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Prostate Centre

Diagnosis

The San is NSW’s only accredited Prostate Imaging Centre of Excellence

The latest multi parametric MRI (MPMRI) techniques, now available at the San, have radically changed the way clinicians have traditionally approached prostate cancer diagnosis and intervention.

In 2015 San Radiology was awarded with Centre of Excellence accreditation in Prostate MRI by Radboud University Medical Centre (RUNMC), Nijmegen Holland, which is is a world leader in prostate imaging and research.

For our prostate patients, this accreditation means:

  • San Radiologists and technicians have been trained and accredited by the global leaders in prostate imaging
  • San Radiology’s technology, techniques and methodology is world’s best practice
  • For difficult cases we have the ability to seek second opinions and collaborate with the RUNMC Prostate MR Reference Centre team

Diagnostic Procedures

World class radiology equipment for prostate cancer diagnosis

San Radiology offers the new gold standard for prostate diagnosis and management with two new 3T mpMRI machines. Our prostate MRI radiologists and radiographers have been trained by Prof Jelle Barentz who is one of Europe’s leading Prostate MRI experts lecturing internationally on prostate cancer diagnosis.

A 3T mpMRI allows the specialist to see where the possible cancer is and direct the biopsy needle directly to that area. MRI provides accurate targeting for biopsy under either MRI or with fusion technology using ultrasound, and in comparison to a traditional ultrasound-guided biopsy, allows the specialist to see the needle going directly into the area that looks abnormal. This allows less biopsies – as little as two instead of 12 - and means a reduction in discomfort, bleeding and the risk of infection.

This targeted imaging guided biopsy has not been possible to date. mpMRI is a relatively new technique and this area of diagnosis and downstream guided biopsy and intervention options is developing at a fast pace. Like any imaging and intervention technique mpMRI quality is dependent on the quality of the equipment, the staff using the equipment and the training and experience of the radiologist interpreting the test. The latest MRI techniques provide a new pathway for prostate cancer diagnosis and intervention. Multi parametric MRI (mpMRI) is now able to provide anatomical information about the location and size of the tumour, and its likely aggressiveness.

Technology

  • Multi-parametric 3T MRI (mpMRI)
  • MRI in-bore guided biopsy 


Gallium 68 PSMA PET scans (Nuclear Medicine)

Gallium 68 PSMA (prostate specific membrane antigen) PET Scans are important in managing patients who have had prostate cancer in the early detection of recurrent disease to allow timely and appropriate therapy. Recently available Gallium 68 PSMA PET scans are able to detect prostate cancer relapses and metastases even at low PSA levels, and therefore help guide the most appropriate treatment for individual patients.
Visit their website for more information: www.northernnuclearmedicine.com.au

Urodynamics / Flow Studies

Urodynamics and flow studies are specific tests designed to obtain accurate information about bladder function, and help diagnose bladder and prostate problems. A low flow rate and incomplete emptying of the bladder often indicate a blockage, usually related to an enlarged prostate, and the need for further treatment. A flow study can also be used after treatment to check for improvement or monitor if blockages have recurred.

TRUS (Trans-rectal ultrasound) Biopsy

This technique allows surgeons to visualise the entire prostate gland with ultrasound waves. It provides information about the actual size of the prostate gland and indicating whether or not there are suspicious areas. Most importantly, the ultrasound is able to assist in focusing biopsies more accurately on areas that may be suspicious for cancer.

Transperineal Biopsy 

An alternative to the TRUS biopsy, a transperineal biopsy of the prostate is carried out through the skin between the scrotum and rectum, while imaging is obtained by an ultrasound probe passed into the rectum. The transperineal biopsy may be performed if the traditional TRUS biopsy has not idenitified the cause of an elevated PSA, and is sometimes a preferred option for men resistant to antibiotics or potentially carrying resistant bacteria, due to a much lower risk of infection.


Pathology

San Pathology (operated by Douglas Hanley Moir) has various collection centres, including one in the San Integrated Cancer Centre, as well as a very comprehensive laboratory located on site. Histopathologists are key members of the multidisciplinary team - they identify tumour types, size and staging to facilitate the best treatment.

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