healthcare professional if you:
- Can't urinate when your bladder feels full.
- Have infection symptoms, such as fever and chills.
- Have pain that isn't relieved by pain medicine you can buy without a prescription.
- Notice an increase in the amount of bright red blood in your urine, semen or stool.
النتائج
Results from a prostate fusion biopsy state whether cancer was found in any of the tissue samples taken from the prostate. Ask your healthcare team when you can expect to receive your results.
After the biopsy, the prostate tissue samples go to a lab. In the lab, doctors who specialize in analyzing blood and body tissue to make a diagnosis look at the samples. These doctors are called pathologists. They look for cancer cells in each sample using microscopes.
Sometimes the biopsy finds conditions that aren't cancer, such as an enlarged prostate or prostate inflammation.
If cancer is found, the biopsy results may include information about:
- The type of prostate cancer. Most prostate cancers start in gland cells. This type of prostate cancer is called adenocarcinoma. Other types of prostate cancer are rare.
- The Gleason score and grade group. The Gleason score and grade group are numbers that tell the healthcare team whether the cancer is likely to grow quickly or grow slowly. To get these numbers, the pathologist compares the cancer cells to healthy cells. Cancer cells that look very different from healthy cells are more likely to grow quickly.
- The number of positive samples. Several tissue samples are removed during a biopsy. The results may state how many contained cancer or the percentage of samples that were positive. This helps the healthcare team get a sense of the size of the cancer.
Biopsy reports are often written for healthcare professionals and can be hard to read. Your healthcare professional will review the results with you and explain what they mean.
التجارب السريرية
استكشِف دراسات مايو كلينك حول الاختبارات والإجراءات المخصصة للوقاية من الحالات الصحية واكتشافها وعلاجها وإدارتها.