University Hospitals Urology Institute first in Cleveland to use new prostate cancer biopsy technique
CLEVELAND — The University Hospitals Urology Institute is the first in Northeast Ohio to utilize a new method in diagnosing prostate cancer. This new method allows urologists to perform a prostate biopsy with a reduced risk of introducing bacteria than the traditional transrectal ultrasound-guided method. This older method has been in use for the past 30 years.
The new technique is called the PrecisionPoint™ Transperineal Access System (PPTAS) in conjunction with MRI-guided fusion technology. The method optimizes cancer detection and can be used in an office setting under local anesthesia or sedation. It is the first-ever FDA-cleared device that allows free-handed transperineal biopsy of the prostate.
UH Urology Institute urologic oncologist Jonathan Shoag, MD, is the first physician in Greater Cleveland to use PrecisionPoint. “This new technique may be the future of prostate cancer diagnosis.” He said.
Dr. Shoag is involved with a randomized clinical study with the expectation of yielding the highest level of evidence to evaluate the disadvantages of transperineal MRI-targeted biopsy.
Historically, the diagnosis of prostate cancer is done by conducting a transrectal prostate biopsy. The transrectal approach continues to comprise 97 percent of all prostate biopsies performed today.
With the transrectal approach, the biopsy needle passes (at least 12 times) from the rectum, which hosts a slew of bacteria, into the sterile prostate. This repetition is why it is risky, and it introduces bacteria into the prostate. Antibiotics are given beforehand to prevent infection.
Approximately 1 million prostate biopsies are performed each year in the United States. This volume is expected to increase considering the greater adoption of active surveillance.
“With our transperineal biopsy technique, we also incorporate MRI-targeting, which has gained widespread acceptance due to evidence demonstrating its superiority in cancer detection. We believe that the transperineal MRI-targeted approach may improve prostate cancer detection in addition to reducing infections. This is because the transperineal MRI-targeted biopsy needle trajectory may improve sampling of the anterior, or front, prostate as compared to transrectal MRI-targeted biopsy, in which the biopsy needle travels from back to front,” said Dr. Shoag.
“This is particularly important in African-American men, who are more likely than white men to die of prostate cancer, and also more likely to have anterior prostate cancers. Earlier and better detection of these anterior tumors with transperineal MRI-targeted biopsy may catch these cancers earlier when they are curable,” he continued.