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Larger urology groups have the potential for setting an example of how to successfully integrate multiparametric MRI fusion biopsies into practice. Groups that have started utilizing this tool already have many lessons learned and have recognized challenges.
Gary M. Kirsh, MD, provides insights into some of the challenges groups may face when implementing this diagnostic tool, one of which is economic. Kirsh suggests although patients must come first there is also an obligation to stay in business. With this in mind, there is often resistance to invest heavily in this technology and service without a guarantee of future reimbursement.
The second challenge Kirsh stresses is determining which patients should be receiving this type of biopsy. Richard Harris, MD, adds that multiparametric MRI fusion biopsies cannot necessarily be the first biopsy conducted in a patient. He notes that most insurance companies won't even pay for it. If they do pay, many will require at least 1, or even 2, negative standard biopsies before they will reimburse for this technology's use.
As the adoption process rolls out, Raoul S. Concepcion, MD, hopes that the larger groups can work collaboratively with industry and academic partners to answer some key clinical and implementation questions. Still, there are definite benefits to using MRI fusion. First, saturation biopsies are performed under an anesthetic; the multiparametric MRI biopsies are not. This reduces the invasiveness and the risk of toxicity for the patient. Thus, future adoption and use of this technology will need to balance consumer demand, reimbursement barriers, and practice protocols.