DIAGNOSIS and predicted prognosis of prostate cancer may become more accurate according to the results of a large study into a new testing method. The study explored the effects of a combined biopsy method for diagnosis to decrease the incidence of overtreatment and undertreatment of the disease with the aim to ascertain the most favourable combination of diagnostic test.
Imaging, systematic biopsies are the primary diagnostic method for prostate cancer. This approach is nontargeted and can give rise to missed areas of cancer, causing clinicians to overtreat or undertreat patients if the diagnosis is not accurate. Crucially, the most aggressive cancers may go undertreated. In this new study, the systematic biopsy was used in combination with the MRI-targeted biopsy, a method which incorporates MRI and ultrasound. First developed over 10 years ago by a team led by co-authors of this recent study, this method has a greater ability to detect high-grade cancers.
The study included 2,103 men who underwent systematic biopsy, MRI-targeted biopsy, or systematic biopsy plus MRI-targeted biopsy. The researchers discovered that the combined method of systematic biopsy plus MRI-targeted biopsy resulted in 208 more cancer diagnoses than systematic biopsy alone. Furthermore, 458 changes in diagnosis, including some to a more aggressive cancer, were made because of the inclusion of MRI-targeted biopsy and based on histopathological analysis. The senior author Dr Peter Pinto, from the Urologic Oncology Branch in NCI’s Center for Cancer Research in Bethesda, Maryland, USA, said of the findings: “With the addition of MRI-targeted biopsy to systematic biopsy, we can now identify the most lethal cancers within the prostate earlier, providing patients the potential for better treatment before the cancers spread.”