Fusion prostate biopsy
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PSA has bounced every three months from 6-9-3-5-7(current). Three months ago had 3t prostate MRI which showed 2 pi-rads level 3 lesions in the intermediate zone. So asked urologist about getting fusion biopsy ( they overlay MRI and ultrasound pics to target suspicious lesions). The alternative biopsy is a blind ultrasound that targets more random areas. To my amazement the urologist said ( relayed by his nurse) that they only do the fusion biopsies for pi-rads level 1 or 2 lesions. Can this be true? Why wouldn't they do the fusion biopsy in order to sample known level 3 lesions???
0 likes, 16 replies
james43046 rolf61809
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greg43014 rolf61809
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I had pirads 4 and they did a fusion biopsy and found out i had a gleason 3+3. I don't understand why the doctor wouldn't do it maybe you should get another urologist
bernie_0105 rolf61809
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greg43014 bernie_0105
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greg43014 rolf61809
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What a blind biopsy they don't know where to target the legion with an MRI Fusion biopsy they Target the area of where the MRI said it was very good procedure
geoff90305 rolf61809
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I think the nurse relayed the wrong message. I would have thought sheshould have said, "the doctor does not do fusion biopsies for Pirad 1 and 2 because nothing there to see when the fusion takes place".
When I spoke to my urologist, he said the Pirad 1 score is perfect tissue. Pirad 2 score means the tissue not quite 'perfect' but probably consistant with a persons age. When you get to Pirad level 3 and above, you usually see marked change in the tissue and lesions to actually carry out the biopsy on.
barney34567 rolf61809
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The most definitive biopsy is one that fuses MRI images and guided by an ultrasound. The safest approach is transperennial and not transrectal.
I advise you to get the MRI u/s guided transperennial biopsy which is proven to have less instances of sepsis.
mellysmell rolf61809
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j12080 mellysmell
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romneyj j12080
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barney34567 romneyj
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Tybeeman rolf61809
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romneyj rolf61809
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Fusion biopsy is not so much 'hard' as needing training. Usually any one imaging team will have perhaps two people with sufficient training (these could be technicians under the guidence of an imaging specialist). There is no question that a blind biopsy leds to a high risk of finding nothing or at least missing key locations in a prostate that is already demonstrated to require biopsy. As many have already said, this is a case of needing a second opinion.
Good luck. I hope it goes well.
Tybeeman romneyj
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romneyj Tybeeman
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barney34567 romneyj
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