Multiparametric MRI-ultrasonography software fusion prostate biopsy: initial results using a stereotactic robotic-assisted transperineal prostate biopsy platform comparing systematic vs targeted biopsy

2020 ◽  
Vol 126 (5) ◽  
pp. 568-576 ◽  
Author(s):  
Alvin Y.M. Lee ◽  
Xin Yan Yang ◽  
Han Jie Lee ◽  
Yan Mee Law ◽  
Hong Hong Huang ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Multiparametric Mri ◽  
Targeted Biopsy ◽  
Robotic Assisted ◽  
Transperineal Prostate Biopsy ◽  
Initial Results ◽  
Software Fusion

scholarly journals MRI-Guided, Transperineal Prostate Biopsy Using Fixed Coordinate Needle Guide: Initial Feasibility Study

2019 ◽  
Author(s):  
Pankaj Kulkarni ◽  
Sumit Laha ◽  
Sakura Sikander ◽  
Pradipta Biswas ◽  
Heather Cornnell ◽  
...  
Keyword(s):  
Image Registration ◽  
Prostate Biopsy ◽  
Clinical Applications ◽  
Proof Of Concept ◽  
Procedure Time ◽  
3T Mri ◽  
Transperineal Prostate Biopsy ◽  
Guide System ◽  
Mri Guided ◽  
Initial Results

Most of the existing MRI guided robotic needle guide systems have been limited to research purposes and have not progressed towards clinical applications due to complex and bulky structures. The ‘device-to-image’ registration step further complicates the operation and significantly increases the overall procedure time. To address limitations, we developed an MRI guided transperineal prostate biopsy guide system that uses the concept of a ‘fixed coordinate device’ to simplify the overall biopsy procedure and eliminate the registration step, making the procedure more clinically friendly. We performed proof-of-concept targeting experiments using an agar phantom under 3T MRI. The targeting results were analyzed, and initial results prove that the simplified intervention concept would well be feasible. We plan to extend the study further to identify error components.

scholarly journals Assessment of the Performance of Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy against a Combined Targeted Plus Systematic Biopsy Approach Using 24-Core Transperineal Template Saturation Mapping Prostate Biopsy

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Francis Ting ◽  
Pim J. Van Leeuwen ◽  
James Thompson ◽  
Ron Shnier ◽  
Daniel Moses ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Subgroup Analysis ◽  
Detection Rate ◽  
Primary Outcome ◽  
Multiparametric Mri ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Detection Rates ◽  
Strategy Versus ◽  
Saturation Mapping

Objective.To compare the performance of multiparametric resonance imaging/ultrasound fusion targeted biopsy (MRI/US-TBx) to a combined biopsy strategy (MRI/US-TBx plus 24-core transperineal template saturation mapping biopsy (TTMB)).Methods.Between May 2012 and October 2015, all patients undergoing MRI/US-TBx at our institution were included for analysis. Patients underwent MRI/US-TBx of suspicious lesions detected on multiparametric MRI+/-simultaneous TTMB. Subgroup analysis was performed on patients undergoing simultaneous MRI/US-TBx + TTMB. Primary outcome was PCa detection. Significant PCa was defined as ≥Gleason score (GS)3+4=7PCa. McNemar’s test was used to compare detection rates between MRI/US-TBx and the combined biopsy strategy.Results.148 patients underwent MRI/US-TBx and 80 patients underwent MRI/US-TBx + TTMB. In the MRI/US-TBx versus combined biopsy strategy subgroup analysis (n=80), there were 55 PCa and 38 significant PCa. The detection rate for the combined biopsy strategy versus MRI/US-TBx for significant PCa was 49% versus 40% (p=0.02) and for insignificant PCa was 20% versus 10% (p=0.04), respectively. Eleven cases (14%) of significant PCa were detected exclusively on MRI/US-TBx and 7 cases (8.7%) of significant PCa were detected exclusively on TTMB.Conclusions.A combined biopsy approach (MRI/US-TBx + TTMB) detects more significant PCa than MRI/US-TBx alone; however, it will double the detection rate of insignificant PCa.

scholarly journals Repeated biopsy in the detection of prostate cancer: When and how many cores

2014 ◽  
Vol 86 (4) ◽  
pp. 311 ◽  
Author(s):  
Vincenzo Scattoni ◽  
Andrea Russo ◽  
Ettore Di Trapani ◽  
Umberto Capitanio ◽  
Giovanni La Croce ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
English Language ◽  
Transrectal Ultrasound ◽  
Targeted Biopsy ◽  
Negative Biopsy ◽  
Transperineal Prostate Biopsy ◽  
The Future ◽  
Critical Literature

Purpose: We performed an analysis of the literature about the optimal prostate biopsy (PBX) scheme in the repeated setting Methods: We performed a clinical and critical literature review by searching Medline Database from January 2005 up to January 2014. Electronic searches were limited to the English language. The keywords were: prostate cancer, prostate biopsy, transrectal ultrasound, transperineal prostate biopsy. Results: The recommended approach in repeated setting is still the extended scheme (EPBx) (12 cores). An approach with more than 12 cores according to the clinical characteristics of the patients may optimize cancer detection. Saturation PBx (> 20 cores) clearly improves cancer detection if clinical suspicion persists after previous negative biopsy. Nevertheless international guidelines do not strongly recommended SPBx in all situations of repeated setting. EPBx or SPBX may be, in the future, substituted by multiparametric MRI-targeted biopsies. Conclusions: Since the scenario in which a PBx is changing, the issue about the number and location of the cores in PBx is still a matter of debate in repeated setting. At present, EPBx are still the gold standard even if SPBx seems to be necessary in many cases. However, random PBx does not represent the approach of the future, but rather imaging targeted biopsy.

scholarly journals Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate: an original technique with a good cancer detection rate

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lei Wang ◽  
Xiaofei Wang ◽  
Wenfeng Zhao ◽  
Zichen Zhao ◽  
Zhihu Li ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Targeted Biopsy ◽  
Cognitive Fusion ◽  
Transperineal Prostate Biopsy ◽  
Surface Projection ◽  
Positive Rate ◽  
Clinically Significant

Abstract Background To report a new standardized cognitive fusion technique on transperineal targeted biopsy (TB) of prostate, and to evaluate its efficacy for cancer detection combined with systematic biopsy (SB) . Methods We present a retrospective review of consecutive patients undergoing multiparametric magnetic resonance (mpMRI) imaging of the prostate with subsequent transperineal prostate biopsy from January 2016 to December 2018. A free-hand 12-core SB was performed for each patient. PI-RADS 3–5 lesions were further targeted for biopsy with our TB technique. Firstly, a central point of suspicious lesion (B′) was registered cognitively on a transverse section of transrectal ultrasound (TRUS). Then, biopsy gun punctured vertically through a fixed pioneer site (A) on skin of perineum, and deep into the TRUS section to get A’. Next, targeted site (B), the surface-projection of B′, would be determined on skin of perineum by A and distance from B′ to A’. Finally, puncture through B to reach B′. Pathological findings of SB and TB were analyzed. Results A total of 126 patients underwent transperineal prostate biopsy (47 SB only, 79 SB + TB). The age of the patients was 68.7 ± 9.2 years. The median preoperative PSA value was 11.8 ng/mL. Preoperative prostate volume was 60.5 ± 50.0 mL. The numbers of patients with PI-RADS scores of 1 through 5 were 4, 43, 27, 21 and 31, respectively. The overall detection rate of cancer was 61/126 (48.4%), and it was significantly higher in the combination cohort (56/79, 70.9%) compared with the SB only cohort (5/47, 10.6%, p<0.001). When focused on the combination cohort, TB detected a similar overall rate of PCa (53/79, 67.1% vs 52/79, 65.8%; p = 0.87) compared with SB. The clinically significant PCa (csPC) detection rate was 52/79 (65.8%), while for TB and SB the csPC/PC rate was 51/53 (96.2%) and 48/52 (92.3%), respectively(p = 0.44). TB demonstrated a better sampling performance (positive rate for each core) compared with SB (51.0% vs 31.3%, p < 0.001). Conclusions Surface-projection-based transperineal cognitive fusion targeted biopsy of the prostate has a good efficacy in detecting PCa.

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