Our Case Studies Speak for Themselves
Diagnosing prostate cancer is not easy. Men may have to undergo several procedures, all the while not knowing. Here are just a few of the cases where Advanced Prostate Imaging at VCU Medical Center have helped men to know, not guess if cancer was present, as well as pinpoint the tumors so treatment could be more targeted.
Finding the cancer after several years of guessing.
After five TRUS biopsies that did not locate any prostate tumors but with persistent elevation of PSA level since 2002, his most recent PSA level was 72 ng/ml. This man wanted to stop guessing and know for sure.
If a PSA level is great than 10 ng/ml, there is over a 50% chance that prostate cancer is present. Using the multiparametric prostate MRI, the specially trained abdominal radiologists at VCU Medical Center were able to pinpoint the location of the tumor to guide the next biopsy. You can see below the patient’s abnormal scan with a (+) indicating a suspicious area. The scan used was MR Perfusion, or Contrast Enhanced Imaging (DCE), that detected the increase blood flow to the tumor.
Once the MRI guided biopsy was preformed, it was found that he had a Gleason score 7 tumor. He then underwent a radical prostatectomy, and he is doing very well now.
MR guided biopsy to find a tumor in the prostate that is located anteriorly.
The extra precision of a biopsy performed during a MRI can help find tumors that may be very small, very anterior or close to the urethra. This man had a PSA level of 27, and six negative TRUS biopsies. The multiparametric MRI pinpointed the anterior area to be suspicious and it was decided to use MR guided biopsy to guide the needle to the exact spot.
The DCE image on the left shows the anterior area with increased blood flow (arrow). The MR image on the right shows the needle being guided through the tumor (arrow). For this man, the tumor was found to be a Gleason grade 9. Tumors graded 8 to 10 are aggressive tumors. Any delay in the diagnosis of this kind of cancer could lead to a bad outcome.
Advanced Prostate Imaging helped determine if a radical prostatectomy was needed.
A 55 year old man came to VCU Medical Center after three negative TRUS biopsies. The MR guided biospy was able to locate and confirm a tumor with a Gleason grade 7. The man’s urologist initally planned on a radical prostatectomy including removing the nerves which would impact his life quality greatly.
Studies have shown that after reviewing MR imaging, urologists can change the initial treatment plans. In one study, 27% of men were changed to a more reasonable surgical approach with majority of them to a nerve sparing procedure. For this paitent, after revieiwng the MRI, the urologist felt a nerve-sparing proceedure was the best course of treatment. He has kept his quality of life well after the surgery.
What are the men saying who have experienced Advanced Prostate MR Imaging at VCU Medical Center?
Patient A.H. - Central Virginia
Patient K.C. - Florida
Patient G.L. - Central Virginia