Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

  • 1
    Keywords: CANCER ; tumor ; MODEL ; THERAPY ; DIAGNOSIS ; MRI ; magnetic resonance imaging ; PERFORMANCE ; EXPERIENCE ; prostate cancer ; FUSION ; BIOPSY ; GUIDANCE ; three-dimensional imaging ; GUIDED BIOPSY ; MAPPING BIOPSY ; TRUS
    Abstract: Background. A key challenge for prostate cancer (PC) therapy is to exactly diagnose tumor lesions. In this context we describe a new stereotactic prostate biopsy system, which integrates pre-interventional MRI with peri-interventional ultrasound for targeted perineal prostate biopsies. Furthermore, the novel system allows exact documentation of biopsies in three dimensions. Patients and methods. Stereotactic biopsy was performed in 50 consecutive men with suspicion of PC [median age 67 years (42-77), mean PSA 8.9 +/- 6.8 ng/ml, and mean prostate volume 51 +/- 23.7 ml]. Twenty-five of these patients (50%) had already had a negative transrectal ultrasound (TRUS)-guided biopsy. All men underwent multiparametric, contrast-enhanced 3T MRI without endorectal coil. Suspicious lesions were marked before the obtained data were transferred to a novel stereotactic biopsy system. Using a custom-made biplane TRUS probe mounted on a stepper, 3-D ultrasound data were generated and fused with the MRI. As a result, suspicious MRI lesions were superimposed onto the TRUS data. Next, 3-D biopsy planning was performed including systematic biopsies from the peripheral zone of the prostate. According to local standards patients were treated with perioperative quinolone antibiotics and applied a rectal enema the evening before the procedure. Perineal biopsies were taken under live US imaging, and the location of each biopsy was documented in an individual 3-D model. Feasibility, safety, target registration error, and cancer detection were evaluated. Results. The median number of biopsies taken per patient was 24 (12-36). In 27 men of the initial cohort of 50 consecutive patients presented here, biopsy samples showed PC (54%). In patients undergoing their first biopsy, cancerous lesions were diagnosed in 13 of 19 patients (68%). The result was positive in 36% of men undergoing a re-biopsy without previous cancer diagnosis (9/25). A positive correlation between MRI findings and histopathology was found in 72%. In MRI lesions marked as highly suspicious, the tumor detection rate was 100% (13/13). Looking at single cores from highly suspicious lesions, 40 of 75 (53%) biopsies were positive. The target registration error of the first 1,159 biopsy cores was 1.7 mm. Regarding adverse effects, one patient experienced urinary retention and one patient a perineal hematoma. Urinary tract infections did not occur. Conclusion. Perineal stereotactic prostate biopsies guided by the combination of MRI and ultrasound allow effective examination of suspicious MRI lesions. Each biopsy core taken is documented accurately for its location in 3-D enabling MRI validation and tailored treatment planning. The morbidity of the procedure was minimal
    Type of Publication: Journal article published
    PubMed ID: 21935634
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    Abstract: Abstract Purpose: To determine the targeting error of a novel stereotactic prostate biopsy system that integrates preinterventional MRI with peri-interventional ultrasonography (US) for perineal navigated prostate biopsies. Materials and Methods: We performed stereotactic biopsies on five prostate phantoms (one CIRS 053-MM and four CIRS 066). Phantom 053-MM incorporates three MRI- and transrectal ultrasonography (TRUS)-visible lesions, while lesions within phantom 066 are only detectable on MRI. In both phantoms, the 0.5 cc volume lesions are placed randomly. The phantoms were examined by 3T-MRI preinterventionally. Then three stereotactic biopsies from one lesion in phantom 053-MM and from all US-invisible lesions in the 066 phantoms were taken under live-fusion imaging guidance. During intervention, a mix of blue ink and gadobutrol was injected into each biopsy channel. Afterward, another 3T-MRI was obtained. These MRI images were then fused again with the intraoperative TRUS data. Thus, the targeting error (TE) between the planned and performed biopsy cores could be measured. In addition, the procedural targeting error (PTE) between the virtually planned biopsy trajectory and the manually registered three-dimensional needle position of every single biopsy core taken was calculated. Results: The overall TE of the 39 biopsy cores taken was 0.83 mm (standard deviation [SD]: 0.48 mm) with the highest TE in the sagittal plane (1.09+/-0.54 mm), followed by the coronal (0.72+/-0.43 mm) and axial (0.69+/-0.34 mm) planes. The procedural TE, which is provided intraoperatively, was 0.26 mm on average (SD: 0.46 mm). Comparing PTE and TE, there was no statistically significant difference (P=0.39). Conclusion: The TE of stereotactic biopsies using our novel perineal prostate biopsy system is below 1 mm and can be estimated in vivo by the automatically calculated procedural TE. Thus, stereotactic prostate biopsies guided by the combination of MRI and US allow effective and precise examination of MRI lesions.
    Type of Publication: Journal article published
    PubMed ID: 22283184
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    German Medical Science GMS Publishing House; Düsseldorf
    In:  62. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie; 20160414-20160415; Münster; DOCF6.2 /20160225/
    Publication Date: 2016-02-26
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...