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A Novel Stereotactic Prostate Biopsy System Integrating Pre-Interventional Magnetic Resonance Imaging and Live Ultrasound Fusion

2011; Lippincott Williams & Wilkins; Volume: 186; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2011.07.102

1527-3792

Boris Hadaschik, Timur H. Kuru, Corina Tulea, Philip Rieker, Ionel Valentin Popeneciu, Tobias Simpfendörfer, Johannes Huber, Pawel Zogal, Doğu Teber, Sascha Pahernik, Matthias Roethke, Patrik Zámecnik, Wilfried Roth, Georgios Sakas, Heinz-Peter Schlemmer, Markus Hohenfellner,

MRI in cancer diagnosis

No AccessJournal of UrologyAdult Urology1 Dec 2011A Novel Stereotactic Prostate Biopsy System Integrating Pre-Interventional Magnetic Resonance Imaging and Live Ultrasound Fusion Boris A. Hadaschik, Timur H. Kuru, Corina Tulea, Philip Rieker, Ionel V. Popeneciu, Tobias Simpfendörfer, Johannes Huber, Pawel Zogal, Dogu Teber, Sascha Pahernik, Matthias Roethke, Patrik Zamecnik, Wilfried Roth, Georgios Sakas, Heinz-Peter Schlemmer, and Markus Hohenfellner Boris A. HadaschikBoris A. Hadaschik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Timur H. KuruTimur H. Kuru Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Corina TuleaCorina Tulea Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Philip RiekerPhilip Rieker Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Ionel V. PopeneciuIonel V. Popeneciu Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Tobias SimpfendörferTobias Simpfendörfer Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Johannes HuberJohannes Huber Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Pawel ZogalPawel Zogal Department of Radiology, German Cancer Research Center, Heidelberg, Germany , Dogu TeberDogu Teber Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Sascha PahernikSascha Pahernik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany , Matthias RoethkeMatthias Roethke Department of Radiology, German Cancer Research Center, Heidelberg, Germany , Patrik ZamecnikPatrik Zamecnik Department of Radiology, German Cancer Research Center, Heidelberg, Germany MedCom GmbH, Fraunhofer Institute for Computer Graphics, Darmstadt, Germany , Wilfried RothWilfried Roth Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany , Georgios SakasGeorgios Sakas Department of Cognitive Computing and Medical Imaging, Fraunhofer Institute for Computer Graphics, Darmstadt, Germany , Heinz-Peter SchlemmerHeinz-Peter Schlemmer Department of Radiology, German Cancer Research Center, Heidelberg, Germany , and Markus HohenfellnerMarkus Hohenfellner Department of Urology, University Hospital Heidelberg, Heidelberg, Germany View All Author Informationhttps://doi.org/10.1016/j.juro.2011.07.102AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We developed an effective way to precisely diagnose prostate cancer using a novel prostate biopsy system that integrates pre-interventional magnetic resonance imaging with peri-interventional ultrasound for perineal navigated prostate biopsy. Materials and Methods: A total of 106 men with findings suspicious for prostate cancer (median age 66 years, prostate specific antigen 8.0 ng/ml and prostate volume 47 ml) underwent multiparametric 3 Tesla magnetic resonance imaging. Suspicious lesions were marked and data were transferred to the novel biopsy system. Using a custom-made biplane transrectal ultrasound probe mounted on a stepper we gathered 3-dimensional ultrasound data and fused them with magnetic resonance imaging data. As a result, suspicious magnetic resonance imaging lesions were superimposed over the transrectal ultrasound data. Three-dimensional biopsy planning was done, including systematic biopsies. Perineal biopsies were taken under live ultrasound guidance and the precise site of each biopsy was documented in 3 dimensions. We evaluated feasibility, safety and cancer detection. Results: Prostate cancer was detected in 63 of 106 patients (59.4%). Magnetic resonance imaging findings correlated positively with histopathology in 71 of 103 patients (68.9%). In magnetic resonance imaging lesions marked as highly suspicious, the detection rate was 95.8% (23 of 24 cases). Lesion targeted cores had a significantly higher positivity rate than nontargeted cores. The procedural targeting error of the first 2,461 biopsy cores was 1.7 mm. Regarding adverse effects, 2 patients experienced urinary retention and 1 had a perineal hematoma. Urinary tract infections did not develop. Conclusions: Perineal stereotactic prostate biopsies guided by the combination of magnetic resonance imaging and ultrasound enable effective examination of suspicious magnetic resonance imaging lesions. Each biopsy core taken is documented accurately for its location in 3 dimensions, enabling magnetic resonance imaging validation and tailored treatment planning. The morbidity of the procedure was minimal. References 1 : Cancer statistics, 2010. CA Cancer J Clin2010; 60: 277. Google Scholar 2 : Prostate Cancer Early Detection V. 2.2010. www.nccn.org. Accessed March 20, 2011. Google Scholar 3 : Effect of dutasteride on prostate biopsy rates and the diagnosis of prostate cancer in men with lower urinary tract symptoms and enlarged prostates in the Combination of Avodart and Tamsulosin Trial. Eur Urol2011; 59: 244. Google Scholar 4 : Optimizing prostate cancer detection: 8 versus 12-core biopsy protocol. J Urol2009; 182: 1329. Link, Google Scholar 5 : Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol2003; 169: 125. Link, Google Scholar 6 : Focal therapy for prostate cancer: possibilities and limitations. Eur Urol2010; 58: 57. Google Scholar 7 : Focal therapy for localized prostate cancer: a phase I/II trial. J Urol2011; 185: 1246. Link, Google Scholar 8 : Appropriate patient selection in the focal treatment of prostate cancer: the role of transperineal 3-dimensional pathologic mapping of the prostate—a 4-year experience. Urology2007; 70: 27. Google Scholar 9 : Three-dimensional prostate mapping biopsy has a potentially significant impact on prostate cancer management. J Clin Oncol2009; 27: 4321. Google Scholar 10 : Prostate cancer: value of multiparametric MR imaging at 3 T for detection—histopathologic correlation. Radiology2010; 255: 89. Google Scholar 11 : Is it time to consider a role for MRI before prostate biopsy?. Nat Rev Clin Oncol2009; 6: 197. Google Scholar 12 : MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol2006; 50: 738. Google Scholar 13 : Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol2010; 183: 520. Link, Google Scholar 14 : MR-guided biopsy of the prostate: an overview of techniques and a systematic review. Eur Urol2008; 54: 517. Google Scholar 15 : Real-time virtual sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data. Int J Urol2010; 17: 855. Google Scholar 16 : Initial clinical experience with real-time transrectal ultrasonography-magnetic resonance imaging fusion-guided prostate biopsy. BJU Int2008; 101: 841. Google Scholar 17 : Documenting the location of prostate biopsies with image fusion. BJU Int2011; 107: 53. Google Scholar 18 : Technique for a hybrid system of real-time transrectal ultrasound with preoperative magnetic resonance imaging in the guidance of targeted prostate biopsy. Int J Urol2010; 17: 890. Google Scholar 19 : Real-time MRI-TRUS fusion for guidance of targeted prostate biopsies. Comput Aided Surg2008; 13: 255. Google Scholar 20 : Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting. Prostate Cancer Prostatic Dis2010; 13: 71. Google Scholar 21 : Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol2010; 58: 851. Google Scholar 22 : Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner. BJU Int2008; 101: 181. Google Scholar 23 : Feasibility of 3T dynamic contrast-enhanced magnetic resonance-guided biopsy in localizing local recurrence of prostate cancer after external beam radiation therapy. Invest Radiol2010; 45: 121. Google Scholar 24 : Transrectal prostate biopsy: Effective anesthesia, complications, and influence on clinical outcome after radical prostatectomy. Urologe A2011; 50: 452. Google Scholar 25 : The morbidity of transperineal template-guided prostate mapping biopsy. BJU Int2008; 101: 1524. Google Scholar 26 : Prostate biopsy in the supine position in a standard 1.5-T scanner under real time MR-imaging control using a MR-compatible endorectal biopsy device. Eur Radiol2006; 16: 1237. Google Scholar 27 : Trans-rectal versus trans-perineal saturation rebiopsy of the prostate: is there a difference in cancer detection rate?. Urology2011; 77: 921. Google Scholar 28 : Prostate cancer detection rate in patients with repeated extended 21-sample needle biopsy. Eur Urol2009; 55: 600. Google Scholar 29 : Is apparent diffusion coefficient associated with clinical risk scores for prostate cancers that are visible on 3-T MR images?. Radiology2011; 258: 488. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byDistler F, Radtke J, Bonekamp D, Kesch C, Schlemmer H, Wieczorek K, Kirchner M, Pahernik S, Hohenfellner M and Hadaschik B (2017) The Value of PSA Density in Combination with PI-RADS™ for the Accuracy of Prostate Cancer PredictionJournal of Urology, VOL. 198, NO. 3, (575-582), Online publication date: 1-Sep-2017.Lee D, Recabal P, Sjoberg D, Thong A, Lee J, Eastham J, Scardino P, Vargas H, Coleman J and Ehdaie B (2016) Comparative Effectiveness of Targeted Prostate Biopsy Using Magnetic Resonance Imaging Ultrasound Fusion Software and Visual Targeting: a Prospective StudyJournal of Urology, VOL. 196, NO. 3, (697-702), Online publication date: 1-Sep-2016.Brock M, Löppenberg B, Roghmann F, Pelzer A, Dickmann M, Becker W, Martin-Seidel P, Sommerer F, Schenk L, Palisaar R, Noldus J and von Bodman C (2014) Impact of Real-Time Elastography on Magnetic Resonance Imaging/Ultrasound Fusion Guided Biopsy in Patients with Prior Negative Prostate BiopsiesJournal of Urology, VOL. 193, NO. 4, (1191-1197), Online publication date: 1-Apr-2015.Walton Diaz A, Hoang A, Turkbey B, Hong C, Truong H, Sterling T, Rais-Bahrami S, Siddiqui M, Stamatakis L, Vourganti S, Nix J, Logan J, Harris C, Weintraub M, Chua C, Merino M, Choyke P, Wood B and Pinto P (2013) Can Magnetic Resonance-Ultrasound Fusion Biopsy Improve Cancer Detection in Enlarged Prostates?Journal of Urology, VOL. 190, NO. 6, (2020-2025), Online publication date: 1-Dec-2013.Rais-Bahrami S, Siddiqui M, Turkbey B, Stamatakis L, Logan J, Hoang A, Walton-Diaz A, Vourganti S, Truong H, Kruecker J, Merino M, Wood B, Choyke P and Pinto P (2013) Utility of Multiparametric Magnetic Resonance Imaging Suspicion Levels for Detecting Prostate CancerJournal of Urology, VOL. 190, NO. 5, (1721-1727), Online publication date: 1-Nov-2013.Kuru T, Roethke M, Seidenader J, Simpfendörfer T, Boxler S, Alammar K, Rieker P, Popeneciu V, Roth W, Pahernik S, Schlemmer H, Hohenfellner M and Hadaschik B (2013) Critical Evaluation of Magnetic Resonance Imaging Targeted, Transrectal Ultrasound Guided Transperineal Fusion Biopsy for Detection of Prostate CancerJournal of Urology, VOL. 190, NO. 4, (1380-1386), Online publication date: 1-Oct-2013.Kasivisvanathan V, Dufour R, Moore C, Ahmed H, Abd-Alazeez M, Charman S, Freeman A, Allen C, Kirkham A, van der Meulen J and Emberton M (2012) Transperineal Magnetic Resonance Image Targeted Prostate Biopsy Versus Transperineal Template Prostate Biopsy in the Detection of Clinically Significant Prostate CancerJournal of Urology, VOL. 189, NO. 3, (860-866), Online publication date: 1-Mar-2013.Sonn G, Natarajan S, Margolis D, MacAiran M, Lieu P, Huang J, Dorey F and Marks L (2012) Targeted Biopsy in the Detection of Prostate Cancer Using an Office Based Magnetic Resonance Ultrasound Fusion DeviceJournal of Urology, VOL. 189, NO. 1, (86-92), Online publication date: 1-Jan-2013.Long J, Hungr N, Baumann M, Descotes J, Bolla M, Giraud J, Rambeaud J and Troccaz J (2012) Development of a Novel Robot for Transperineal Needle Based Interventions: Focal Therapy, Brachytherapy and Prostate BiopsiesJournal of Urology, VOL. 188, NO. 4, (1369-1374), Online publication date: 1-Oct-2012. Volume 186Issue 6December 2011Page: 2214-2220 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsbiopsyultrasonographymagnetic resonance imagingprostateprostatic neoplasmsMetrics Author Information Boris A. Hadaschik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany Equal study contribution. More articles by this author Timur H. Kuru Department of Urology, University Hospital Heidelberg, Heidelberg, Germany Equal study contribution. More articles by this author Corina Tulea Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Philip Rieker Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Ionel V. Popeneciu Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Tobias Simpfendörfer Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Johannes Huber Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Pawel Zogal Department of Radiology, German Cancer Research Center, Heidelberg, Germany Financial interest and/or other relationship with MedCom. More articles by this author Dogu Teber Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Sascha Pahernik Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Matthias Roethke Department of Radiology, German Cancer Research Center, Heidelberg, Germany More articles by this author Patrik Zamecnik Department of Radiology, German Cancer Research Center, Heidelberg, Germany MedCom GmbH, Fraunhofer Institute for Computer Graphics, Darmstadt, Germany More articles by this author Wilfried Roth Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Georgios Sakas Department of Cognitive Computing and Medical Imaging, Fraunhofer Institute for Computer Graphics, Darmstadt, Germany Financial interest and/or other relationship with MedCom. More articles by this author Heinz-Peter Schlemmer Department of Radiology, German Cancer Research Center, Heidelberg, Germany More articles by this author Markus Hohenfellner Department of Urology, University Hospital Heidelberg, Heidelberg, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...