Jelle Barentsz, MD, PhD

E. David Crawford, MD, Professor of Urology at the University of California, San Diego, discusses the usefulness of adjustable needle sizes for prostate biopsies with Jelle Barentsz, MD, PhD, Professor of Radiology at the Nijmegen Medical Center of Radboud University in Nijmegen, The Netherlands. Dr. Barentsz agrees with Dr. Crawford that a needle that can be adjusted from 10 to 60 gauge would be useful in situations such as when the smaller needle sometimes needed to reach an area is unable to pierce through fat to take the needed core sample. Drs. Barentsz and Crawford then address the pros and cons of mapping biopsy of the prostate: Dr. Barentsz contends that the use of 180 needles to obtain only slightly more accurate results than MRI may not be warranted, and Dr. Crawford notes that mapping biopsies are usually reserved for patients with negative MRIs and negative biopsies.

Jelle Barentsz, MD, PhD, Professor of Radiology at the Nijmegen Medical Center of Radboud University in Nijmegen, The Netherlands, discusses the ins and outs of diagnosing clinically significant prostate cancer (csPC) using mpMRI. He goes on to discuss how to improve the diagnostic accuracy of mpMRI, including optimizing image acquisition, use of training sessions to refine the radiologist’s expertise and interpretation of results, as well as how to reduce systematic and random error associated with MRI-directed biopsy.

Jelle Barentsz, MD, PhD, Professor of Radiology at the Nijmegen Medical Center of Radboud University in Nijmegen, The Netherlands, discusses the capacity of MRIs to predict extracapsular disease. He notes that this is not a perfect technology and it is not possible to predict with one hundred percent accuracy, but he emphasizes how it can be useful for staging. He also discusses when it is necessary to wait and how long to wait after a biopsy for a staging MRI. Lastly, he covers situations where it is not necessary to wait for an MRI.

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology, interviews Jelle Barentsz, MD, PhD, Professor of Radiology at the University in Nijmegen in the Netherlands, about prostate cancer suspicions and which metrics define prostate cancer risk. Dr. Barentsz discusses the steps that must be taken if there is a suspicion of prostate cancer and emphasizes the importance that MRIs and molecular markers play in this. He notes that in an optimal world with a perfect MRI a molecular marker test is often unnecessary, but that sometimes we do not have perfect MRIs, and in these cases, molecular marker tests like SelectMDX are good tests to use. However, MRIs offer more information about potential cancer and are also better at excluding more significant cancers than molecular marker tests. Dr. Crawford and Dr. Barentsz come to the conclusion that which is better or necessary often depends on the country the patient resides in.