ProstateBenign prostate enlargement Prostatitis Prostate carcinoma Prostate cyst

Prostate biopsy with the Artemis prostate fusion biopsy system

Targeted diagnostics for suspected prostate cancer

Prostate biopsy is a medical procedure for taking tissue samples from the prostate. It serves to reliably clarify whether a malignant tumour – a so-called prostate carcinoma – is present and makes it possible to determine the degree of malignancy. At the Goldstadt Private Clinic, a modern form of tissue sampling is used for diagnosis: the so-called MR fusion biopsy. This combines the image data of a multiparametric magnetic resonance imaging scan (mpMRI) with real-time ultrasound images. In this way, suspicious areas in the prostate can be targeted and tissue samples taken precisely.

This method is performed using the Artemis prostate fusion biopsy system – a robot-assisted 3D navigation system that further increases the accuracy of the biopsy. Compared with classic, untargeted biopsy, Artemis technology significantly improves the detection rate of clinically relevant tumours. Studies show that up to 90% of clinically significant prostate carcinomas are detected with this method – compared with around 60–65% with standard biopsy.

Advantages of the Artemis prostate fusion biopsy system

The classic prostate biopsy is still used as standard in many clinics. The tissue samples are usually taken systematically but untargeted – often without prior imaging. As a rule, 10 to 12 samples are taken, regardless of whether there are suspicious areas or not. MR fusion biopsy with the Artemis prostate fusion biopsy system represents a diagnostic milestone. It enables targeted, reproducible and hygienically safer tissue sampling. Depending on the MRI findings, up to 30 biopsy samples can be taken, precisely from the suspicious regions of the prostate. This higher number of samples not only improves the detection rate of clinically relevant tumours, but also provides a sound basis for individual treatment planning.

This form of examination is so far only available in a few specialised centres – including the Goldstadt Private Clinic. It offers significantly greater diagnostic certainty and corresponds to the current state of the urological guidelines.

When is a prostate biopsy recommended?

A prostate biopsy is recommended if certain findings are abnormal during the urological screening examination. These four diagnostic indications are regarded as medically relevant indications:

Finding and significance

Digital rectal palpation
Palpation of the prostate reveals a hardening or asymmetry.
Transrectal ultrasound
Ultrasound shows structural changes in the prostate, e.g. hypoechoic areas.
Elevated PSA value
The prostate-specific antigen value is above the normal range for the patient's age.
Multiparametric MRI
The MRI reveals suspicious regions that may indicate prostate carcinoma.
If one of these findings is present, a prostate biopsy is indicated according to the urological guidelines.

Which access route is chosen for the prostate biopsy?

There are two established access routes for taking tissue samples from the prostate: the transrectal route through the rectum and the transperineal route through the perineal area. Both methods are medically recognised, but differ in terms of hygiene, precision and risk of infection.

Comparison of access routes

Transrectal access
(access through the rectum)
Description:
The biopsy needle is guided to the prostate via the rectum.
Advantages:
Short puncture route, good ultrasound visualisation
Special features:
Higher risk of infection from intestinal bacteria
Transperineal access
(access through the perineal area)
Description:
The biopsy needle is inserted through the skin between the scrotum and the anus (perineum).
Advantages:
Lower risk of infection, more targeted control
Special features:
Longer puncture route, usually under short general anaesthesia

Why is the transperineal route preferred for the Artemis biopsy?

The Artemis system uses the transperineal route because it is more hygienic and allows more precise control of the biopsy needle. In combination with MR fusion imaging, suspicious areas can be targeted with millimetre precision – while at the same time reducing the risk of infections or complications.

At a glance:
Prostate biopsy with the Artemis prostate fusion biopsy system

Purpose of the examination
Clarification of suspected prostate cancer by histological analysis
Technique
MR fusion biopsy with robot-assisted 3D navigation (Artemis system)
Access route
Transperineal (via the perineal area)
Imaging
Combination of multiparametric MRI and real-time ultrasound
Anaesthesia
Short general anaesthesia
Hospital stay
Usually one day as an inpatient
Duration
approx. 30–45 minutes
Number of samples
up to 30 targeted biopsy samples (multiple biopsy)
Detection rate
up to 90% for clinically relevant prostate carcinomas
Risks
low risk of infection, rarely blood in the urine or temporary weakening of the urine stream
Aftercare
Take it easy for 1–2 days, urological follow-up recommended

Course of the prostate biopsy with the Artemis prostate fusion biopsy system

MR fusion biopsy with the Artemis prostate fusion biopsy system is performed in several steps.

Before the procedure, the image data from a multiparametric magnetic resonance imaging scan (mpMRI) are imported into the Artemis system. These show suspicious areas in the prostate that are to be examined in a targeted manner.

During the examination, the prostate is visualised by ultrasound. The Artemis prostate fusion biopsy system superimposes the live images on the MRI data and creates a three-dimensional model of the prostate. This allows suspicious regions to be localised with millimetre precision.

The biopsy needle is guided to the prostate via the perineal area (transperineally). The Artemis prostate fusion biopsy system guides the needle precisely to the suspicious areas. Depending on the findings, up to 30 targeted tissue samples can be taken.

The samples taken are examined histologically in a specialised laboratory. This determines whether a prostate carcinoma is present and how aggressive it is.

The result is available after a few days. On this basis – if the findings are positive – an individual treatment plan can be drawn up.

FAQ

An antibiotic is usually administered before the procedure to reduce the risk of infection. Depending on the clinic, a laxative suppository or a short period of fasting may also be recommended. Blood-thinning medication should be temporarily discontinued after consultation with the doctor.

The prostate is visualised by ultrasound and superimposed with MRI image data. The biopsy needle is guided to the prostate via the perineal area and navigated specifically to suspicious areas.

Tissue sampling is usually performed under short general anaesthesia. The procedure is well tolerated. When performed under anaesthesia, the biopsy is completely painless.

In the classic biopsy, 10 to 12 samples are usually taken. With the Artemis system, up to 30 targeted samples can be taken, depending on the MRI findings. This multiple biopsy increases diagnostic certainty and improves treatment planning.

MR fusion biopsy with the Artemis system takes about 30 to 45 minutes. Samples are usually taken during a one-day inpatient stay.

The histological examination of the samples taken is carried out in a specialised laboratory. As a rule, the result is available after a few days. In individual cases, it can take up to two weeks.

MR fusion biopsy with the Artemis system offers very high diagnostic certainty. Nevertheless, a repeat biopsy may be necessary in rare cases, especially if the suspicion of prostate carcinoma persists despite an unremarkable initial finding.

According to current scientific knowledge, there is no risk that a prostate biopsy will spread tumour cells or trigger a malignant tumour.

As with any medical procedure, side effects can also occur with a prostate biopsy. These include temporary bleeding, a weakened urine stream or – rarely – inflammation. However, the transperineal approach and the administration of an antibiotic significantly reduce the risk of infection.

After the procedure, physical exertion, sexual intercourse and cycling should be avoided for 24 to 48 hours. In the event of symptoms such as fever, pain or persistent bleeding, medical advice should be sought immediately.

In most cases, full resilience is restored after one to two days. Slight traces of blood in the urine or ejaculate are normal for a few days.

A repeat biopsy may be necessary if the PSA value continues to rise or new abnormalities appear on imaging – even if the first biopsy was unremarkable. In such cases, the Artemis system enables an exact re-biopsy at the same sites.

Private health insurance companies generally cover the costs of MR fusion biopsy. Patients with statutory health insurance have the option of treatment as self-payers. On request, the clinic will provide information in advance about the expected costs.

More information in the videos:

VIDEO

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Artemis MR fusion biopsy

A modern method for targeted prostate cancer diagnosis

In this video, you will learn everything important about MR fusion biopsy for suspected prostate carcinoma: when it is performed, how it works and what advantages it offers.

  • Definition: A special biopsy of the prostate in which MRI images are superimposed on the ultrasound image in order to take samples from suspicious areas in a targeted manner.
  • Indication: Suspected prostate cancer, often triggered by an elevated PSA value. Before the biopsy, a multiparametric MRI examination is carried out to identify the suspicious regions.
  • Procedure: The biopsy is navigated with a modern system (e.g. Artemis) – the MRI image serves as an exact template for ultrasound-guided sampling. The biopsy is performed via the perineal area, which significantly reduces the risk of infection.
  • Advantage: High hit rate in the suspicious areas, reliable diagnostics and precise allocation of the samples. Compared with cognitive ("estimated") biopsy, navigated MR fusion biopsy is significantly more accurate.
  • Special feature: Careful planning and navigation of the biopsy increases the accuracy of the histological examination and is therefore the recommended method when a prostate needle biopsy is necessary.

VIDEO

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Detecting prostate cancer better and earlier

Artemis MR fusion biopsy of the prostate

Everything important about MR fusion biopsy: how prostate cancer is specifically detected, when the examination is necessary and how it works.

  • Definition: Targeted removal of prostate tissue at suspicious sites using MRI imaging and ultrasound fusion.
  • Indication: Abnormal palpation findings, elevated PSA value, transrectal ultrasound findings or multiparametric MRI with a suspicious area
  • Preparation: Prophylactic antibiotics, analysis and marking of the MRI images and integration of the images into the Artemis fusion biopsy system
  • Procedure: The patient lies on their back while a transrectal ultrasound visualises the prostate. The MRI and ultrasound images are superimposed so that the system can target the suspicious areas with millimetre precision. The biopsy is performed precisely with robot-assisted 3D navigation, under local or general anaesthesia.
  • Advantages: Significantly higher detection rate compared with the classic, random needle biopsy. Even small tumours can be reliably detected, while the risk of tumour spread is minimal.
  • Goal: Safe, targeted diagnosis of prostate cancer with maximum precision.

VIDEO

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Prostate cancer: how the prostate biopsy works

Here you will find everything important about prostate biopsy: when it is necessary, how it works and what methods there are. Why is an MRI useful, which access routes are possible and what should patients bear in mind?

  • Taking tissue samples to clarify prostate cancer.
  • Recommended in the event of abnormal palpation findings, elevated PSA or abnormal MRI.
  • Methods: systematic multiple biopsy, MRI fusion biopsy or targeted biopsy of hardened areas.
  • Access routes: transrectal (through the anus) or transperineal (through the perineal area).
  • Procedure: Patient in the lithotomy position, ultrasound/MRI for orientation, removal of several samples.
  • The results help to plan therapy and surgery, e.g. nerve sparing, optimally.

VIDEO

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Inhalt dieses Videos:

What the PSA value means

An elevated PSA value causes uncertainty for many men. This video explains how the PSA value is produced, what an elevated PSA value can mean and when there is reason for further diagnostics.

  • Introduction: why the PSA value is so important
  • What is prostate-specific antigen (PSA)?
  • Free PSA, total PSA and PSA ratio explained
  • Age-adjusted normal PSA values & PSA density
  • Common sources of error: examination, sport, inflammation
  • Interpreting PSA fluctuations correctly
  • Which PSA trends are dangerous?
  • How often should the PSA value be checked?
  • PSA value and age: who benefits from screening?
  • Overdiagnosis vs. overtreatment – what is really true?

Special consultation for prostate needle biopsy

Take advantage of our special consultation for prostate needle biopsy.

You can find all information about the consultation at the following link:

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About this page:

Author

Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

About the author
Creation Date: 25.05.2022Modification date: 24.11.2025

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