New Prostate Biopsy Procedure Reduces Risk, Improves Accuracy

UC San Diego Health is the first health system in San Diego County to offer a new minimally invasive prostate biopsy procedure that reduces the risk of infection, improves imaging for accuracy and may increase cancer detection in a clinic setting.

Called a transperineal biopsy, the procedure is combined with 3D MRI fusion guided technology to highlight prostate cancer. It is the latest urological cancer diagnostic tool to be added to an extensive list of innovative resources used for diagnosing cancer at UC San Diego Health.

“Prostate cancer is one of the most diagnosed cancers in men worldwide,” said Juan Javier-DesLoges, MD, assistant professor of urology at University of California School of Medicine and urologic oncologist at UC San Diego Health. “The main driver for moving to transperineal biopsies is to reduce infection complications to almost zero. Also, we can now do the transperineal biopsy in the clinic under local anesthesia versus the operating room.”

Traditionally, a transrectal biopsy was the standard procedure to test for prostate cancer if a prostate-specific antigen blood test was elevated and/or a digital rectal exam was flagged.

During a transrectal biopsy, a physician passes the biopsy needle through the rectal lining to reach the prostate. A transperineal biopsy avoids the rectum and passes instead through the perineum, an area of skin between the base of the scrotum and the rectum. This is noteworthy because passing through the rectum increases the risk of introducing fecal material and bacteria into the prostate.

Patients who receive transrectal biopsies are prescribed antibiotics to lessen the approximate 1 to 2% chance of infection, according to the American Urological Association. Antibiotics are typically not needed or are limited for transperineal biopsies, however, because the infection rate is close to zero.

In addition, the 3D MRI fusion guided technology heightens the ability to pinpoint potential cancer in the prostate.

“We are able to merge the MRI findings with the ultrasound imaging to give us a three-dimensional look at the prostate,” said Aditya Bagrodia, MD, associate professor of urology at UC San Diego School of Medicine and urologic oncologist at UC San Diego Health. “That improves imaging accuracy and allows us to make sure we’re targeting any areas that are suspicious, including spots that are difficult to reach via transrectal approaches.”

According to the 2022-2023 U.S. News & World Report “Best Hospitals” survey, UC San Diego Health is ranked 20th for cancer, among the nation’s top 50 programs, out of more than 4,500 hospitals nationwide. Moores Cancer Center at UC San Diego Health is the only National Cancer Institute-designated Comprehensive Cancer Center in San Diego County, the highest possible rating for a U.S. cancer center. NCI recognizes centers around the country that meet rigorous standards for transdisciplinary, state-of-the-art research focused on developing new and better approaches to preventing, diagnosing, and treating cancer.

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