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To: i-node who wrote (32785)	10/3/2017 10:39:14 PM
From: w0z	2 Recommendations Recommended By FJB i-node Read Replies (2) \| Respond to of 39298

It does NOT make any sense...just as the USPSTF's recommendation that men not have PSA tests made no sense (now they're modifying that decision). If you have the MRI first, and nothing is indicated, there is no need for a biopsy. Furthermore the so-called fusion biopsy (using ultrasound by a urologist trying to align with a prior MRI by a radiologist) is less accurate than an in-tube MRI-guided biopsy. The latter allows real time MRI guidance to precisely target a few needles (typically 3 or 4) into a small lesion. In my case Dr. Busch hit my 0.55 cc lesion (in my 79 cc prostate) with 3 of 4 needles (i.e. 75% accuracy). What are the odds that a blind 12-needle biopsy would have hit that lesion which was 0.7% of my prostate volume? I had my initial MRI and follow-up guided biopsy the same day but I understand Dr. Busch no longer does that. I'm not sure why but it may have to do with scheduling...i.e. they may be booking MRI time which is unused if the guided biopsy is not needed. Now the follow up is done the next day. Just a word of advice...take charge of your diagnosis and insist on the MRI first. If your urologist won't give you an order for an MRI, your GP can do it. Beware that most urologists are trained that their "standard of care" is 12-needle biopsy for diagnosis and radical prostatectomy for treatment (the "If your only tool is a hammer everyone looks like a nail" syndrome). Both of these are outdated and indicate you need to find a different urologist (or radiologist) who is current with modern technology.