MRI-US Fusion Target Management of Prostate Cancer in the Office Setting
Fernando J. Bianco, MD, Investigator-in-Chief for the Urological Research Network in Miami, Florida, discusses treatment of prostate cancer using MRI-ultrasound fusion biopsy in an office setting. Dr. Bianco remarks how the results of the PIVOT and ProtecT trials have shifted the emphasis away from radical prostatectomy to focal therapy. The next consideration has been whether the procedure could be done in an office setting if sedation or anesthesia were not needed. The development of a transperineal block allowed physicians to perform biopsy and treatment in-office under local anesthesia. Dr. Bianco then describes his technology, Focalyx® Fusion, which uses MRI-ultrasound fusion to diagnose, biopsy, and then treat using cryoablation. The combination of MRI and ultrasound fusion during treatment provide the physician with a clearer picture of the treatment in real-time. The technology utilizes programmed workflows to prioritize patients and also shares procedure results back to the patients via an app. He notes that patients show a drop in PSA, improved urinary function, and no major deterioration in rectal performance following the procedure. Dr. Bianco also discusses current research to determine whether prophylactic antibiotics before a transperineal prostate biopsy are necessary.
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