Michael A. Gorin, MD, presented “Transperineal Fusion Biopsy” during the 26th Annual Southwest Prostate Cancer Symposium conference on April 13, 2023, in Scottsdale, Arizona.
How to cite: Gorin, Michael A. “Transperineal Fusion Biopsy.” April 13, 2023. Accessed Jul 2024. https://grandroundsinurology.com/transperineal-fusion-biopsy/
Transperineal Fusion Biopsy – Summary
Michael A. Gorin, MD, discusses transperineal fusion biopsy as a viable alternative to transrectal prostate biopsy and its complications. He emphasizes the gravity of the risk of infection, given the large number of prostate biopsies performed.
Dr. Gorin then displays American Urological Association (AUA) recommendations for infection avoidance, highlighting the strategy of transperineal biopsy. He explains that the European Association of Urology (EAU) recommends transperineal biopsy as the first choice for infection avoidance, citing data from a meta-analysis that show a decrease in complications with transperineal biopsies versus transrectal biopsies by more than half.
Further, he shares data showing improved detection of anterior tumors with transperineal biopsy and explains the positioning of the biopsy cores in transperineal biopsy is superior to that of transrectal biopsy. Dr. Gorin shares further data illustrating improved cancer detection with transperineal biopsy before turning to methods of performing transperineal prostate biopsy.
Dr. Gorin addresses magnetic resonance imaging (MRI) targeting, explaining that as of 2020, the AUA endorses the use of pre-biopsy MRI. He displays data showing improved cancer detection with MRI-targeted biopsy and addresses cognitive fusion and explains that a lack of mapping cores is a drawback but explains that today, there are many options for transperineal MRI/transrectal ultrasound (TRUS) fusion prostate biopsy that include grid, mini-grid, and freehand elements.
Dr. Gorin concludes that transrectal prostate biopsy carries a significant risk of infectious complications and transperineal prostate biopsy reduces these risks and can be performed under local anesthesia. Additionally, multiple systems are available to perform transperineal prostate biopsy with TRUS/MRI fusion.
About the 26th Annual Southwest Prostate Cancer Symposium:
This conference educated attendees about advances in the management of localized and advanced prostate cancer, with a focus on imaging, technology, and training in the related devices. It included a scientific session, as well as live demonstrations of surgical techniques. You can learn more about the conference here.
ABOUT THE AUTHOR
Dr. Gorin is an Associate Professor of Urology in the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai. Dr. Gorin attended college at the University of Michigan, earning a Bachelor of Science in Cellular and Molecular Biology. He then attended medical school at the University of Miami Leonard M. Miller School of Medicine, where he graduated as an inductee to the Alpha Omega Alpha Honor Medical Society. Following medical school, Dr. Gorin completed a general surgery internship, urology residency, and fellowship in endoscopic and minimally invasive urology at the James Buchanan Brady Urological Institute at Johns Hopkins University School of Medicine.
Dr. Gorin is an internationally recognized expert on the use of molecular imaging techniques in the diagnosis and management of urologic malignancies. He is also widely recognized for his work developing novel methods for performing MRI-guided transperineal prostate biopsy and focal ablative treatments for prostate cancer. As a fellowship-trained endourologist, Dr. Gorin’s clinical practice primarily focuses on caring for patients with kidney stones, lower urinary tract symptoms, and prostate cancer.
Dr. Gorin has published over 300 articles in peer-reviewed journals with collaborators from around the world. Additionally, he has contributed to multiple medical textbooks, including chapters in Campbell-Walsh-Wein Urology, The 5-Minute Urology Consult, and Gray’s Anatomy. In July 2022, Dr. Gorin was selected to serve as Editor-in-Chief of BJUI Compass, the open-access companion journal to the BJU International. Dr. Gorin also serves on the editorial boards of several other journals, including UROLOGY (the Gold Journal), Urologic Oncology: Seminars and Original Investigations, and the World Journal of Urology. Dr. Gorin has received numerous honors and awards for his scholarly work, including the Drs. Carl and Barbara Alving Endowed Award for Outstanding Biomedical Research from the University of Miami Miller School of Medicine and the William F. Rienhoff, Jr., M.D. Scholar Award from Johns Hopkins University School of Medicine.
