Diagnosis and Staging Pathway for Men with Prostate Cancer

Avoids unnecessary treatment

Multi-Parametric MRI

is used to accurately target cancer areas 

Patient Selection is key to successful outcome!

Customized Diagnosis and Treatment Pathway for Prostate Cancer

For patients with elevated PSA.

  • Get 4k score to detect presence of aggressive cancer.

  • Get an MRI of the prostate in a 3T magnet with trained radiologist

  • Targeted biopsy of prostate cancer using state of art BK Fusion System 2017 technology 

  • Discussion on treatments, Surgery, Radiation, cyberknife, freezing and HIFU

For men with PSA less than 1

Men who have a PSA less than 1 after age 60 only have a 2% chance of getting prostate cancer so the risk is low. They need to get checked for PSA as per theirDr's recomnedation and neeed not worry too much for prostate cancer as long as the PSA remains less than 1.

For men with PSA over 3

Men with PSA higher than 3 ng/dl have a high risk of developing prostate cancer. This risk varies based on several factors including, level of PSA, family History of Prostate Cancer, Patient's age, race, weight, and other risk factors. For men with PSA greater then 3 there is a test called the 4k Score currently available. The 4k test uses data from serum PSA along with other PSA like proteins in the blood as well as clinical risk factors to calculate a percent risk of aggressive cancer for each individual patient. If the 4k score is under 7.5% the chances of metastasis over the next 20years is less than 2%. If the 4k Score is over 20% chances of developing metastasis over the next 20 years is close to having the risk of developing prostate cancer that will metastasize over the years is close to 20%. based on the 4k score, men can determine to get a biopsy or how aggressive they want to be with regards to getting diagnosed or treated for prostate cancer.  

Multiparametric MRI

In the past, when a patient was found to have a PSA that was elevated over 3, the conventional technique of biopsy was a trans rectal sextant bopsy where 6-12 cores of tissue was removed by random sampling of the prostate at the base, mid, and apex regions on the right and left side. More recently, multiparametric mri has been found to be sensitive and accurate in diagnosing aggressive cancer within the prostate. Patients who have an elevated PSA and a 4k score higher than 7.5% should get a multiparametric MRI, MPMRI will diagnosis whetehr the patient has aggresssive cancer  and also where it is located. This allows the physician to do targeted biopsy of only the areas that are normal, instead of biopsying the entire prostate. 

At our center, we have the most advanced fusion biopsy system that integrates MRI images into the ultrasound machine so that accurate targetted biopsies can be performed safely and with least likelylihood of complications and side effects. 

Prostate Biopsy

Transrectal Biopsy: 

Details that make the difference in accuracy

Transperineal MRI Fusion Biopsy - state of the art Predictive Fusion using BK technology for MRI Positive patients

Transrectal Office Biopsy for MRI Negative Patients

Less Side-Effects

Avoids unnecessary biopsies 

4K Score and Genomic studies for personalized predictive pathways