What Are The Advantages And Disadvantages Of Having An Mri Scan Before A Biopsy
- It can give your doctor information about whether there is cancer inside your prostate, and how quickly any cancer is likely to grow.
- Its less likely than a biopsy to pick up a slow-growing cancer that probably wouldnt cause any problems in your lifetime.
- It can help your doctor decide if you need a biopsy if theres nothing unusual on the scans, this means youre unlikely to have prostate cancer that needs to be treated. You may be able to avoid having a biopsy, and its possible side effects.
- If you do need a biopsy, your doctor can use the scan images to decide which parts of the prostate to take samples from.
- If your biopsy finds cancer, you probably wont need another scan to check if it has spread, as the doctor can get this information from your first MRI scan.;This means you can start talking about suitable treatments as soon as you get your biopsy results.
- Being in the MRI machine can be unpleasant if you dont like closed or small spaces.
- Some men are given an injection of dye during the scan this can sometimes cause mild side effects.
Preparing For Your Ct Scan
A couple of hours before your scan you might need to stop eating and drinking. Tell;your doctor if this;is a problem for you:;for example, if you have diabetes.
You might have a drink or an injection of contrast medium, or both. Contrast medium is a dye that helps body tissues show up more clearly on the scan.
Before you have the contrast medium, the radiographer asks;if you have any medical conditions or allergies.;Some people are allergic to the dye.
They also check the results of your most;recent blood test. This is to make sure your kidneys are working well and;able to flush;the contrast medium out of your body. You’ll have a blood test before the scan if you haven’t had one recently.
The radiographer explains how to drink the contrast. You usually drink the liquid slowly for about an hour before the scan.
Some people feel claustrophobic or closed in when theyre having a scan. Tell the radiographers before your appointment if you think youre likely to feel this way. They can take extra care to make sure youre comfortable.
How Prostate Cancer Is Diagnosed
A diagnosis of;prostate cancer can involve screening tests such as a serum PSA or digital rectal exam, as well as procedures that can include MRI-TRUS fusion with targeted biopsy, or an ultrasound-guided random 12-core biopsy.
Based on biopsy findings, a Gleason score is used to describe the aggressiveness of the tumor.
Further tests, such as a CT scan, magnetic resonance imaging , bone scan, or PET scan may be done to stage the tumor. Since prostate cancers can differ in their tendency to grow or spread, staging is important in choosing the best treatments, determining the risk of recurrence, and estimating the prognosis of the disease.
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Preparing For Your Pet
For most PET-CT scans, you;need to stop eating;about 4 to 6 hours beforehand. You can usually drink water during this time. You might have instructions not to do any strenuous exercise for 24 hours before the scan.
Some people feel claustrophobic when theyre having a scan. Contact the department staff before your test if youre likely to feel like this. They can take extra care to make sure youre comfortable and that you understand whats going on.
Your doctor can arrange to give you medicine to help you relax, if needed.
Prostate Cancer Urine Test
This test detects the gene PCA3 in your urine and can also help your doctorbetter assess your prostate cancer risk.
PCA3 is a prostate-specific noncoding RNA. Its a gene thats only in yourprostate. If the gene is overexpressed , then theres a greater chance you have prostate cancer.
Like PSA and PHI tests, this isnt definitive, either. But data suggestthat when cancer is present, the PCA3 will be positive 80 percent of thetime. This test can also help your doctor determine whether a biopsy isnecessary.
Both of these new tests are more accurate than the PSA test. Your doctormay recommend one or more than one, based on the specifics of your case.
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What Else Should I Know About This Test
- Although a CT scan is sometimes described as a slice or a cross-section, no cutting is involved.
- The amount of radiation you get during a CT scan is a good deal more than that with a standard x-ray.
- People who are very overweight may have trouble fitting into the CT scanner.
- Be sure to tell your doctor if you have any allergies or are sensitive to iodine, seafood, or contrast dyes.
- Tell your doctor if you could be pregnant or are breastfeeding.
- CT scans can cost up to 10 times as much as a standard x-ray. You may want to be sure your health insurance will cover this test before you have it.
Our team is made up of doctors and;oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American College of Radiology/Radiological Society of North America.;Body CT/CAT scan. September 23, 2014. Accessed at www.radiologyinfo.org/en/info.cfm?pg=bodyct on November 13, 2015.
American College of Radiology/Radiological Society of North America.;Computed Tomography Abdomen and Pelvis. August 13, 2014. Accessed at www.radiologyinfo.org/en/info.cfm?pg=abdominct on November 13, 2015.
American College of Radiology/Radiological Society of North America. Computed Tomography landing page. Accessed at www.radiologyinfo.org/en/submenu.cfm?pg=ctScan on November 13, 2015.
Last Revised: November 30, 2015
How Is A Prostate Ultrasound Done
When you get to the facility for the test, an ultrasound technician may ask you to take off your clothes and change into a gown. Then, the technician will ask you to lie down on your back or side on an examination table and bend your knees.
To perform a transrectal ultrasound , the technician covers a small imaging tool called a transducer with ultrasound gel to help the tool broadcast good images. Then, the technician slowly inserts the transducer into your rectum and moves it around gently to get images of your prostate from various angles. For a biopsy, the technician will slowly insert a needle alongside the transducer into your prostate to remove the tissue.
Your rectum might feel like its swelling while the transducers inside, and the gel can feel damp and cold. Let the technician know if youre uncomfortable during the procedure. Your technician may use local anesthesia or a sedative to help you feel you more comfortable.
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When And Why Are Pet Scans Used For Prostate Cancer
- Staging: A PET Scan is used for patients with known prostate cancer in order to pinpoint its exact location and to determine the extent of disease and to determine a treatment strategy.
- Planning Treatment: In some instances, a PET scan may be used to specifically target certain high-risk areas for special treatment.; There are occasions when a PET scan is the only diagnostic test that can identify these otherwise hidden areas of cancer spread.
- Evaluation During and After Treatment: A PET Scan can be used during and after treatment of prostate cancer to determine the effectiveness or response of specific drugs and therapies.;
- Ongoing Cancer Care After Detection of Biochemically Recurrent Prostate Cancer Restaging:A PET scan allows physicians to locate and assess the extent of recurrent prostate cancer. Specifically, a new radiopharmaceutical called Axumin has a superior ability to detect recurrent prostate cancer, even in very early stages and in patients with low PSA levels.
A Negative Ct Scan For Prostate Cancer Isnt Anything To Get Too Hopeful About Because A Ct Scan Can Actually Miss Prostate Cancer
Yes, a CT scan can miss prostate cancer, says Jonathan W. Simons, MD, President and Chief Executive Officer of the Prostate Cancer Foundation, David H. Koch Chair.
Dr. Simons explains, A CT scan is fundamentally a three-dimensional X-ray of the body. It does not intrinsically distinguish between cancer and normal tissue.
We therefore rely on anatomical changes to tell us the probability something is normal or is cancer.
For example, if a lymph node is normal in size it still has the potential to have cancer in it.
However, if a lymph node is enlarged it has a much higher probability there is cancer present, although not guaranteed.
Any imaging modality cant identify microscopic disease, so a CT scan, MRI scan and PET scan can miss prostate cancer that may have spread.
The presence of prostate cancer can be indicated by an abnormally elevated PSA blood test result or by a digital rectal exam .
These tests do not diagnose a malignancy; they can only raise suspicion. Diagnosis is made only via a biopsy of tissue extracted from the prostate gland.
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What Are The Advantages Of Mri
Where MRI really excels is showing certain diseases that a CT scan cannot detect. Some cancers, such as prostate cancer, uterine cancer, and certain liver cancers, are pretty much invisible or very hard to detect on a CT scan. Metastases to the bone and brain also show up better on an MRI.
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How Is Prostate Cancer Treated
There are many treatment options for cancer limited to the prostate gland. You and your doctor should carefully consider each option. Weigh the benefits and risk as they relate to the aggressiveness and/or stage of the cancer as well as your age, overall health, and personal preferences. Standard treatments include:
- Surgery : The surgeon makes an incision in the lower abdomen or through the perineum and removes the prostate. If they cannot remove the entire tumor, you may need radiation therapy. You will need to keep a urinary catheter in place for several weeks after the procedure. Possible side effects can include incontinence and impotence. Some surgeons may use three small incisions to do robot-assisted prostatectomy. This may result in a shorter hospital stay and quicker recovery. This procedure may be preferable for some patients, but not for all.
- External beam therapy : a method for delivering a beam of high-energy x-rays or proton beams to the location of the tumor. The radiation beam is generated outside the patient and is targeted at the tumor site. These radiation beams can destroy the cancer cells, and conformal treatment plans allow the surrounding normal tissues to be spared. See the External Beam Therapy page;for more information.
- Active surveillance: No treatment, with careful observation and medical monitoring.
Advanced treatment options may avoid or minimize some of the side effects associated with standard therapies. These options include:
Why Is A Pet/ct Scan Better Than A Ct Scan
A PET/CT scan, meanwhile, does show if tissue is cancerous or not, and how active it is. This means you wont receive a false negative. Plus, you will avoid continuing treatment if it’s not actually needed. Weve had clients whod been told that they were cancer-free, based on a CT scan. But when they got a PET/CT scan, it showed a cancerous tumour that would have otherwise gone untreated.
Simply put, you cannot rely on a CT scan. See our PET/CT vs CT Comparison to learn more about how and why CT scans can fail cancer patients.
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Do Ct Pelvic Scans Detect Cancer
While pelvic CT scans can detect a variety of issues, they can be especially useful for detecting cancer. In particular, doctors can use this technology to look for tumors in this part of your body, but they can also use these scans to monitor the growth of tumors, to see how treatments are working, and to guide treatments.
Biopsy During Surgery To Treat Prostate Cancer
If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .
The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.
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Types Of Imaging Studies
If your doctor suspects your cancer might be spreading, they will likely order more imaging tests. A common imaging workup may include a;bone scan;and a;CT scan;of the abdomen and pelvis. An;MRI;might be done as well. Some research centers are also using magnetic MRIs or PET scans to further refine the staging of prostate cancer.
Prostate Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Prostate Cancer: Advancements In Screenings
Dr. Christian Paul Pavlovich
You may know thatprostate canceris one of the most common cancer types in men. The good news is that thereare many treatment and management options, even if the cancer is caught ata later stage.
What you may not know: There are several options when it comes toprostate cancer screening. After considering multiple factors, your doctor may recommend theprostate-specific antigen test, and/or one of the newer screeningtests that are now available.
Johns Hopkins urologistChristian Pavlovich, M.D., explains what you should know.
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How To Tell If Your Cancer Has Metastasized
Prostate cancer metastasis may be suspected if you have specific symptoms such as new lower back pain or elevated liver enzymes. These may be signs your cancer has spread to your spine or your liver, respectively. If your;prostate-specific antigen levels;continue to rise despite treatment, especially if they are rising particularly fast, this may be a sign that cancer is metastasizing somewhere in your body.
Psma Pet Scanning For Prostate Cancer Care
PSMA PET scans are now FDA-approved and ongoing studies continue to suggest that it will be an even more valuable imaging tool used for both staging and restaging prostate cancer in the near future. The specifics of PSMA will hopefully allow for even more accurate imaging and the earliest possible detection when performing PET scans for prostate cancer.
When Is A PSMA PET Scan Used For Prostate Cancer?
Now FDA approved, we are currently performing PSMA PET Scans at our facility for the following purposes.
- Staging: Patients with a first-time diagnosis of prostate cancer benefit from using a PSMA PET scan because of its superior ability to detect cancer spread offering the best possible future treatment options.;
- Restaging: Patients with suspected biochemically recurrent prostate cancer, meaning patients with elevated PSA levels after definitive therapy, benefit from using PSMA PET scans because of its ability to precisely locate recurrent prostate cancer and detect cancer spread. For both of these reasons, PSMA PET scans offer the best treatment options for recurrent prostate cancer.;
How Do PSMA PET Scans Work?
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Lymph Node Biopsy As A Separate Procedure
A lymph node biopsy is rarely done as a separate procedure. Its sometimes used when a radical prostatectomy isnt planned , but when its still important to know if the lymph nodes contain cancer.
Most often, this is done as a needle biopsy. To do this, the doctor uses an image to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.
How Accurate Is A Prostate Ultrasound
A prostate ultrasound is more accurate than an X-ray. This is because your technician can see the images as the transducer moves through your rectum rather than having to take a snapshot and develop the images. Ultrasound tests are also safer than X-rays because they dont produce any dangerous radiation.
A prostate ultrasound is also faster than a computed tomography test, which provides 3-D images of your prostate and the areas around it. CT scans require more preparation and time for testing, and they dont provide real-time images.
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A Note On Suspicious Results
A suspicious result indicates that the biopsy sample contained some abnormalities but no cancer was found. There are a couple of potential explanations for a suspicious prostate biopsy result, including:
- Prostatic intraepithelial neoplasia refers to changes within prostate cells that are abnormal, but not indicative of cancer. This condition is low-grade or high-grade, depending on how abnormal the cells are. Low-grade PIN is very common and isn’t associated with prostate cancer. High-grade PIN, however, is associated with a higher risk of prostate cancer. If you have high-grade PIN after a prostate biopsy, your doctor may recommend that biomarker tests be performed on the sample to learn more about the cells. Alternatively, another prostate biopsy may be suggested.
- Atypical small acinar proliferation indicates that the biopsy sample contains some cells that appear to be cancerous, but not enough to confirm the diagnosis. In most cases, this finding suggests that another prostate biopsy is needed.
- Proliferative inflammatory atrophy describes a prostate biopsy that reveals inflammation in the prostate and abnormally small prostate cells. While these cells arent cancerous, having PIA may be associated with an increased risk of developing prostate cancer.