Cleveland’s University Hospitals Urology Institute offers alternative prostate cancer biopsy technique

CLEVELAND — The University Hospitals Urology Institute is the first in Northeast Ohio to use a new technique to diagnose prostate cancer. The method allows the urologist to obtain a prostate biopsy with a much lower risk of introducing bacteria than the traditional transrectal ultrasound guided method which has been used for the past 30 years.

The new technique is called the PrecisionPoint™ Transperineal Access System (PPTAS) in conjunction with MRI guided fusion technology.  It optimizes cancer detection and can be used in an office setting under local anesthesia or with sedation. It is the first FDA-cleared device allowing free-handed transperineal biopsy of the prostate. 

UH Urology Institute urologic oncologist Jonathan Shoag, MD, is the first physician in Greater Cleveland to use PrecisionPoint. He said, “This new technique may be the future of prostate cancer diagnosis.” Dr. Shoag is involved with a randomized clinical study to yield the highest level of evidence to evaluate the tradeoffs of transperineal MRI-targeted biopsy.

About 1 million prostate biopsies are performed annually in the United States, and this volume is expected to increase due to greater adoption of active surveillance, that is, close monitoring of the cancer.

Historically, prostate cancer is diagnosed with a transrectal prostate biopsy. The transrectal approach continues to comprise 97 percent of all prostate biopsies performed. With the transrectal approach, the biopsy needle passes (at least 12 times) from the rectum, which hosts bacteria, into the sterile prostate. Antibiotics are given beforehand to prevent infection. However, due to increasing bacterial resistance, the risk of infection is increasing, with current rates approaching 7 percent. These infections may require hospitalization. The transperineal procedure goes through the skin between the scrotum and the rectum for the prostate biopsy, greatly minimizing the risk of infection.

“With our transperineal biopsy technique, we also incorporate MRI-targeting, which has gained widespread acceptance due to evidence demonstrating its superiority in cancer detection,” said Dr. Shoag. “We believe that the transperineal MRI-targeted approach may improve prostate cancer detection in addition to reducing infections. This is because the transperineal MRI-targeted biopsy needle trajectory may improve sampling of the anterior, or front, prostate as compared to transrectal MRI-targeted biopsy, in which the biopsy needle travels from back to front.“

“This is particularly important in African-American men, who are more likely than white men to die of prostate cancer, and also more likely to have anterior prostate cancers. Earlier and better detection of these anterior tumors with transperineal MRI-targeted biopsy may catch these cancers earlier when they are curable.”

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About University Hospitals / Cleveland, Ohio Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Oxford University and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children’s Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women’s Hospital, Ohio’s only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with a total research portfolio exceeding $265 million and more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.