‘Targeted’ biopsy could better identify aggressive prostate cancers

In collaboration with the Press Association
Prostate cancer cell

An experimental biopsy procedure appears to be more effective than the current tests in identifying ‘high-risk’ prostate cancers, according to a US clinical trial.

"This finding is an extremely interesting and exciting - although experimental - idea" - Professor Malcolm Mason, Cancer Research UK

If confirmed in larger studies, the results could lead to fewer men subsequently having more invasive tests that they may not need.

‘Targeted’ biopsies use a combination of ultrasound and MRI scans to try to ensure a more accurate sample, compared with the current biopsy method.

To test whether targeted biospies were indeed more effective, 1,003 men were enrolled in a clinical study at the National Cancer Institute at the National Institutes of Health in Bethesda, Maryland, between 2007 and 2014.

The men had already received results indicating prostate cancer via other preliminary tests - either high levels of prostate-specific antigen (PSA), or abnormal rectal examination results - often despite previous negative biopsies.

After undergoing an imaging procedure to highlight any suspected areas of prostate cancer, they were then offered both standard and targeted biopsy - allowing a comparison of both methods.

The research team, led by Dr Peter Pinto and Dr Minhaj Siddiqui, looked at the results from each technique individually and also in combination.

Both methods were comparable when identifying prostate cancer overall - 469 patients were identified by standard biopsy and 461 by targeted biopsy - and in two thirds of cases, both methods gave the same result.

But when detecting high-risk cancers, targeted biopsy identified 30 per cent more instances of aggressive tumours - 173 to 122 - than standard biopsy.

It also highlighted fewer low-risk cancers.

Cancer Research UK's prostate cancer expert Professor Malcolm Mason said the findings represent an exciting development in efforts to reduce the number of men who unnecessarily undergo invasive biopsies.

Professor Mason added: "The effectiveness of this procedure needs confirming in larger studies. But being able to distinguish aggressive prostate cancers from slow-growing harmless cancers is a key step to make sure that men don't have unnecessary invasive biopsies.

"This difference isn't something we can detect at the moment, so this finding is an extremely interesting and exciting - although experimental - idea.

"The next step for this work will be to test the combination in more people in a controlled clinical trial, to ensure that this would actually bring benefits to patients."

The study is published in the journal JAMA.


  • Siddiqui, M., et al. (2015). Comparison of MR/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer JAMA, 313 (4) DOI: 10.1001/jama.2014.17942