Advancements in Imaging Improve Prostate Cancer Detection

Soroush Rais-Bahrami, MD, right, and Jeffrey Nix, MD, study a patient's prostate image with the help of MRI/US Fusion Guided Prostate Biopsy.

Prostate cancer is the most common cancer among American men outside of skin cancers and is the most common solid organ malignancy in American men. UAB Hospital has developed a program for personalized prostate care and advanced state-of-the-art imaging tools that is helping doctors detect and fight this disease.

"Data varies, but about one in eight U.S. men will be diagnosed with prostate cancer in their lifetimes. That doesn't account for the men who may have harbored prostate cancer but never had it investigated or diagnosed. It is a common cancer," says Soroush Rais-Bahrami, MD, associate professor of Urology and Radiology at UAB and director of the UAB Program for Personalized Prostate Cancer Care. "By the time the prostate cancer shows symptoms, it may have achieved a higher aggressiveness and a higher stage of the disease.

"A prostate-specific antigen (PSA) blood screening test is an important tool that men should use to manage their health. Some sign of elevation may prompt a biopsy, as could a digital rectal exam where the physician may detect asymmetry of the prostate border, nodules, or a firmness of the prostate."

When a man receives a prostate cancer diagnosis at UAB, the team of medical personnel in the UAB Program for Personalized Prostate Cancer Care is ready to help. The center is comprised of experts who are focused only on prostate cancer and includes urologists, radiology colleagues and specialized pathologists. Radiation oncology and medical oncology team members are also involved in treatment planning.

"It was my goal, along with Dr. Jeffrey Nix, to bring together a group of people who have an interest in prostate cancer and caring for people with the disease. These people have helped us to achieve that goal in the past four to five years," Rais-Bahrami says. "This multi-disciplinary approach allows us to manage prostate cancer care from diagnosis to risk stratification to management and treatment decision making."

A large part of the center's success has resulted from the use of advanced imaging, specifically MRI/US Fusion Guided Prostate Biopsy, which combines magnetic resonance imaging (MRI) and ultrasound (US) technologies. UAB was the first facility in the Southeast that offered the MRI/US fusion biopsy technique, and Rais-Bahrami and Nix are two of only a select few urologists in the United States trained to use this technology.

"Unlike traditional imaging methods, MRI/US fusion offers a targeted biopsy that can focus on suspicious areas of the prostate. This screening technique is also able to detect prostate cancer much sooner and risk stratify more accurately, marking one of the most significant advances in prostate cancer detection in 30 years," Rais-Bahrami says.

The technology can help urologists precisely target the area of the prostate that needs to be biopsied, which ensures doctors that they are sampling the exact regions in the prostate where there is a concern for cancer. "Until now, prostate cancer was the only solid organ cancer that was tissue sampled, biopsied and diagnosed in a random way," Rais-Bahrami says. "Now that we have MRI, we see not only the anatomic differences in various areas of the gland but also functional differences in terms of tissue density and blood flow in all areas of the prostate."

Studies of the technique show that it increases the overall cancer detection rate, increases high-risk cancer detection, and improves staging for patients who are considering active surveillance to monitor low-risk prostate cancer for any changes.

"The MRI/US fusion is expected to help men who have a history of negative biopsies, but are still suspected of having cancer because of an unexplained elevated PSA level. It will also help patients with enlarged prostates and patients who are being guided toward active surveillance for improved staging," Rais-Bahrami says. "MRI/US fusion also allows us to look at a patient's anatomy and surrounding tissues that may be harboring prostate cancer within the prostate gland. This technology is already making a significant difference in prostate cancer care. It has shifted the paradigm from where we were, even a few years ago."

Rais-Bahrami and colleagues have published information about MRI/US fusion in a number of journals. Articles can be accessed through PubMed via Lister Hill Library. Article IDs: 30172834, 29988101, 29942727, 29770762, 29551676, 29526599, 29164056, 28976544, 28677001, 28238033, 28140460, 27574875, 27022486, 26523543


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UAB Program for Personalized Prostate Cancer Care; prostate cancer imaging; MRI/


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