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Urology

We provide state-of-the-art surgical and nonsurgical diagnosis and treatment of the genitourinary system. Our urologists' combined experience, skill, and compassion enables us to give patients the highest quality urologic care.

MRI Fusion Prostate Biopsy

Today, most cancer is being found before a man turns age 70. With the help of the prostate specific antigen (PSA) blood test and the digital rectal exam (DRE), approximately 75 percent of prostate cancer is found within the gland.

In response to earlier detection, new paradigms are emerging in prostate cancer treatments that are less invasive and better at reducing side effects. There are also new programs designed to delay or avoid treatment altogether called “Active Surveillance” or “Watchful Waiting”.  Other new options focus on destroying only the known tumors while sparing the remaining healthy prostate tissue.

Due to the changing landscape, patients want and need clear, reliable information that will help them and their doctor make an accurate diagnosis and, if necessary, the right choice for treatment or management.  The most advanced and accurate way to perform a prostate biopsy is through the use of MRI fusion.  In the prostate, fusion merges previously captured prostate MRI images with live TRUS (transrectal ultrasound) images while the ultrasound transducer is inserted during the biopsy.  Not every patient needs MRI fusion for a biopsy, and a urologist can discuss with a patient whether he/she needs it.

What Is Navigo™?

Westmed was the first medical practice in the United States to purchase the Navigo™, a revolutionary device that allows physicians to image, plan, place and record prostate biopsy samples in high, 3-D resolution. Our team is considered a national leader in the use of the Navigo™ Fusion machine and trains other urologists in performing MRI Fusion biopsies.  With the Navigo™, we can now more confidently sample precise areas of the prostate and record biopsy locations for future reference.

Dr. Judd Boczko explains that the Navigo™ is the most advanced MRI fusion device and is better suited for today’s prostate cancer environment than any alternatives.  The Navigo™ serves as an add-on to a transrectal ultrasound for 3D prostate model rendering and automated biopsies registration (immune to a patient’s movements).  The Navigo™ allows the fusion of past and present biopsy procedures and, therefore, is a powerful tool for executing a follow-up biopsy in men undergoing active surveillance. It also allows accurate pinpoint localization of prostate cancer. Westmed is proud to offer this technology as part of the most complete active surveillance program available anywhere.

Navigo™ TRUS-MRI Fusion Software

Prostate fusion imaging is usually done in the urologist’s office to help identify the target area for the biopsy.  The radiologists, urologists and pathologists at Westmed work in collaboration and are specially trained to work as a team using the Navigo™ MRI fusion 3-D system and to read a prostate MRI and identify the area of interest.  Westmed urologists input the prostate outline into the computer to facilitate matching MRI and TRUS shapes.  Special fusion software that can recognize both types of images is necessary to assign “coordinates” to each type and match the images coordinate-by-coordinate.  This is called image registration or co-registration, and it overlays the live TRUS 3-D model onto the static MRI 3-D model.  The result is a 3-D image of the patient’s gland that combines previous data (such as MRI, previous biopsy, etc.) into the current, real-time prostate that is scanned.