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Prostate cancer is the second most common cancer in men.

For this reason, the European and American Urological societies have established annual screening for every man after the age of 50, with PSA and examination by a urologist. Thus, any increased value or sudden increase in PSA should raise the suspicion of prostate cancer and subsequently be investigated by a urologist.

In recent years, three important developments have decisively changed the way prostate cancer is diagnosed:

A) Initially, the appearance of multiparametric magnetic resonance imaging of the prostate (mpMRI) in centers with experience and modern equipment allows for accurate detection of cancer in the gland. Besides, the guidelines of the European Urological Association (EAU) recommend that the specific imaging of the biopsy be performed first. One could say that the era when biopsies were performed simply with ultrasound guidance is gone forever.
B) The second revolution concerns the utilization of information from mpMRI, where special software is used to create a three-dimensional (3D) reconstruction of the prostate and the suspicious area. This technology performs a fusion (fusion) of the multiparametric magnetic resonance of the prostate and real-time ultrasound images during the biopsy. The result is the ability to target suspicious areas with extreme precision.
C) The most recent development in Greece is the application of prostate biopsy through the perineum (perineal biopsy). It is also a recommendation of the guidelines of the European Urological Association (EAU). Until recently, prostate biopsies were performed transrectally in most urological centers. However, a significant limitation of this method is the passage of the needle through the anus, which is teeming with microbes. In this way, the rates of infections (5-7%) and sepsis after biopsy increase significantly, as well as the need for readmission for hospitalization (1-3%). This fact, combined with the conditions of ever-increasing microbial resistance to existing antibiotics, makes it necessary to take biopsies through the perineum (perineal biopsy), which can be applied with antiseptic rules and therefore does not require the long-term intake of multiple antibiotics as was done until now.

Another important factor in favor of transperineal biopsy is the greater diagnostic accuracy of the method, as it is superior in the diagnosis of cancers of the anterior zone and apex of the prostate as well as clinically significant cancers, compared to transrectal biopsy. In addition, transperineal access reduces the likelihood of rectal bleeding, as the needle no longer injures the intestine.

Finally, in the case of a diagnosis of prostate cancer, the precise location of the lesion and its extent offers new possibilities for targeted treatment of the disease (targeted non-invasive therapy), which gives new possibilities in the treatment of cancer. These data make transperineal prostate biopsy the most appropriate method (gold standard) in the diagnosis of prostate cancer.

Athens Hospital consistently invests in technological developments, always remaining one step ahead even in prostate cancer, for the benefit of the Greek citizen.

Advances in prostate cancer diagnosis:

• Multiparametric prostate MRI (mpMRI)
• Fusion (fusion) of multiparametric prostate MRI images and real-time ultrasound images
• Simultaneous perineal prostate biopsy

Advantages of transperineal fusion prostate biopsy:

• Higher diagnostic accuracy
• Higher reliability
• Lower risk of infections/sepsis
• No risk of rectal bleeding
• Less need for readmission to the hospital
• Less need for antibiotics
• Possibility of targeted subsequent therapeutic options