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Fusion prostate biopsy

Posted , 9 users are following.

rolf61809
rolf61809

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

16 Replies

  • james43046
    james43046 rolf61809

    Posted

    Not as familiar with these tests. Why not do a traditional biopsy that is probably more definitive?     
  • greg43014
    greg43014 rolf61809

    Posted

    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

  • greg43014
    greg43014 rolf61809

    Posted

    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
    geoff90305 rolf61809

    Posted

    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
    barney34567 rolf61809

    Posted

    I agree with those that indicted either the nurse was confused in what she said or your urologist is of little use.

    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
    mellysmell rolf61809

    Posted

    I would definitely get a second opinion! 
    • j12080
      j12080 mellysmell

      Posted

      I used a Interventional radiologist and he has a site I uploaded my 3TMRI to him and it was so easy. I called him on the phone for a consultation and he talked to me for over an hour. I inserted the cd and touch the link button on his page. He studied it and called me and we spoke for about 2 hours. He told me he has been treating Gleason 7 and lower with Focal Laser Abalation and he explained everything. The best part was he did not charge me anything and is glad to do it. He did not put and pressure on me to use his services. Only information about FLA compared to all the other treatments. If you would like his web and contact numbe I will provide it through a Private Message and you can follow up. His site has a great power point link he gives to other Doctors with audio and video on the presentation as to why this soluion is better. I main concern was sexual side effect which this has none if done correctly by an experienced IR. Just let me know and I will send it to anyone who wants it. On this site they will block the info if you do not private message it. Don't understand it but it is the rules so, ok. 

    • romneyj
      romneyj j12080

      Posted

      Hi j12080, the only problem could be if you have a Gleason 7 but a T3 or higher (even a T3a) as ablation methods are no longer used under those circumstances - or at least in UK...
    • barney34567
      barney34567 romneyj

      Posted

      Spot on. A 3+ 4 without reference to the T stage is not enough to go by.
  • Tybeeman
    Tybeeman rolf61809

    Posted

    Fusion prostate biopsy is very hard. The Mayo did mine and had to have 3 doctors in the room while preforming it.
  • romneyj
    romneyj rolf61809

    Posted

    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
      Tybeeman romneyj

      Posted

      RomneyJ if you dont have training. it is Hard same differance. My point was the same as yours it needs to be done by someone well trained
    • romneyj
      romneyj Tybeeman

      Posted

      Please accept my apologies Tybeeman, it was not intended as a rejection of your point, more that centres who are doing this will have trained people. One of the problems though that I think you were making is that the number of patients needing fusion biopsy puts a big pressure on a centre.
    • barney34567
      barney34567 romneyj

      Posted

      Agreed. Ideally one should go to a medical centre where the urologist you want only does fusion biopsies. Ideally transperennial. This is what I did.
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