A new state-of-the-art prostate diagnostic service involving multi-parametric MRI scans is now available at Bristol Urology Associates and South West Andrology.

Men with suspected prostate cancer could benefit from less invasive testing

Following a recent Internationally reputed study it has been revealed that men with suspected prostate cancer could benefit from less invasive testing. The PROMIS (Prostate MRI Imaging Study) found that up to a quarter of men could avoid undergoing an invasive biopsy if they had an MRI scan first. There are no signs and symptoms in early prostate cancer and currently there is no test to diagnose it.

A multi-parametric MRI (MpMRI) scan is able to create an incredibly detailed picture of the prostate and the tissue that surrounds it. This scan also helps to provide useful information about the size and location of any suspected tumours to enable more accurate targeting, doubling the detection rates of any aggressive cancers, if present.

Professor Raj Persad, Consultant Urologist at North Bristol Director of Bristol Urology Associates, said that,

“these findings mean that a group of patients will be able to have one simple, painless scan and avoid need for a biopsy while in others we will be able to better target biopsies in those who still require the procedure to diagnose prostate cancer.’ This is a major advance that goes hand in hand with all the other technologies we are developing to make cancer diagnosis and treatment more precise.”

Prof Persad continued,

“patients who may be suitable for an mpMRI scan usually have an elevated PSA or another cause for worry such as a strong family history of prostate cancer. They need to be referred to a Consultant Urologist, who specialises in fdetermining who needs an mpMRI and who doesn’t, as there is further clinical information needed before planning a scan”.

The MRI scanner we use in Bristol is a powerful and accurate one and appointments are available with no waiting list and rapid turnaround of scan results. These results will be interpreted by Prof Persad and his colleagues to determine the necessity of biopsies of the prostate and any follow-on treatment that may be necessary. Using this scanning technique we will be able to reduce the number of unnecessary prostate biopsies by up to 30%.

If the MRI shows an abnormality in the prostate this can be accurately targeted with safe and sophisticated transperineal (through the skin of the perineum) biopsies which produce less pain and less risk of sepsis and sexual dysfunction than traditional transrectal biopsies.

The traditional pathway was ‘blind’ biopsy of the prostate using transrectally guided prostate biopsy needles

Until the recent PROMIS trial in which Professor Persad was one of the main investigators, the standard pathway was ‘blind’ biopsy of the prostate using transrectally guided prostate biopsy needles, for anyone with an elevated PSA. This type of biopsy was recognised to cause a significant chance of pain, infection and intra-prostatic trauma and bleeding whilst being poor in accuracy in diagnosing the main index lesion. The greater trauma involved with type of biopsy can also cause marked sexual dysfunction. Now we are generally able to do less but more accurately placed biopsies. The consequence is less trauma and sexual dysfunction, more accuracy in diagnosis and the ability to avoid biopsy in a significant number of patients with unsuspicious MRI scans of the prostate.

For more information contact South West Andrology or Bristol Urology Associates 0117 980 4118