When it may help
- Suspicious MRI lesion requiring targeted tissue diagnosis
- Persistently concerning PSA despite a prior negative biopsy
- Confirmatory staging before active surveillance or focal therapy
Prostate cancer diagnosis
3D Mapping & Fusion Biopsy
Two complementary approaches to improve localization: MRI-ultrasound fusion targets visible lesions, while systematic transperineal mapping samples the gland in an organized spatial pattern.
Know where the cancer is.
MRI-targeted cores
Systematic gland sampling
Recorded three-dimensional locations
At a glance
Targeted plus systematic information
Fusion biopsy overlays previously acquired MRI targets onto real-time ultrasound, helping direct cores into suspicious regions. A mapping biopsy uses a transperineal grid or tracked locations to sample multiple regions and define spatial disease distribution.
Targeted and systematic sampling answer different questions. MRI can miss some clinically significant cancer; systematic cores may identify disease outside MRI-visible targets.
Fusion
Targets MRI lesions
Mapping
Defines distribution
Pathology
Determines grade
Wall Street Journal · March 31, 2009“The Man, the Gland, the Dilemmas”
The Journal’s diagnostic-feature article describes prostate mapping with the familiar “Battleship” analogy and includes Dr. Barqawi’s perspective on prostate screening.
Read the Wall Street Journal article ↗In the press
The “Battleship” mapping analogy
Systematic coordinates help the clinical team record where samples were taken and where cancer was found—turning biopsy results into a spatial map that can inform surveillance or treatment planning.
What it can add
- Better sampling of anterior and apical regions
- Documentation of cancer grade, volume and location
- A treatment map for selected focal-therapy planning
Risks and limits
- Blood in urine or semen, discomfort and temporary urinary retention
- Infection risk is generally lower transperineally but not zero
- No biopsy samples every cell; clinically significant cancer can still be missed
Interpreting results
A biopsy is a decision tool, not a treatment.
Pathology must be interpreted with PSA, prostate volume, MRI, examination, prior biopsy history and patient goals. For active surveillance or focal therapy, both targeted and systematic information may be important because upgrading can occur outside MRI-targeted regions.
Build the treatment decision on accurate staging.
The appropriate biopsy plan depends on MRI findings, prior biopsy, PSA history, gland size and the decision the biopsy needs to inform.
Contact the clinicGeneral education only. The exact biopsy approach and anesthesia plan are individualized.