News | February 06, 2014

3-D Mapping Biopsies Improve Prostate Cancer Detection

February 6, 2014 — Ultrasound-guided biopsies miss prostate cancers that are detected by the slightly more expensive and slightly more invasive 3-D mapping biopsies. A 2006 study compared ultrasound-guided biopsy of 180 men diagnosed with early stage prostate cancer to 3-D mapping biopsy. The study showed nearly a quarter of patients were upgraded to a more clinically significant stage of disease after 3-D mapping found pockets of cancer missed by the first technique. A University of Colorado Cancer Center study reports the locations of these most-missed pockets of prostate cancer.
 
"There are three major reason we perform these 3-D mapping biopsies in the clinic: First, a man may have rising PSA despite a series of negative biopsies and so want a more detailed opinion,” said . “Second, a man may prefer additional reassurance that watching and waiting rather than treatment is the best course of action Al Barqawi, M.D., investigator at the CU Cancer Center, associate professor at the CU School of Medicine and the paper's senior author. Third, a man may pursue focal therapy in which only the cancerous sections of the prostate are removed and so need accurate information on the position of his cancer." 
 
In a 3-D mapping biopsy technique, needle biopsies are taken 5mm apart across the x-, y- and z-axes of a three-dimensional grid through the prostate. Barqawi has performed over 600 of these procedures.
 
The current study enrolled 161 men with a mean age of 61.6 years who had been diagnosed with low-stage prostate cancer by ultrasound-guided biopsy. The study performed 3-D mapping biopsies at a mean 192 days after the first and compared the results. Overall, ultrasound-guided biopsy found an average of 1.38 cancerous zones per patient, whereas 3-D mapping biopsy found 3.33 per patient.
 
The follow-up findings from the 3-D mapping study resulted in upgrading the severity of many of these seemingly low-grade cancers. Specifically, after first biopsy, 7.5 percent of patients had been graded Gleason 7, the lowest grade at which treatment is considered "medium risk" and for which treatment is a reasonable option. After second biopsy, the percentage increased to 25. After first biopsy, no patients had been scored above Gleason 7, and after 3-D mapping biopsy, 4 percent were found to have Gleason 8, and 2 percent had Gleason 9.
 
"What we hoped to discover in this study is exactly where cancer is being missed by ultrasound-guided biopsy,” Barqawi said.
 
Of these 161 total cases, cancer was found in the left-mid section of the prostate 62 times after it had been missed by ultrasound-guided biopsy. Likewise, 3-D mapping found 62 unreported cancers in the right-mid section and 41 undetected cancers in the left-apex zone.
 
"This study adds to our knowledge about the interface and best uses of these two techniques. The cost and invasiveness of 3-D mapping biopsy make it inappropriate for screening,” Barqawi said, “but our message is that with the confirmation or strong suspicion of cancer, 3-D mapping biopsy offers a much more accurate assessment of the location, stage and risk.”
 
For more information: www.ucdenver.edu

Related Content

SpaceOAR Hydrogel Now Available in Japan
News | Patient Positioning Radiation Therapy | July 16, 2018
Augmenix K.K. announced that SpaceOAR hydrogel, a soft, implanted absorbable gel spacer is now available to all...
SNMMI Image of the Year Highlights Theranostic Approach for Advanced Prostate Cancer

IMAGE OF THE YEAR: PSMA PET before and after lutetium-177 PSMA617 theranostics in 8 patients with metastatic prostate cancer who exhausted standard therapeutic options.

68Ga-PSMA11 PET maximum intensity projection (MIP) images at baseline and 3 months after 177Lu-PSMA617 in 8 patients with PSA decline ≥ 98 percent in a prospective phase II study. Any disease with SUV over 3 is in red. Credit: Michael Hofman, John Violet, Shahneen Sandhu, Justin Ferdinandus, Amir Iravani, Grace Kong, Aravind Ravi Kumar, Tim Akhurst, Sue Ping Thang, Price Jackson, Mark Scalzo, Scott Williams and Rodney Hicks, Peter MacCallum Cancer Centre, Melbourne, Australia.

News | PET Imaging | June 29, 2018
In the battle against metastatic castrate-resistant prostate cancer, studies have demonstrated a high response rate to...
Technology | Focused Ultrasound Therapy | June 19, 2018
EDAP TMS SA has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Focal One device for...
New Prostate Cancer Radiotherapy Technique Aims to Preserve Sexual Function
News | Radiation Therapy | June 18, 2018
A multicenter clinical trial being led by UT Southwestern physicians is testing a technique for sparing nerve bundles...
Hitachi Medical Systems Europe Named Imaging Supplier for London Prostate Cancer Program
News | Prostate Cancer | June 14, 2018
Hitachi Medical Systems Europe has been awarded the contract to supply six ultrasound systems as part of the RAPID...
PET/CT Changes Care for 59 Percent of Suspected Recurrent Prostate Cancer Cases
News | Prostate Cancer | June 13, 2018
A recently presented investigational clinical trial evaluated the impact of 18F fluciclovine positron emission...
News | Brachytherapy Systems | June 07, 2018
IsoRay Inc. announced the upcoming release of its Build-Blu delivery system for real-time prostate brachytherapy.
New Studies Highlight MRI Use for Prostate Cancer Screening and Management
News | Magnetic Resonance Imaging (MRI) | May 21, 2018
Three new studies presented at the 113th annual meeting of the American Urological Association (AUA) highlight the...
News | Radiopharmaceuticals and Tracers | May 09, 2018
Blue Earth Diagnostics signed an exclusive, worldwide agreement with Scintomics GmbH, Germany, a specialist in...
USPSTF Updates Recommendations for Prostate Cancer Screening
News | Prostate Cancer | May 09, 2018
The U.S. Preventive Services Task Force (USPSTF) posted a final recommendation statement and evidence summaries on...
Overlay Init