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Targeted Prostate Cancer Screening More Effective Than Traditional Method

UC Academic Health Center
Abhinav Sidana, MD (right), Timothy Struve, MD (left), and Sadhna Verma, MD (top left), members of the UC Cancer Institute and UC Health physicians, created a multidisciplinary prostate cancer clinic for patients to learn about options for treatment.

A newer prostate cancer screening method is outperforming standard prostate biopsies, according to a study from the University of Cincinnati.Researchers found prostate cancer screenings were more accurate when using MRI and ultrasound to inspect suspicious lesions in the prostate gland, and target a biopsy to a specific area rather than doing a standard biopsy.

The findings could lead to a more efficient standard for men's prostate cancer screenings, says Abhinav Sidana, MD, director of urologic oncology and an author on the study.

Traditionally, doctors collect a number of samples from random parts of the prostate. "However, this can lead to over-diagnosis of clinically insignificant cancer, meaning prostate cancer where treatment is not needed, under-diagnosis of clinically significant cancer, meaning prostate cancer where treatment is needed, and has a high false-negative rate, meaning tests that read negative for cancer when it is truly malignant," Sidana says.

The data is published in the journal Urologic Oncology.

Sidana says the MRI fusion biopsy is a promising alternative, especially for patients with previously negative prostate biopsies.

"Patients with continued suspicion of prostate cancer and negative prior prostate biopsy are a diagnostic challenge, and around 38 percent will undergo repeat standard or saturation biopsy over five years in order to obtain a diagnosis," he says. "Unfortunately, repeating this has little efficacy in identifying cancerous lesions with only a 10 to 25 percent cancer detection rate even after the fourth repeat biopsy. These multiple re-biopsies also lead to increased cost, delayed diagnosis and could contribute to progression of a patient's disease."

About The Study

The cases of 779 patients—each with a history of one or more negative biopsies who also underwent MRI biopsy fusion—from four institutions were analyzed making it one of the largest studies in this population.
The average age of patients was 63. Of the 779 patients, cancer was detected in 346 patients (44 percent), and the clinically significant cancer detection rate was 30.7 percent with fusion biopsy detecting 26.3 percent (205 cases) and systematic biopsy detecting only 4.4 percent (34 cases).