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UCLA Prostate Imaging and Treatment

UCLA Prostate Imaging and Treatment
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UCLA Prostate Imaging and Treatment

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  • Case Studies
    • Radiation Therapy
    • Small Volume Low Grade Disease
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    • Example of Change to Nerve Sparing
    • Extracapsular Extension and Seminal Vesicle Invasion
    • Dynamic Contrast-Enhancement for Biochemical Failure
    • MR-Guided Targeted Biopsy
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  • Clinical Trials
  • CME Course
  • Research Publications
  • Case Studies
  • Clinical Trials
  • CME Course
  • Research Publications
  • Radiation Therapy
  • Small Volume Low Grade Disease
  • Active Surveillance
  • Example of Change to Nerve Sparing
  • Extracapsular Extension and Seminal Vesicle Invasion
  • Dynamic Contrast-Enhancement for Biochemical Failure
  • MR-Guided Targeted Biopsy
  • Benign Disease (Infertility)
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  5. MR-Guided Targeted Biopsy

MR-Guided Targeted Biopsy

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History

  • 63 y/o, PSA 8.8 → 13.2 over 5 years
  • All systematic biopsies negative
  • Hypointense left anterior lesion with restricted diffusion is moderately suspicious, not in biopsy zone

Imaging

 

LEFT: Axial T2-weighted image: asymmetric anterior low signal
RIGHT: Apparent diffusion coefficient (ADC) map: focal restricted diffusion

 

Oblique Axial T2-weighted image
LEFT: Oblique Axial T2-weighted image from in-bore MR-guided targeting
Corresponding sagittal T2-weighted image
RIGHT: Corresponding sagittal T2-weighted image from in-bore MR-guided targeting

 

Results

  • Gleason grade 3+3=6/10
  • All biopsies over 5 mm and over 50% of core

Advantage: UCLA Prostate MRI

Suspicious findings on diagnostic multiparametric prostate MRI can be targeted for direct in-bore MRI-guided biopsy or MRI-ultrasound fusion targeted biopsy

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