MRI-Ultrasound Fusion Adds Precision to Prostate Cancer Care

Submitted by Leslie Lingaas on July 25, 2014 at 5:08 pm

UCSF recently acquired an MRI-ultrasound fusion device that will allow doctors to more precisely diagnose and treat prostate cancer in selected patients.

Transrectal ultrasound (TRUS) is the imaging tool urologists use during a prostate biopsy, but it provides much less anatomical detail than magnetic resonance imaging (MRI).MRI Fusion

“Combining the two imaging methods enhances our ability to locate and precisely biopsy prostate cancers,” says UCSF urology professor Katsuto Shinohara, MD.

The In Vivo UroNav fusion biopsy system acquired by UCSF is the latest generation of these innovative machines.  Shinohara envisions using the fusion system as a diagnostic tool in particular subgroups of patients. Those who may benefit from the fusion system include:

  • Men who have a rising PSA after previously negative ultrasound-guided biopsies.  The MRI/US fusion device lets physicians image the gland in detail and biopsy specific areas of interest.
  • Men on active surveillance for presumably low-risk cancer who have a rising PSA.  The fusion device will ensure that patients can still be followed safely with active surveillance by allowing the urologist to biopsy any areas that look suspicious on MRI.  
  • Men who have undergone previous radiation therapy and have a rising PSA.  The fusion device can help doctors spot any local recurrences.

 The MRI/US fusion system can also be used to deliver targeted cancer therapy. Shinohara’s clinical research is centered on ways to treat small or recurrent prostate tumors with localized “focal” therapy that reduces the risk of sexual or continence side effects. If a tumor is found with the fusion device, Shinohara and his colleagues may choose to treat these tumors with MRI/ultrasound-guided focal cryoablation (freezing of the tumor). If a man previously treated with radiation therapy is found to have a local recurrence, the fusion device can help ensure precise placement of focal brachytherapy (radioactive seeds).

"Our commitment to innovation and exceptional care define this department," says chair Peter R. Carroll, MD, MPH.  "Utilizing fusion technology is an example of this."

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