If there is an increased or significant increase in repeat PSA controls, this may be an indication for a biopsy (biopsy) of the prostate to detect prostate cancer as early as possible.
After a test phase in February 2017 and an approximately five-year preparatory phase, we can now offer our patients the further development of this technology from April 2017.
Technically-digital fusion biopsy is the superimposition of special magnetic resonance images of the prostate (mp-MRT-P) with the real-time transrectal ultrasound examination or biopsy of the prostate.
Carrying out a multiparametric MRI of the prostate in a center equipped for this purpose (the information from the magnetic resonance examination is prepared in three different ways) and finding a diagnosis and localization by a radiologist. The examination must be carried out in a strict axial alignment, since otherwise the subsequent fusion with the transrectal ultrasound is not possible.
In a complicated technical procedure, the contours of the prostate are drawn in the MRI images and the suspicious foci are marked by the radiologist.
The equipment with the BIO-JET system allows the fusion of the MRI images with the ultrasound and is the prerequisite that a technical-digital biopsy is also possible. In addition to the corresponding software, highly technical equipment is required.
In our practice, a high-end ultrasound device with two different transrectal ultrasound probes is available. Depending on the location of the focal point and the individual anatomy of the prostate, we have the opportunity to choose the best access route.
The patient lies supine with angled legs (lithotomy position). The transrectal transducer is attached to an arm that can be moved and fixed in all directions and inserted into the rectum.
After appropriate local anesthesia and possibly also corresponding sedoanalgesia, the prostate is scanned with the ultrasound and then the coverage is performed with the MRI images.
Each site of the prostate can then be specifically biopsied via a special transporter and each of these biopsies can be stored in an individual graphic 3D model of the prostate. This allows access to this documentation at any time and provides valuable information for subsequent therapies (surgery, radiotherapy, brachytherapy, active surveillance) or controls.
Depending on the individual circumstances of the patient, we are now able to biopsize the prostate via the perineal route in addition to the transrectal approach. This is especially important as it may almost completely exclude infection by germ transmission (especially with regard to the dramatic increase in antibiotic-multidrug-resistant gut germs).