NEW HYDE PARK, NY – Since the 1980s, men have undergone prostate biopsies in the same way with no reliable imaging tools to help diagnose prostate cancer – until now. North Shore-LIJ’s prostate cancer team is the first site to use the commercial version of a new prostate fusion biopsy technology, which combines magnetic resonance imaging (MRI) with real-time ultrasound for visualization of suspicious areas within the prostate gland and guidance of the biopsy needles to these “target areas.”
The new technology is called the UroNav Fusion Biopsy System and was developed through collaboration between Invivo, a subsidiary of Philips Healthcare, and the National Institutes of Health. Since March 2012, LIJ has been part of a national clinical trial testing the new MRI/ultrasound fusion-guided system to target abnormal prostate tissue. Led by Art Rastinehad, DO, director of interventional urologic oncology at LIJ Medical Center, the study’s results are impressive. Based on this clinical trial, an additional 37 to 45 percent of cancers were detected in patients who already received prior negative biopsies.
“We can now see cancers we couldn’t visualize in the past,” said Dr. Rastinehad, who unveiled the new prostate imaging system at a news conference Thursday, May 2 at LIJ. “Traditional techniques only sample the bottom part of the prostate, but 30 percent of cancers are outside this zone.”
Here’s how the ultrasound-guided fusion biopsy works: an electro-magnetic navigation system, similar to a GPS tracking device, is placed over the patient’s hip to locate the needle position and guide the biopsy. The MRI and ultrasound images are aligned and overlaid in real-time and visible “targets” are displayed based on the MRI exam findings. The fusion-guided biopsy can sample areas of the prostate not readily sampled by the standard 12-core biopsy procedure, which only samples a small portion of the prostate. The MRI can provide an evaluation of 100 percent of the prostate gland - and now for the first time, the diagnostic power of an MRI exam can be integrated as part of this new fusion biopsy procedure.
“Our goal is to inform patients of the amount of cancer they have and the best treatment options available to them,” said Dr. Rastinehad, who also practices at North Shore-LIJ’s Arthur Smith Institute for Urology in Lake Success. The Institute includes a Prostate Cancer Center, which provides a team approach offering coordinated multidisciplinary evaluation of patients by urologists, radiation oncologists, medical oncologists and other healthcare professionals.
Prostate cancer affects one in six men in the US. More than 240,000 new cases are diagnosed each year in the country and approximately 30,000 men die of the disease.
Richard Bolton, 61, of Point Lookout, NY, a retired financial executive, learned of his prostate cancer diagnosis after he received a prostate fusion biopsy at LIJ in January.
Mr. Bolton had been undergoing regular prostate exams for the past six years because his PSA (prostate-specific antigen) had been steadily increasing. He underwent two standard 12-core biopsies, which according to Dr. Rastinehad, samples less than one-half of one percent of the prostate tissue. Both times Mr. Bolton’s biopsy results were negative. With a high PSA, Mr. Bolton was referred to the Smith Institute for Urology for further testing. The consulting urologists recommended that he participate in the clinical study and undergo a prostate fusion biopsy. The test revealed that he had locally advanced cancer. As part of the study, all patients undergo the standard of care, a 12-core biopsy, and it was negative for a third time. “There’s no telling when his cancer may have been detected by standard biopsy,” said Dr. Rastinehad
Doctors estimated Mr. Bolton’s tumor was there for several years. “I feel fortunate to be part of the study and the new technology was available in New York,” said Mr. Bolton. “I’m grateful to my doctors who caught the cancer. It hasn’t spread, it’s localized and in one spot – that’s the good news.” Mr. Bolton is currently undergoing treatment.
To see a video from the news conference go here.