Kiri Sandler1,
Charles Lynne2, Merce Jorda3, Alan Pollack1,
Radka Stoyanova1
1Department
of Radiation Oncology, University of Miami, Miami, FL, United States; 2Department
of Urology, University of Miami, Miami, FL, United States; 3Department
of Pathology, University of Miami, Miami, FL, United States
With a trend towards more conservative management of prostate cancer, it is vital to be able to identify those men on active surveillance with tumors that warrant conversion to treatment. We use functional MRI to identify suspicious lesions, and MRI-guided real-time ultrasound image fusion to target and biopsy them. Using this strategy, we identified a patient on active surveillance with Gleason 3+4 disease in the prostate apex which was not palpable by digital rectal exam, and had not been sampled with traditional transrectal ultrasound-guided biopsy.