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With prostate cancer Australia’s most commonly diagnosed men’s cancer,1 a biopsy of the prostate is the only way to confirm a diagnosis,2 and can be performed either via the transrectal (TR) or transperineal (TP) pathway.

The increasing rate of TR-biopsy related sepsis3,4 escalating antibiotic resistance5 and potential for underdiagnosis6 has fuelled the global conversation around the shift away from TR and towards TP.

Utilising the TP pathway has been demonstrated to minimise risk of infection,7 as the needle does not need to pass through the rectum.

Furthermore, TR biopsy (TRB) offers limited access to the anterior prostate, and may result in missed or underdiagnosed disease. Accessing the prostate via the perineum enables sampling of the entire gland, including the anterior prostate, optimising cancer detection.6,8,9

As of November 1, 2020, the Medicare Benefits Scheme (MBS) item numbers for transrectal and transperineal prostate biopsy were updated, with differing levels of renumeration. The changes encourage transperineal biopsy as the standard of care and recommends patients are informed of the potential risks and alternative methods to transrectal biopsy, ensuring they can make a suitable decision for their circumstances. Visit MBS Online for more information.

Although TP biopsy (TPB) has traditionally required general anaesthetic, the PrecisionPoint™ transperineal access system enables free-hand prostate biopsy to be performed under local anaesthetic in a clinical setting.6 This helps to reduce theatre waiting lists, which is particularly crucial in the current COVID-19 environment.

PrecisionPoint™

Watch the below video to find out more about free-hand transperineal prostate biopsy using PrecisionPoint™:

The introduction of Transperineal Access Systems such as PrecisionPoint has helped to drive TRexit – the switch from TRB to TPB – in hospitals around the world.10

Of note is the South East London Cancer Alliance TRexit initiative spearheaded by Mr Rick Popert, Consultant Urologist, Guy’s and St Thomas’ Hospital. Improved access to comprehensive training and resources has enabled the six hospitals comprising the Alliance to cease all TRB and successfully transition to TPB under local anaesthetic.10 The initiative has since gained the backing of more than 120 hospitals, Prostate Cancer UK and the British Association of Urological Nurses (BAUN).

Recognising the global movement towards transperineal biopsy as the standard of care in prostate biopsy, BXTAccelyon is the sole distributor of PrecisionPoint for Australia and New Zealand (ANZ).

PrecisionPoint™ has also just received the 2020 MedTech Breakthrough Award for ‘Best New Technology Solution - Biopsy’.

Resources

BXTAccelyon facilitates regular PrecisionPoint™ training workshops via webinar and will soon resume face-to-face training courses.

For more information on 2021 workshops, please contact Nicola Leavold, Commercial Director, Australasia on 0409 458 852 or
Nicola.Leavold@bxt-accelyon.com.

MRI-PRO

With high-level evidence11 now confirming prostate magnetic resonance imaging (MRI)’s place in the diagnostic process of prostate cancer detection internationally, demand for healthcare professionals experienced in interpreting and accurate reporting of MRI scans is skyrocketing. Gaining the experience that is required for accurate interpretation of prostate MRI is essential, but is difficult to obtain without the availability of immediate histological feedback.

BXTAccelyon has a global agreement with MRI PRO, the new, online self-learning tool for prostate MRI diagnostics, designed and developed by a team of specialist MRI radiologists and urologists.

Watch the MRI PRO prostate MRI training course tutorial

Watch the MRI PRO Prostate Imaging Masterclass webinar from USANZ’s 2020 (virtual) Annual Scientific Meeting in April

As the sole PrecisionPoint distributor outside of North America and through their partnership with MRI PRO, BXTAccelyon is committed to facilitating effective prostate cancer diagnosis.

If you have any questions or would like to find out more about PrecisionPoint or MRI PRO, please contact Nicola Leavold, Commercial Director, Australasia on 0409 458 852 or Nicola.Leavold@bxt-accelyon.com or visit www.bxt-accelyon.com.


References

  1. Australian Government Cancer Australia. Prostate cancer: Prostate cancer in Australia statistics. 2020 [June 2020]; Available from: https://prostate-cancer.canceraustralia.gov.au/statistics.
  2. Prostate Cancer Foundation of Australia. How is advanced prostate cancer diagnosed? 2020 [June 2020]; Available from: https://www.prostate.org.au/awareness/for-recently-diagnosed-men-and-their-families/advanced-prostate-cancer/diagnosis/how-is-advanced-prostate-cancer-diagnosed/.
  3. Borghesi, M., et al., Complications after systematic, random, and image-guided prostate biopsy. European urology, 2017. 71(3): p. 353-365. https://www.europeanurology.com/article/S0302-2838(16)30471-7/fulltext#section-a8e3cf85-9a4f-4bb2-bf45-4b7cef04bc50
  4. Tamhankar, A.S., et al., The clinical and financial implications of a decade of prostate biopsies in the NHS: analysis of Hospital Episode Statistics data 2008-2019. BJU Int, 2020. 126(1): p. 133-141. https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bju.15062
  5. Grummet, J.P., et al., Sepsis and ‘superbugs’: should we favour the transperineal over the transrectal approach for prostate biopsy? BJU international, 2014. 114(3): p. 384-388. https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/bju.12536
  6. Kum, F., et al., Initial outcomes of local anaesthetic freehand transperineal prostate biopsies in the outpatient setting. BJU Int, 2020. 125(2): p. 244-252. https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/bju.14620?af=R
  7. Brown, M. and P. Viswambaram Prostate biopsy: a change of approach. MJA InSight, 2020. https://insightplus.mja.com.au/2020/29/prostate-biopsy-a-change-of-approach/
  8. DiBianco, J.M., J.K. Mullins, and M. Allaway, Ultrasound Guided, Freehand Transperineal Prostate Biopsy: An Alternative to the Transrectal Approach. Urology Practice, 2016. 3(2): p. 134-140. https://www.auajournals.org/doi/10.1016/j.urpr.2015.05.007
  9. Meyer, A.R., et al., Initial Experience Performing In-office Ultrasound-guided Transperineal Prostate Biopsy Under Local Anesthesia Using the PrecisionPoint Transperineal Access System. Urology, 2018. 115: p. 8-13. https://www.goldjournal.net/article/S0090-4295(18)30070-0/fulltext
  10. Grummet, J., et al., "TREXIT 2020": why the time to abandon transrectal prostate biopsy starts now. Prostate Cancer Prostatic Dis, 2020. 23(1): p. 62-65. https://www.nature.com/articles/s41391-020-0204-8
  11. Thompson, L.C. and M.R. Pokorny, Multiparametric MRI in the diagnosis of prostate cancer - a generational change. Aust Fam Physician, 2015. 44(8): p. 597-602. https://www.racgp.org.au/afp/2015/august/multiparametric-mri-in-the-diagnosis-of-prostate-cancer-%E2%80%93-a-generational-change/

PrecisionPoint™ is entered in the ARTG, ARTG ID: 298093. BXTACCELYON AUSTRALIA PTY LIMITED. ABN 55 165 390 241. Level 16, Tower 2 Darling Park, 201 Sussex Street, Sydney, NSW 2000.