Multi-parametric MRI (mpMRI) represents a breakthrough in the diagnosis and management of prostate cancer with a sensitivity and specificity dramatically superior to TRUS [1-2-3].
Notwithstanding the accuracy of mpMRI,
prostate biopsy is still considered the gold standard for the histological characterization and clinical management of prostate cancer.
systematic TRUS guided biopsy is accepted as the technique of choice as it is friendly,
well-tolerated and inexpensive.
As it consists of a randomized sampling,
the major limit is represented by the possibility of missing clinically significant...
Methods and materials
For the present study a MyLabTwice ultrasound scanner (ESAOTE,
Italy) equipped with an EM tracking system and Virtual Navigation (VN) software was used (Fig 2).
The procedure was performed on 20 patients (average age 75) with an end-fire (3-9 MHz) transrectal probe with single use guiding system and a reusable tracking bracket for magnetic sensor (CIVCO,
USA) (Fig 3).
All the patients enrolled had a preliminary mpMRI or at least bi-parametric MRI performed within one month of the biopsy.
MRI images were loaded onto a...
The targeted TRUS guided biopsy with MRI-TRUS fusion using EM tracking system was introduced in the daily practice of our department without any significant change to the current procedure followed for systematic TRUS guided biopsy.
The time required for the TRUS-MRI co-registration was in all cases less than 5 minutes (with an average of 4 minutes).
The time required for each targeted biopsy was similar to the one necessary for the systematic sample,
thus demonstrating that the different visualization environment on the US monitor did...
Our feasibility study demonstrates that TRUS guided biopsy with MRI-TRUS fusion using an EM tracking system can be easily incorporated in the conventional procedure for systematic biopsies.
This result offers a valuable opportunity to all patients (both biopsy-naïve and not),
referred for a systematic prostatic biopsy,
whichalready performed a prostatic mpMRI.
no significant additional cost as regard time consumption and personnel requirement was generated.
As regard the cost of the equipment,
we should consider that the EM tracking systems are currently embedded in...
1) Lars Schimmöller,
Gerald Antoch and Michael Quentin.
MRI-Guided In-Bore Biopsy: Differences Between Prostate Cancer Detection and Localization in Primary and Secondary Biopsy Settings.
AJR January 2016; 206 (1):92-99
2) Murphy G,
The expanding role of MRI in prostate cancer.
AJR 2013; 201:1229–1238
3) Dickinson L,
Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection,localization,
and characterization: could standardization...