Imaging and advanced tissue sampling techniques could supplement or supersede conventional biopsies of the sensitive gland.
Credit: Imperial College London
Alternative strategies for imaging and sampling the prostate, including the use of magnetic resonance imaging and transperineal rather than transrectal biopsy, are starting to transform the diagnostic process. Many studies suggest that these approaches can help physicians to focus on serious disease and prevent unnecessary interventions.
The use of multiparametric MRI before a biopsy is now widespread in the United Kingdom, and is gaining momentum in the rest of Europe and in the United States. Ahmed estimates that among the hospitals in his subnetwork of the National Health Service , known as the West London NHS Trust, 40–45% of men are being spared biopsy thanks to a negative MRI.
Transperineal biopsy is becoming the standard for numerous urologists. Gorin routinely performs the procedure under local anaesthesia, and Ahmed oversaw a transition to the technique for hospitals across the West London NHS Trust in early 2017. But not everybody is adopting this strategy: Gorin estimates that only about 10% of US practitioners are using transperineal biopsy.
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