Prostate MRI has become a revolutionary imaging test for the diagnosis and treatment planning of prostate cancer in Australia. Dr Pokorny assisted Dr Les Thompson with the first Australian trial comparing the use of MRI and MRI guided prostate biopsy to the conventional standard trans-rectal ultrasound guided random prostate biopsies for the detection of prostate cancer in men with a raised PSA. This study was a collaboration between the following institutions and researchers:
- Wesley Hospital urologists.
- Wesley Medical Imaging.
- Wesley and St Andrews Research Institute.
- Radboud University Radiologists, led by Prof Jelle Barentsz, Nijmegen, The Netherlands.
This study was published in 2014 in European Urology, the top Urology journal internationally. The findings of this study have revolutionized the way urologists approach the diagnosis and assessment of men with a suspicious or raised PSA. Since 2012 when the Wesley Hospital first started performing prostate MRI and MRI guided biopsy, several thousand men have undergone prostate imaging and MRI prostate biopsies. The use of prostate MRI has now become very common across Australia.
The Wesley Hospital, through the expertise of Wesley Medical Imaging, is now a reference centre for prostate MRI, reflecting the high quality of imaging, reporting, quality control and education that has been achieved by the expert radiologists, radiographers and urologists in this centre. Patients can be assured that their MRI investigations and reporting are of the highest standards and internationally renowned.
By performing an MRI of the prostate first before doing a biopsy in a man with a suspicious PSA test, it is possible to exclude men who have a normal MRI and therefore a very low risk of prostate cancer. Secondly, it is possible to identify small cancers or cancers in difficult locations that would not normally be accessible or targeted by standard trans-rectal ultrasound biopsy or even transperineal (through the skin behind the scrotum) biopsy. What this means for patients is that up to half of men seeing a urologist might not need a biopsy. Secondly, it is possible to avoid a diagnosis of small insignificant cancers that are detected by chance and cause anxiety for patients but pose no real threat to the patient’s life. Furthermore our study found that up to 17% more cancers are detected by MRI and MRI guided biopsy than traditional trans-rectal ultrasound pathway. This means that significant cancers, which might have been missed by standard biopsy techniques, are now seen from the outset and properly assessed. Dr Pokorny along with other urologists at the Wesley Hospital now uses MRI for all of his patients presenting with a raised PSA test. The information this gives us is indispensable in counselling men and their partners about their risks and what the next step should be in the investigation of such patients.