Fusion Prostate Biopsy

What is Fusion Prostate Biopsy?

Unlike ultrasound-guided classical prostate biopsy, fusion biopsy uses images from a prostate mpMRI to identify suspected lesions.

These images are superimposed over those from the ultrasound allowing detection of nodules or suspicious areas that may not otherwise be visible. Besides showing whether nodules exist and whether they are suspicious, multiparametric NMR of the prostate is the basis for “guiding” the biopsy to areas where the lesions are located. 

The accuracy this provides is remarkable and far exceeds classical biopsy. It allows biopsies of 4–5mm or less to be done accurately.

Importance of this Test

It allows guided prostate biopsies – of very small nodules and sometimes in areas where they would not be detected or biopsied using the classical ultrasound-guided technique – that are far more precise.

Fusion biopsies are becoming much more common.

The guidelines for their use have therefore undergone major evolution and have been modified as more information has come to light and the technique’s benefits have become better known.

Currently, this type of biopsy is advised for situations where suspicious nodules or lesions are only visible on an mpNMR of the prostate when they are very small, located in difficult to access areas (such as the anterior section) and when prior biopsies were negative and one or more suspicious lesions are detected in the NMR.

What is the Procedure?

Like other diagnostic and therapeutic techniques, the Instituto da Próstata was one of the first clinics in Portugal to perform this precise and sophisticated procedure.

It is crucial for this test to be performed by experienced doctors so that the results correspond to expectations. In fact, the test is highly sophisticated and specialised and requires appropriate equipment and experienced operators who are conversant with the various aspects and conditioning factors.

Fusion biopsies are much more precise than classical prostate biopsies. They can therefore increase the capacity and diagnostic precision of prostate biopsies. Understandably, using more precise, specialised, specific and reliable images and data (prostate mpNMR) improves the biopsy results and also increases their precision, reliability and diagnostic capacity, particularly of small lesions or lesions that are undetectable by ultrasound.

This type of biopsy is also performed perineally (i.e., via the zone between the scrotal sac – which holds the testicles – and the anus) and not transrectally. Besides potentially better tolerance by patients (an anaesthetic is required of course, or it would be painful), it significantly cuts the risk of infection after a biopsy. Infection is one of the potential complications of any prostate biopsy but, understandably, if it is performed via the rectum, the possibility of contamination and consequent infection is greater than when performed perineally – even when antibiotics are used beforehand.

Toque No Assunto Ep4

New Diagnostic Methods – Fusion Biopsy

Dr. José Santos Dias

Clinical Director of the Instituto da Próstata

  • Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
  • Specialist in Urology
  • Fellow of the European Board of Urology
  • Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"

FAQs about Fusion Biopsy

Are fusion biopsies better than normal classical biopsies?

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What types of fusion biopsies exist?

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Where can I do a fusion biopsy?

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  • Fusion Guided Prostate Biopsy – THE NEW GOLD STANDARD 
  • Prostate MRI and transperineal TRUS/MRI fusion biopsy for prostate cancer detection: clinical practice updates 
  • Guidelines from the European Association of Urology 
  • MRI/Ultrasound Fusion Biopsy of the Prostate 
  • Fusion Guided Biopsy: A Smarter Way to Look for Prostate Cancer

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