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Newly introduced technologies and diagnostic techniques are making it possible, both internationally and in South Africa, to improve the detection of prostate cancers, as well as for treatments to be better targeted.

This was pointed out by urologist and robotic surgeon Dr James Urry, who practises at Netcare Waterfall City Hospital in Midrand. Dr Urry was speaking after he and his team at the hospital recently completed a successful investigative biopsy procedure that was the first of its kind to have been undertaken at the hospital.

Sophisticated new software that combines ultrasound and magnetic resonance imaging (MRI) images, provided the team at the hospital with the means to guide their biopsy procedure, and improve their targeting of potentially cancerous areas of prostate tissue much more precisely.

"MRI ultrasound fusion guided biopsy, as the procedure is known, has been shown to be more effective in detecting high-risk prostate cancers at an earlier stage, when they are likely to be more responsive to treatment," notes Dr Urry, who has trained abroad in the new investigative procedure.

"The combined ultrasound and MRI images generate a three-dimensional image or 'visual map' of the prostate. This allows us to better visualise irregularities in the prostate tissue and to investigate whether they may be cancerous.

"The 3D view also provides us with improved visual real-time guidance during the biopsy procedure itself. This means that we can perform more targeted biopsy procedures and obtain better quality tissue samples for further testing," he explains.

Jacques du Plessis, managing director of the Netcare hospital division, describes MRI ultrasound fusion guided biopsy as “an important new advance in diagnostic technique for the detection and diagnosis of prostate cancer”. He congratulated Dr Urry, who is an accredited Da Vinci robotic surgeon, and his team for introducing it at the hospital.

"This fusion approach is not entirely new and is now commonly used in Europe and the United States due to the advantages it offers. In South Africa, it has been used previously on a fairly ad hoc basis, as few doctors have been familiar with, and trained in, the technique.

"Now, however, it is being offered as a standard investigative and diagnostic procedure for prostate cancer by Dr Urry and his team at Netcare Waterfall City Hospital. This is a positive development for our patients in the Gauteng region."

Dr Urry, who is in practise with urologist Dr Marius Conradie at Netcare Waterfall City Hospital, and has a special interest in minimally invasive urology, explains that when urologists suspect the presence of prostate cancer, or wish to investigate irregular prostate tissue, they may deem it necessary to obtain a tissue sample or biopsy for further investigation.

"Prostate biopsy procedures have previously been guided by means of ultrasound technology alone, and involved taking a number of random tissue samples from various places within the prostate gland.

"As the fusion-guided biopsy enables the biopsy needle to be guided directly to the suspected cancer lesion, fewer tissue samples are needed. This means that the new procedure tends to be safer with a lower risk of complications," concludes Dr Urry.