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Methods of Biopsy - Uronav, Artemis, mpMRI ???

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Prostate Cancer
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Posted 8/17/2014 10:05 AM (GMT -5)
After my first biopsy came back negative 20/20 samples, my PSA has gone up to 17.6 even after taking Finasteride for months. I am sure my Urologist is going to recommend a 2nd biopsy. Rather than the blind trial and error method of finding the cancer, I want to increase my odds by getting a biopsy using new technology - a combined MRI and Ultrasound which helps more accurately target suspicious areas of the prostate. I am in the Sacramento, CA area. Do any of you know where they are using this procedure and was it successful in finding the cancer? Thank you!
Posted 8/17/2014 10:57 AM (GMT -5)
Pemberton1,

I had both a 3.0T mpMRI (multiparametric MRI) with and without contrast, and an ultrasound and neither showed any cancer. My urologist said that if a DRE is positive than the mpMRI should find the cancer, but my DREs were all negative. From what I gather if the cancer load is low many times the mpMRI and ultrasound will be inconclusive.

I do believe if there is a small tumor that is located in the prostate at a location that can't be felt then these modalities should detect it.
Posted 8/17/2014 11:06 AM (GMT -5)
Thank you LApilot. I appreciate your insight. This is all new and scary to me.

I am trying to locate the closest medical facility to me (Sacramento) which uses a combination of MRI and Untrasound during the biopsy.
Posted 8/17/2014 12:38 PM (GMT -5)
I think the mpMRI is a good idea too. I would think there would be several centers in the Sacramento area which do it. You might consider a transperineal biopsy also, if your urologist is willing to do it. This type of biopsy has excellent results in finding cancer due to the extensive sampling of the entire prostate.
Posted 8/17/2014 1:45 PM (GMT -5)
UCSf and UCLA both have MP-MRI and Duke Bahn in Ventura does color Doppler and is very good at finding hard to see cancers.
Posted 8/17/2014 5:44 PM (GMT -5)
Thank you John T., I'll look into insurance etc. tomorrow.
Posted 8/17/2014 6:26 PM (GMT -5)
UCSF is probably the closest. The gold standard is a transperineal saturation biopsy. You might want to have a PCA3 (urine) and PHI (blood) test to confirm suspicion before having more biopsies. PSA that jumps around like that is suspicious for prostatitis or urinary retention.

- Allen
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