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University urologists have extensive training and experience with fusion biopsies, having collectively completed over 1,000 procedures to date.

When it comes to detecting the presence of prostate cancer, the gold standard is to perform a biopsy, which involves inserting a needle into the prostate and collecting tissue for analysis.

With the traditional approach, a urologist performs a “transrectal ultrasound guided biopsy” to take tissue samples. Samples are taken in a grid-like fashion over the surface of the prostate. The procedure is generally safe, effective at detecting cancer, and well tolerated by patients.

However, since 2016, UNC Urology has been an early adopter in North Carolina of an advanced technique called “MRI-ultrasound fusion-guided prostate biopsy,” in which the images from a specialized MRI are “fused” with the ultrasound used to guide the prostate biopsy. This enhances doctors’ ability to target areas of suspicion and find cancerous cells.

Fusion Biopsies: Seeing the Entire Picture

Patients undergoing the procedure have an MRI taken of their prostate in advance, and that image is overlaid with real-time ultrasound images during the biopsy. This allows the physician to use both images – overlaid as one combined image – to better determine from which specific areas to collect tissues, vs. taking samples in a standardized, grid-like pattern.

“Using the fusion biopsy technique gives us a much better ability to identify and sample areas of suspicion,” says Dr. Ray Tan, Director of Urologic Oncology, and Associate Professor of Urology at UNC.

“We can see what’s there, and navigate the process more effectively so there is less chance of missing cancer and possibly under-grading the cancer,” he explains. “By better understanding the severity of the cancer, physicians can treat it in the most appropriate and effective way possible.”

Expertise and Quality Control Lead to Enhanced Cancer Detection

UNC Urology also implements a quality assurance program with its radiologists to review cases, has a specialized protocol and 3T magnet as recommended by national professional organizations, and is part of a larger quality collaborative to continually improve the accuracy of fusion biopsies.

Dr. Tan adds that the procedure is especially helpful for situations in which definitive diagnosis has proven difficult, such as for men who have had negative previous biopsies, but whose PSA (Prostate Specific Antigen – a potential marker for cancer) continues to rise.

“While no one wants cancer, being able to have answers allows patients to move forward and get the treatment they need. It’s really exciting to provide our patients with the most advanced and accurate techniques available.”

Hung-Jui (Ray) Tan, MD, MSHPM
Directory of Urologic Oncology,
Urologic Oncology Fellowship Program Director
Associate Professor of Urology


If you or a loved one are interested in learning more about these procedures or related urologic topics, you may visit our website’s Patient Care section, or meet with a provider by contacting one of our UNC Urology clinic locations.

About Our Ahead of the Curve Series

Our “Ahead of the Curve” blog series covers the latest and most effective treatments and techniques in UNC Urology patient care. Urology is a complex and rapidly evolving field, with new advancements and breakthroughs constantly emerging. In this series, we will explore a range of topics related to urology patient care, including advanced surgical procedures, innovative diagnostic techniques, and innovative medical therapies. Our goal is to provide you with an overview of the excellence and innovation happening right here at UNC Urology.

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