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Journeys to Quality Prostate Care

Diagnosing prostate cancer is not easy, and men may undergo several procedures without moving closer to answers. We know that living with the unknown is stressful and frustrating.

Advanced Prostate Imaging at VCU Health has helped men through their journey towards answers and appropriate healthcare options. We help identify the presence of cancer and pinpoint tumor location to better target treatment.

Years to Find an Answer

Patient's DCE MR Perfusion scan with a (+) indicating a suspicious area.

After five transrectal ultrasound-guided (TRUS) biopsies and a persistent, elevated prostate specific antigen (PSA) level, a patient’s tumor remained unidentified.

This patient came to VCU Health in search of an answer. His recent PSA level was 72 ng/mL, significantly elevated above 10 ng/mL, which indicates more than a 50% chance prostate cancer is present.

Using multi-parametric prostate magnetic resonance imaging (MRI), the specially-trained radiologists at VCU Health pinpointed the tumor location to guide the next biopsy.

The radiologists used a Contrast Enhanced Imaging (DCE), or MR Perfusion, scan, which detected the increased blood flow to a tumor thus pinpointing its location. This image shows a patient's DCE MR Perfusion scan with a (+) indicating a suspicious area.

The patient had his answer and was able to move forward with an appropriate treatment plant. A MR image-guided biopsy was preformed where a Gleason score 7 tumor was located, and he successfully underwent a radical prostatectomy.

MR Guided Biopsy to Finds Anteriorly-located Tumor in Prostate

The extra precision of a biopsy performed during a MRI helps find tumors that are very small, anteriorly located or close to the urethra. A patient with a PSA level of 27 ng/mL and six negative TRUS biopsies came to VCU Health for a multi-parametric prostate MRI. The radiologist pinpointed the suspicious area in an anterior location of the prostate. Following the scan, an MR image-guided biopsy to the exact suspicious spot was successfully completed.

The DCE image on the left, below, shows the anterior area with increased blood flow (arrow).  The MR image on the right shows the needle being guided through the tumor (arrow). The tumor was a Gleason grade 9; and tumors graded 8 to 10 are classified as aggressive. Any further delay in a diagnosis for this kind of cancer would limit treatment options and outcomes.

Advanced Prostate Imaging Helps Determine Treatment

A 55-year old patient came to VCU Heath after three negative TRUS biopsies. An MR image-guided biopsy identified a Gleason grade 7 tumor. Initially, the patient’s urologist recommended a radical prostatectomy, which removes nerves that would impact the man’s quality of life.

 

During review of the results with the patient and his urologist, a different course of action was recommended. The urologist updated the treatment plan to a more reasonable, nerve-sparing surgical approach so the patient would retain his quality of life. The surgery successfully removed the tumor while preserving the patient’s quality of life.

In one study, 27% of surgical approaches were updated to more targeted procedures.

 


"My doctor sent me to VCU Medical Center because they were associated with the VA (Veterans Administration) system.  The staff was very helpful and friendly.  The information I received before helped me know what to expect.

It did not take long to get an appointment and parking was easy.  It was a very smooth and comfortable experience.  I am very happy that I went to VCU and found out for sure my prostate's problem."

Patient G.L. - Central Virginia