The new targeting process is the result of four years of work funded by the National Cancer Institute and based in the Clark Urology Center at UCLA.
Since the mid-1980s, prostate cancer has been diagnosed using trans-rectal ultrasound to sample the prostate. Unlike most other cancers, prostate cancer is the only major malignancy diagnosed without actually visualizing the tumor as a biopsy is done, Marks said.
With the advent of sophisticated MRI, imaging the prostate improved and provided a picture of tumors within the organ. However, trying to biopsy the prostate with the patient inside the MRI has proved to be cumbersome, expensive and time consuming. Thus the fusion process evolved, permitting the targeted biopsy to be done in a clinic setting.
In this study, the volunteers undergo MRI first to visualize the prostate and any lesions. That information is then fed into a device called the Artemis, which fuses the MRI pictures with real-time, three-dimensional ultrasound, allowing the urologist to see the lesion during the biopsy.
"With the Artemis, we have a virtual map of the suspicious areas placed directly onto the ultrasound image during the biopsy," Marks said. "When you can see a lesion, you've got a major advantage of knowing what's really going on in the prostate. The results have been very dramatic, and the rate of cancer detection in these targeted biopsies is very high. We're finding a lot of tumors that hadn't been found before using conventional biopsies."
Prostate cancer was found in 53 percent of 171 study volunteers. Of those tumors found by the fusion biopsy technique, 38 percent had a Gleason score of greater than seven, which indicates an aggressive tumor, more likely to spread than tumors with lower scores. Once prostate cancer
|Contact: Kim Irwin|
University of California - Los Angeles Health Sciences