MRI-Guided Fusion Prostate Biopsy

The prostate is a small gland that surrounds the urethra. Its main role is to produce fluid that nourishes and protects sperm.

Prostate cancer develops when abnormal cells grow uncontrollably within the prostate.

In many men, the disease grows slowly and may not cause noticeable symptoms right away. In others, it can be more aggressive and spread beyond the gland.

Early prostate cancer often produces few or no symptoms. Detecting it relies heavily on screening tests such as the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE). If these tests suggest something abnormal, further evaluation is needed.

MRI-Guided Fusion Prostate Biopsy is available near Charlotte, NC and West Columbia, SC at Carolina Urology Partners.

In a biopsy, small tissue samples are taken from the prostate and examined under a microscope. A prostate biopsy is the definitive way to confirm or rule out cancer.

Traditionally, biopsies were performed in a systematic yet somewhat random manner, with multiple samples, or cores, taken throughout the gland. While this approach can find cancer, it may also miss areas of concern.

An MRI–guided fusion biopsy is a technique that can be used to improve accuracy.

MRI is a type of scan that uses powerful magnets and radio waves to create highly detailed images of the body’s internal structures. For the prostate, an MRI can show areas that look unusual or suspicious, which may not be visible with other tests.

Ultrasound, on the other hand, uses sound waves to create live images of the prostate during the procedure. It is quick, safe, and provides the doctor with real-time guidance as the biopsy is performed.

By fusing the precise MRI images with the live ultrasound picture, the doctor can see both the suspicious areas identified on MRI and the actual position of the biopsy needle at the same time. This enables the targeted sampling of specific prostate tissue, rather than relying only on random collection. The result is fewer unnecessary samples and a higher likelihood of detecting clinically significant cancer at an early stage.

A biopsy may be recommended if:

• Your PSA level is elevated or rising over time
• Your doctor feels an abnormality on a rectal exam
• Imaging shows suspicious regions in the prostate

With prostate cancer, getting an accurate diagnosis early is important. Through this combination of advanced imaging and precise sampling, MRI-ultrasound fusion biopsy helps provide clearer answers. It improves the detection of higher-grade cancers, which helps your doctor to formulate the best treatment plan or monitoring strategy.

The first step is to have a prostate MRI. A radiologist reviews the images and marks any areas that look suspicious.

During the biopsy, your doctor places a small ultrasound probe in the rectum. Software combines MRI and ultrasound images in real-time. Local anesthesia is used to keep you comfortable, and some patients may also receive light sedation.

There are two biopsy routes:

• Transperineal. The biopsy needle goes through the skin between the scrotum and anus into the prostate.
• Transrectal. The biopsy needle passes through the rectal wall into the prostate.

Guided by the fused images, your doctor collects tissue samples, called cores, from the suspicious areas. Additional samples may also be taken from other parts of the prostate to avoid missing hidden cancers. The samples are then sent to a pathology lab for review.

A pathologist examines the biopsy tissue under a microscope. If cancer is present, it is graded, which indicates how aggressive it looks. These results, along with PSA levels, exam findings, and MRI images, help your doctor recommend next steps.

Mild soreness and a small amount of blood in the urine, rectum, or semen are common for a few days. Serious complications are rare, but call your doctor if you develop fever, chills, or difficulty urinating.

• Better targeting. The MRI highlights areas most likely to contain cancer.
• Better detection. Fusion biopsy detects more aggressive cancers and fewer low-risk ones.

1. How long does the MRI-ultrasound fusion biopsy take?

The MRI scan is usually done ahead of time and takes about 30 to 45 minutes. The biopsy itself typically lasts 20 to 40 minutes, depending on how many samples are needed and the approach used.

2. Does the MRI-ultrasound fusion biopsy expose me to radiation?

No. MRI uses magnets and radio waves, while ultrasound uses sound waves. Neither exposes you to ionizing radiation.

All of our providers perform prostate biopsy.