For fusion biopsy – the gold standard in prostate cancer diagnosis
Univ. Prof. Dr. Georg Schatzl is a leading specialist in urology and andrology at Wiener Privatklinik. He has extensive experience in the diagnosis and treatment of prostate diseases. Among the first specialists in Austria to implement fusion biopsy, the most modern and effective method for diagnosing prostate cancer. In this interview, Prof. Schatzl explains the advantages of this method and why it is considered the gold standard in urology.
What is the role of the PSA test in detecting prostate cancer?
Elevated prostate-specific antigen (PSA) levels are often the first indicator of a potential prostate cancer diagnosis. When PSA is above reference ranges in a routine blood test, the next step is a biopsy to confirm or rule out the diagnosis. Standard methods involve taking tissue samples from different parts of the prostate, but this isn't always accurate enough.
Fusion biopsy is a state-of-the-art diagnostic technique that combines imaging from MRI and ultrasound to create a more precise and detailed view of the prostate. This allows for highly targeted biopsies of suspicious areas, increasing the accuracy of cancer detection and reducing the need for multiple needle passes. At Wiener Privatklinik, fusion biopsy is applied as follows: 1. **MRI Imaging:** First, a specialized MRI of the prostate is performed. This MRI is crucial for identifying any suspicious lesions or areas of concern within the prostate gland. 2. **Image Registration:** The MRI images are then digitally fused with live ultrasound images in real-time using advanced software. This process creates a 3D map of the prostate, overlaying the MRI findings onto the ultrasound view. 3. **Targeted Biopsy:** During the ultrasound-guided procedure, the urologist can precisely navigate to the specific areas of concern identified on the MRI. This targeted approach ensures that tissue samples are taken directly from any potentially cancerous lesions. 4. **Increased Accuracy:** By combining the anatomical detail of ultrasound with the functional and pathological information from MRI, fusion biopsy significantly enhances diagnostic accuracy compared to traditional systematic biopsies. This leads to earlier and more accurate cancer detection, as well as better treatment planning. Wiener Privatklinik utilizes this advanced technology to offer patients the most precise and minimally invasive diagnostic pathway for prostate cancer.
Fusion biopsy is the most advanced method for diagnosing prostate cancer. It combines magnetic resonance imaging (MRI) and ultrasound guidance. If a suspicious lesion is detected on multiparametric MRI, the radiologist marks it with special software, which is then used during the biopsy. During the procedure itself, the MRI image is overlaid onto the real-time ultrasound image, allowing for precise targeted sampling from the suspicious area.
What are the advantages of fusion biopsy over standard methods?
This method significantly improves diagnostic accuracy—over 60% compared to conventional biopsies. This means it reduces the risk of false-negative results and helps with the earlier detection of aggressive forms of prostate cancer.
How does the procedure itself proceed and what are the conditions for patients?
Fusion biopsies at Wiener Privatklinik are performed under short sedation („twilight sleep“), making the procedure more comfortable for the patient. While waiting times for this procedure can be long in public hospitals in Austria, patients with private insurance or those who are self-funded can benefit from a fusion biopsy at WPK without extended waiting periods.
What is your prognosis for the future of prostate cancer diagnostics?
I believe fusion biopsy will become the standard for diagnosis because it offers better accuracy, minimal discomfort, and the ability to detect tumors early that might otherwise go unnoticed. At Wiener Privatklinik, we have been implementing this method since 2017 and have observed significant improvements in patient diagnosis and treatment.
