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Hirslanden Clinic performs MR image guided prostate biopsy

Best Practice
Porcellini, Beat, M.D. Zurich, Hirschlanden Clinic Switzerland

The Hirslanden Clinic (Zurich, Switzerland) is using the Philips Elite Prostate Clinical Solution for faster, more controlled prostate biopsy procedures. With a new biopsy device and DynaCAD for Prostate, MR image guided prostate biopsies are vastly simplified.

 Beat Porcellini, MD Hirslanden Clinic
Beat Porcellini, MD
Hirslanden Clinic

Elite Prostate Clinical Solution makes prostate biopsies easier and faster

The most common method for prostate biopsy involves a transrectal procedure with tactile finger guidance performed by a urologist or an ultrasound-guided process. Clinicians at the Hirslanden Clinic are using their Achieva 3.0T with the Elite Prostate solution to perform MR image guided biopsy in the prostate.

"With MR's excellent soft tissue contrast, we can clearly visualize where lesions are, and we can see how to angle and position the biopsy needle. That's the big advantage of MR image guided biopsy," says Beat Porcellini, MD, radiologist at Hirslanden Clinic.

He emphasizes that also ultrasound-guided biopsy is not comparable to the MR image guided method. "A large number of lesions cannot be detected by ultrasound and it may be difficult to reach the entire organ, whereas it is easy to make biopsies of every region using MR image guided biopsy."

MR image guided biopsies help discover more lesions

About 50% to 70% of the time a patient's first blind biopsy is negative, says Dr. Porcellini. "Maybe you can reduce that by taking more biopsy samples, but with 'blind' biopsies the problem remains that even with many samples, a lesion can be missed if none of the needles passes through it."

They have thus far performed MR image guided prostate biopsy on 19 patients referred by urologists who wanted a second, MR image guided biopsy after blind biopsy with negative results. "Out of these first 19 patients, seven have had positive MR image guided biopsy results," says Dr. Porcellini. "In other words, seven patients had a carcinoma that was missed by the previous blind biopsies. That is the dramatic part of MR image guided prostate biopsy: often still finding a lesion in patients who went home after a negative blind biopsy."

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Urologists and radiologists work together for patient outcomes

"In Switzerland's fee-for-service healthcare program urologists and radiologists earn more doing ten biopsies instead of two biopsies," says Dr. Porcellini. "But clinicians are beginning to understand that the way to a more efficient process and better diagnosis is with well-targeted MR image guided biopsy. Our outlook is to bring more patients to both urologists and radiologists by offering this method to their patients."

Hirslanden Clinic urologists are convinced of the need for MR image guided prostate biopsy. "But we also want to propagate and offer this method to other urologists in Zurich," Dr. Porcellini says. "I think the fact that we are getting more patients will be a factor in these referrals; urologists will profit, and consequently we as radiologists also. And, of course, the patients benefit the most. MR image guided biopsy helps us detect more prostate lesions at an earlier stage."

Dr. Porcellini hopes to expand the prostate program soon, bringing in a larger group of urologists and staff.

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Jul 9, 2010

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Best Practice
Achieva 3.0T
Release 2.5, Release 2.6
Quasar, Quasar Dual
biopsy, Body, Prostate, Spectroscopy

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