Commentary

Abstract

Interestingly all the 4 chosen article for tis edition of Highlights come from Clinical Radiology.

The first two are related.  Prostate cancer affects a large number of men in their senior years.  Multiparametric MR imaging along with trans rectal biopsy remains the standard of care in the management of these patients.  Because of the age of incidence a considerable number of these men also have cardiovascular disease for which they are taking either anticoagulation or anti platelet agents.  In addition there is an increasing trend of obtaining at least 8 if not more core at a TRUS biopsy.  This combination makes radiologists nervous when planning the biopsy and quite often the procedure is delayed while the patient stops the antiplatelet agents.  Not only does this delay care it increases cardiovascular morbidity as the therapeutic levels of these drugs bottom out.  In this context Chowdhury et al’s paper makes an important contribution.  They demonstrate that a 10 core TRUS biopsy carried out without stopping the anticoagulation or low dose aspirin imparts no additional risk to the patient.  This should be reassuring to the radiologists and the patients.