Historically, ultrasound (US)-guided biopsies defined the standard of care for prostate cancer diagnostics. Recent and emerging evidence, however, points to the critical limitations of conventional, or “blind” biopsies. Untargeted, US-guided biopsies have been shown to detect more insignificant disease and — even more alarmingly — overlook 46% of cases of high-grade disease.1
To promote earlier detection and better treatment outcomes, the American Urological Association (AUA) updated its biopsy guidelines in 2020, identifying multiparametric magnetic resonance imaging (mpMRI) biopsies as the gold standard for both at-risk biopsy naïve patients or patients who show increasing PSA levels following a negative biopsy.2
Despite the increase in MRI-US fusion utilization in recent years, many urologists continue to perform these procedures off-site, at hospitals or surgery centers, to avoid the challenges associated with in-house fusion.
Evaluating the Landscape: Current Challenges in Fusion Prostate Biopsy Workflows
While leveraging off-site MRI-US fusion allows practices to bypass capital equipment costs, moving care out of the office setting without necessity can significantly disrupt efficiency, quality of care and impact clinical outcomes. Despite the cost-savings, practices that perform fusion biopsies off-site often struggle with:
Difficulty scheduling patients. Physicians have very limited access to off-site fusion facilities — as little as one or two days each month. This creates a massive scheduling bottleneck that can delay critical diagnoses and cause patients to seek care from other providers, or can cause physicians to only do US-guided biopsies, which can compromise high-grade cancer detection.
Greater financial burden on patients. Receiving care at a hospital or surgery center, instead of in the office, multiplies the patient’s out-of-pocket expenses, in addition to the extra costs of traveling to a another site.
Lost revenue opportunities. Off-site fusion restricts practice reimbursements, as physicians can only bill the low-cost professional fee. Moving fusion in-house opens the door to revenue growth, as practices can also bill the US technical component, avoid lost revenues when patients cancel, and achieve with more billables per day than can be accomplished with off-site fusion.
Limited treatment surveillance. Keeping a close eye on a patient’s cancer risk and/or disease progression is crucial to driving positive outcomes. Providing in-house fusion for every patient puts your practice at the center of each patient’s care, allowing you to easily track changes over time and intervene early.
The Role of In-Office Fusion in Optimizing Outcomes and Reimbursement
Far and away, the largest hurdle to moving fusion biopsies in-house is affordability. To help close the cost gap, the Navigo 4D Fusion Navigation System offers a pay-per-procedure model that minimizes upfront equipment costs and helps practices quickly generate return on investment (ROI). This payment structure makes in-house fusion possible for many independent practices, helping countless physicians leverage cutting-edge fusion technology that:
Adapts to patient movement in real time, eliminating delays or the need for manual repositioning to align ultrasound with MRI.
Streamlines biopsy workflows, with an easy-to-use platform that empowers predictable patient scheduling.
Integrates into existing TP and TRUS systems, completely automating your processes without disruptions from ultrasound settings changes or manual marking of biopsies.
Maximizes practice billables, with exponential increases in fusion volume and higher relative value units (RVUs).
By lowering costs and delivering high-quality imaging in an optimized platform, Navigo stands apart as the only truly affordable MRI-US fusion biopsy system for the office setting. To learn more about the clinical and business advantages of in-house fusion, access the white paper here. Interested in learning more about Navigo? Schedule a demo to discover how affordable in-house fusion can benefit your urology practice and your patients.
Sources
Eklund M, Jäderling F, Discacciati A, et al. MRI-Targeted or Standard Biopsy in Prostate Cancer Screening. N Engl J Med. 2021;385(10):908-920.
Bjurlin MA, Carroll PR, Eggener S, et al. Update of the Standard Operating Procedure on the Use of Multiparametric Magnetic Resonance Imaging for the Diagnosis, Staging and Management of Prostate Cancer. J Urol. 2020;203(4):706-712.
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