MR-targeted TRUS prostate biopsy using local reference augmentation: initial experience

Autor: Jelle O. Barentsz, Henkjan J. Huisman, Erik B. Cornel, Jurgen J. Fütterer, Wulphert Venderink, J.P. Michiel Sedelaar, Wendy J. M. van de Ven, Jeroen Veltman
Rok vydání: 2016
Předmět:
Image-Guided Biopsy
Male
Nephrology
medicine.medical_specialty
Pathology
Prostate biopsy
Biopsy
PIRADS
Urology
030232 urology & nephrology
urologic and male genital diseases
Endosonography
030218 nuclear medicine & medical imaging
Cohort Studies
MR–US fusion
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Internal medicine
Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]
Confidence Intervals
Humans
Medicine
Neoplasm Invasiveness
Aged
Neoplasm Staging
Retrospective Studies
Urology - Original Paper
medicine.diagnostic_test
business.industry
Rectum
Prostatic Neoplasms
Middle Aged
Prostate-Specific Antigen
medicine.disease
Immunohistochemistry
Magnetic Resonance Imaging
Urological cancers Radboud Institute for Health Sciences [Radboudumc 15]
Radiology
Neoplasm Grading
business
Follow-Up Studies
Zdroj: International Urology and Nephrology, 48, 7, pp. 1037-45
International Urology and Nephrology
International Urology and Nephrology, 48, 1037-45
ISSN: 0301-1623
Popis: Contains fulltext : 170913.pdf (Publisher’s version ) (Open Access) PURPOSE: To evaluate MR-targeted TRUS prostate biopsy using a novel local reference augmentation method. PATIENTS AND METHODS: Tracker-based MR-TRUS fusion was applied using local reference augmentation. In contrast to conventional whole gland fusion, local reference augmentation focuses the highest registration accuracy to the region surrounding the lesion to be biopsied. Pre-acquired multi-parametric MR images (mpMRI) were evaluated using PIRADS classification. T2-weighted MR images were imported on an ultrasound machine to allow for MR-TRUS fusion. Biopsies were targeted to the most suspicious lesion area identified on mpMRI. Each target was biopsied 1-5 times. For each biopsied lesion the diameter, PIRADS and Gleason scores, visibility during fusion, and representativeness were recorded. RESULTS: Included were 23 consecutive patients with 25 MR suspicious lesions, of which 11 patients had a previous negative TRUS-guided biopsy and 12 were biopsy naive. The cancer detection rate was 64 % (Gleason score >/=6). Biopsy was negative (i.e., no Gleason score) in seven patients confirmed by follow-up in all of them (up to 18 months). After MR-TRUS fusion, 88 % of the lesions could be visualized on TRUS. The cancer detection rate increases with increasing lesion size, being 73 % for lesions larger than 10 mm. CONCLUSION: Tracker-based MR-TRUS fusion biopsy with local reference augmentation is feasible, especially for lesions with an MR maximum diameter of at least 10 mm or PIRADS 5 lesions. If this is not the case, we recommend in-bore MR-guided biopsy.
Databáze: OpenAIRE
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