PSA, MRI & targeted prostate biopsy

Interpreting a raised PSA

A PSA result needs context: earlier values, prostate size, urinary symptoms, infection, medication and family history can all matter. A repeat test or other assessment may be appropriate before a biopsy decision.

An MRI report describes the level of suspicion in identified areas. A negative or equivocal scan does not settle every clinical situation.

MRI fusion and micro-ultrasound

MRI–ultrasound fusion uses previously acquired MRI information to help target a biopsy during ultrasound guidance. ExactVu uses high-frequency micro-ultrasound, operating at 29 MHz, to provide real-time prostate imaging.

Dr. Sachin’s diagnostic work includes MRI-targeted and micro-ultrasound-guided biopsy. The imaging method and sampling plan are selected for the patient; targeted samples may be combined with additional sampling.

What the biopsy involves

Biopsy takes small tissue samples for examination by a pathologist. A transperineal biopsy reaches the prostate through the skin between the scrotum and anus. The anaesthesia and preparation are discussed beforehand.

Possible problems include bleeding, infection, discomfort and temporary difficulty passing urine. Tell the team about blood thinners, allergies, previous infections and earlier biopsy complications.

What happens when results are available

If cancer is identified, the grade and amount of involvement help determine whether more staging or treatment discussion is needed. A benign result is interpreted alongside the original level of suspicion and any further monitoring needed.

• Ask why a biopsy is recommended now.
• Clarify targeted and additional sampling.
• Obtain a written plan for medicines and preparation.
• Confirm when the results will be reviewed and who to contact after the procedure.

Common questions