Magnetic Resonance-Guided Prostate Biopsy

Dianat, Seyed Saeid; Carter, H. Ballentine; Macura, Katarzyna J.

doi:10.1016/j.mric.2015.05.005

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…In core needle breast biopsy for example, the void caused by a 14 gauge (2.11 mm outside diameter [OD]) titanium needle was reported to be 4 mm at 1.5T and almost 9.5 mm at 3T. [6][7][8][9][10] Similar needle artifacts have been discussed in MR-guided prostate, 11,12 head and neck, 13 musculoskeletal, 14 spine, 15 and liver biopsies. 16 Susceptibility artifacts also create difficulties in MRguided brachytherapy 17,18 where both the metallic stylet and the radioactive pellet generate signal voids that make placement under MR guidance inaccurate.…”

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confidence: 91%

Modeling of active shimming of metallic needles for interventional MRI

Sengupta

2020

Magnetic Resonance in Med

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Purpose Artifacts caused by large magnetic susceptibility differences between metallic needles and tissue are a persistent problem in many interventional MRI applications. The signal void caused by the needle can hide procedure targets and prevent accurate image‐based monitoring. In this paper, a solution to this problem is presented in the form of an active shim insert inspired from degaussing coils used in naval vessels, that is designed to correct the field disturbance (ΔB0) caused by the needle. Methods The ΔB0 induced by a 10 gauge hollow single‐beveled titanium needle at 3T is modeled in different orientations. A set of 63 orthogonal coil pairs with unique tip paths are evaluated for shimming performance, and an optimal coil pair is chosen. Shimming performance and current demands are evaluated over a range of needle orientations. Results Robust correction of the titanium needle induced ΔB0 is predicted using a flat no‐loop coil combined with an orthogonal 1½ turn loop coil angled at the bevel angle for most orientations, with currents well below 1 amp per coil. Reductions in ΔB0 standard deviations with shimming ranged from ~49% to ~10% depending on needle orientation, with performance worsening as the needle is aligned more along B0. Conclusion Simulations predict that it is possible to minimize metallic probe induced ΔB0 and signal losses using externally supplied direct current shim coil inserts in arbitrary orientations for potential benefits in many interventional MRI applications.

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confidence: 91%

Modeling of active shimming of metallic needles for interventional MRI

Sengupta

2020

Magnetic Resonance in Med

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“… [9] recently reported the overall mpMRI sensitivity for tumour detection to be 47% with increased sensitivity for tumours larger than 1.0 cm (72%), higher-grade tumours (72% for Gleason ≥7), and index tumours (80%). Such preferential non-invasive diagnosis of clinically significant tumours constitutes a major potential advantage of MRI and has paved the way for the role of targeted biopsies of the prostate [11] , [24] , [25] .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of combination MRI-targeted and transperineal template biopsy in restaging low-risk prostate cancer for active surveillance

Chen

Tay

Law

et al. 2018

Asian Journal of Urology

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ObjectiveActive surveillance (AS) offers a strategy to reduce overtreatment and now is a widely accepted treatment option for low-risk prostate cancer. An ideal tool for risk-stratification would detect aggressive cancers and exclude such men from taking up AS in the first place. We evaluate if a combination of transperineal template biopsy with magnetic resonance imaging (MRI)-targeted biopsy identifies significant prostate cancer amongst men initially diagnosed with low-risk prostate cancer.MethodsThis prospective, single-blinded study included men with low-risk prostate cancer (D'Amico's Criteria) diagnosed on conventional transrectal ultrasound-guided biopsy. Patients first underwent multiparametric MRI of the prostate ≥6 weeks after initial biopsy. Each suspicious lesion is mapped and assigned a Prostate Imaging Reporting and Data System (PIRADS) score. Template biopsy is first performed with the surgeon blinded to MRI findings followed by MRI-targeted biopsy using a robotic transperineal biopsy platform.ResultsThe age of the 19 men included is 65.4 ± 4.9 years (mean ± SD). Prostate specific antigen (PSA) at diagnosis and at the time of transperineal biopsy were comparable (7.3 ± 1.7 ng/mL and 7.0 ± 1.8 ng/mL, p = 0.67), so were prostate volumes (34.2 ± 8.9 mL and 32.1 ± 13.4 mL, p = 0.28). MRI-targeted biopsy had a higher percentage of cancer detection per core compared to template biopsy (11.7% vs. 6.5%, p = 0.02), this was more than 3 times superior for Gleason 7 disease (5.9% vs. 1.6%, p < 0.01). Four of 18 (22.2%) patients with MRI lesions had significant disease with MRI-targeted biopsy alone. Three of 19 patients (15.8%) had significant disease with template biopsy alone. In combination, both techniques upclassified five patients (26.3%), all of whom underwent radical prostatectomy. Whole mount histology confirmed tumour location and grade. All six patients with PIRADS 5 lesions had cancer detected (66.6% significant disease).ConclusionA combination of MRI-targeted and template biopsy may optimally risk-classify “low-risk” patients diagnosed on initial conventional transrectal ultrasonography (TRUS) prostate biopsy.

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“…Magnetic resonance imaging (MRI) demonstrates excellent characteristics for image guidance of interstitial interventional procedures, including the lack of ionizing radiation, high soft tissue contrast, and multiplanar needle guidance with simultaneous acquisition of axial, coronal, and sagittal image data sets in near real-time 1 – 8 . MRI-guided interventions are routinely performed in a broad range of organs, with a primary focus on body regions in which MRI is superior to computed tomography (CT) and ultrasound such as spine, prostate, and liver 1 , 9 – 13 . In particular, the combination of fast fluoroscopic T1-weighted gradient echo (GRE) sequences and hepatobiliary contrast agents has even enabled MRI-guided biopsy of small, CT-occult liver lesions with a diameter < 1 cm 14 .…”

Section: Introductionmentioning

confidence: 99%

Artifact reduction of coaxial needles in magnetic resonance imaging-guided abdominal interventions at 1.5 T: a phantom study

Schmidt

Arnone

Dietrich

et al. 2021

Sci Rep

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Needle artifacts pose a major limitation for MRI-guided interventions, as they impact the visually perceived needle size and needle-to-target-distance. The objective of this agar liver phantom study was to establish an experimental basis to understand and reduce needle artifact formation during MRI-guided abdominal interventions. Using a vendor-specific prototype fluoroscopic T1-weighted gradient echo sequence with real-time multiplanar acquisition at 1.5 T, the influence of 6 parameters (flip angle, bandwidth, matrix, slice thickness, read-out direction, intervention angle relative to B0) on artifact formation of 4 different coaxial MR-compatible coaxial needles (Nitinol, 16G–22G) was investigated. As one parameter was modified, the others remained constant. For each individual parameter variation, 2 independent and blinded readers rated artifact diameters at 2 predefined positions (15 mm distance from the perceived needle tip and at 50% of the needle length). Differences between the experimental subgroups were assessed by Bonferroni-corrected non-parametric tests. Correlations between continuous variables were expressed by the Bravais–Pearson coefficient and interrater reliability was quantified using the intraclass classification coefficient. Needle artifact size increased gradually with increasing flip angles (p = 0.002) as well as increasing intervention angles (p < 0.001). Artifact diameters differed significantly between the chosen matrix sizes (p = 0.002) while modifying bandwidth, readout direction, and slice thickness showed no significant differences. Interrater reliability was high (intraclass correlation coefficient 0.776–0.910). To minimize needle artifacts in MRI-guided abdominal interventions while maintaining optimal visibility of the coaxial needle, we suggest medium-range flip angles and low intervention angles relative to B0.

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Magnetic Resonance-Guided Prostate Biopsy

Cited by 9 publications

References 35 publications

Modeling of active shimming of metallic needles for interventional MRI

Modeling of active shimming of metallic needles for interventional MRI

Outcomes of combination MRI-targeted and transperineal template biopsy in restaging low-risk prostate cancer for active surveillance

Artifact reduction of coaxial needles in magnetic resonance imaging-guided abdominal interventions at 1.5 T: a phantom study

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