MRI / TRUS fusion prostate biopsies – What to expect

When having a MRI/ultrasound fusion biopsy it will start with a prostate MRI. The initial MRI exam is done by a radiologist who will be looking for areas in the prostate containing cancerous cells. The ultrasound fusion biopsy can either be done on the same or following day , if no target is identified during the diagnostic MRI the following biopsy can be cancelled.

Prostate MRI

For a Prostate MRI the patient will be placed on the MRI table, a special device known as a coil will be isertedc into the rectum directly under the prostate. It is normal to feel some mild discomfort during the insertion but you should feel more comfortable during the exam. A balloon tip on the coil is used to hold the device in place.

The MRI specialist will be there on hand to ensure you are comfortable with the examination, images will be takedn of the prostate and its surrounding area. During the prostate MRI a special dye is used via IV near the end of the exam, after all images are obtained the coil balloon will be deflated and removed.

A Radiologist will then review the images and create a 3D image of the prostate with any lesions for cancer being marked on the images using a Uronav workstation, which will then be sent to the Urologist.

Fusion Biopsy

A Transrectal Ultrasound (TRUS) guided biopsy will be done by a urologist, during the biopsy they will annotate the MRI images marking areas with suspicion of cancer on their monitor. TRUS imaging isdone live and in real time, but MRI is not. The Urologist will use the previous MRI images that have been used. The Urologist compare the TRUS biopsy images against the MRI images.

The Week Before Your Biopsy

Please seek advice from your consultant regarding medication, do not take any asprin or asprtin like medication 7 days prior to your biopsy. Consult your GP or Urologist consultant if you are unsure.

The Day before your Biopsy 

Your consultant will prescribe you four 500mg tablets of Cipro and six 500mg tablets of Keflex. You should also purchase a Fleet enema to use the next morning. The night before your exam, take one tablet of Cipro before going to bed.

The Day of your Biopsy

On the morning of the exam take one tablet of Cipro and two tablets of Keflex and then another two tabletsof Keflex just before your biopsy procedure.

You may eat a light breakfast or lunch before the biopsy procedure, but limit the amount of liquids consumed (e.g. water, juice, coffee tea etc.).

An hour before your biopsy drink two glasses of water as a full bladder allows the urologist to see the prostate more clearly.

You will spend around 2 hours in our clinic and for your MRI you will be asked to remove any jewlery and metals

After your  procedure

You should then take the final dosage of antibiotics prescribed (Cipro and Keflex), there are no driving restrictions therefore you do not require anyone to drive you home.

Biopsy results are normally available after 2-3 days and can either be shared via phone or follow up appointment.