cTRUS-ANNA 🇬🇧

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With the help of a neural network, ultrasound images of the prostate can be evaluated more accurately. This increases the probability of detecting prostate cancer and significantly reduces the number of prostate samples (biopsy) required.

Diagnosis of prostate carcinoma

  • If the PSA level or PSA dynamics are elevated or if there are abnormalities in the palpation examination, a prostate punch biopsy is indicated to rule out prostate cancer.

What is a punch biopsy?

  • In a punch biopsy, the doctor takes samples from the prostate under ultrasound control. This sample is usually taken through the rectum. The sample is taken under local anaesthetic.

Conventional prostate punch biopsy

  • In conventional prostate biopsies, random samples are taken from different areas of the prostate where prostate cancer usually occurs.
    This is followed by, usually 10-12 random punch biopsies. In so-called saturation biopsies, up to 40 samples are taken. However, due to the undirected procedure, there is a risk of missing smaller cancer foci.

What is ANNAcTRUS?

  • ANNAcTRUS is the computer-assisted analysis of ultrasound images of the prostate. The ultrasound is performed through the rectum (TRUS).

What is ANNAcTRUS good for?

  • Image analysis can be used to identify areas of the prostate that are suspected of having prostate cancer. This enables the doctor to take a specific sample (punch biopsy) from this area. When using ANNAcTRUS, the number of punch biopsies can be reduced to 6 cylinders through targeted sampling.

For whom is ANNAcTRUS suitable?

  • The ANNAcTRUS method has been tested in trials on patients who (despite suspected prostate cancer) had no evidence of prostate cancer in the undirected punch biopsy. In these patients, ANNAcTRUS was able to find a carcinoma in about 50% of cases. The method is therefore particularly suitable for patients in whom previous prostate punch biopsies could not detect any carcinoma. But ANNAcTRUS can also be used as a preventive measure. All prostate dance biopsies performed are stored in the system and are thus available for many years for comparison and exclusion diagnosis.

Are there other methods of targeted prostate dance biopsy?

  • Yes, for example, multiparametric MRI is offered in radiology. For this, a diagnostic MRT is first performed. If there are any abnormal findings, the prostate punch biopsy is performed in a second MRI session. ANNAcTRUS is considerably less time-consuming and can be performed directly by us, your treating urologist. In a direct comparative study carried out at the University Hospital of Bonn, ANNAcTRUS was superior to MRI in the detection rate of prostate cancer (“sensitivity”).

How is the investigation carried out?

  • The examination takes place in 2 steps, for which 2 visits to the doctor are required. At the first appointment the doctor will perform an ultrasound examination through the rectum (TRUS) and take pictures of the prostate. These images will then be sent for analysis and the doctor will receive the results a few days later. Based on the results, the doctor can then take specific samples from the prostate at a second appointment. The analysis of the samples takes about 5-7 working days.

Are the costs of the examination covered by health insurance?

  • ANNAcTRUS is an innovative examination procedure which is currently not part of the service catalogue of the statutory health insurance companies. Therefore the costs of the image analysis, currently 450 €, must be borne by the patient. In addition, the costs for medical activities amount to approximately 200 €. (German) Private health insurance companies usually cover the costs of ANNAcTRUS.

During his time at the DIAKO Flensburg, Mr. Grabski conducted a weekly prostate cancer consultation with a focus on cTRUS ANNA diagnostics. In 2011 he published his scientific work on this topic in the World Journal Urology: Computerized transrectal ultrasound of the prostate in a multicenter setup (C-TRUS-ANNA): detection auf cancer after multiple negative systematic random and in primary biopses (World J Urol 2011 Oct,29(5):573-9. doi: 10.1007/s00345-011-0713-0) 

Since January 2019, Mr Grabski has been offering this examination at the Uro-Praxis-Nord in Flensburg. Please make an appointment under 0461/3136687 or by e-mail.