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

Abstract

Purpose To evaluate MR-targeted TRUS prostate biopsy using a novel local reference augmentation method.Patients and methodsTracker-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.ResultsIncluded were 23 consecutive patients with 25 MR suspicious lesions, of which 11 patients had a previous negative TRUS-guided biopsy and 12 were biopsy naïve. 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.ConclusionTracker-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.

The transverse and vertical distribution of prostate cancer in biopsy and radical prostatectomy specimens

“…As a consequence, no comparison was attempted between MRI, biopsy pathology, and radical prostatectomy pathology. MRI is of vital importance for locating tumors and detecting major and clinically significant tumors [ 22 – 25 ]. Second, the 11-region biopsy was not adequately meticulous, and additional subdivisions (e.g., basal region and mid-region) should be employed.…”

Role and significance of multiparametric magnetic resonance imaging in prostate cancer diagnostics

“…ПБ-F обнаружила на 67 % больше опухолей с индексом Глисона ≥ 4 + 3, чем СТБ, и пропустила 36 % опухолей с индексом Гли-сона ≤ 3 + 4, тем самым снижая обнаружение кли-нически незначимого РПЖ [24]. Использование тех-нологии ПБ-F с применением данных мпМРТ повышает выявляемость рецидивов РПЖ при разме-рах очагов специфического накопления МРКС от 9 до 12 мм почти в 50 % случаев [25].…”

“…Venderink и соавт. провели многолетние рандо-мизированные исследования, в которых с помощью ПБ-F было диагностировано практически то же чи-сло случаев РПЖ (n = 461), что и при СТБ (n = 469) [25]. Такая же закономерность наблюдалась среди 690 (69 %) мужчин, прошедших эти 2 процедуры.…”

Comparative diagnostic accuracy of multiparametric magnetic resonance imaging-ultrasound fusion-guided biopsy versus systematic biopsy for clinically significant prostate cancer

“…A number of different prostate biopsy approaches have been developed following the introduction of mp-MRI, such as software-assisted MRI-TRUS fusion biopsy (fus-MRTB), cognitive targeted biopsy (cog-MRTB), and direct in-bore MRI targeted biopsy (inbore-MRTB) ( Bass et al, 2022 ; Lee et al, 2020 ; Wegelin et al, 2017 ; de Ven WJ et al, 2016 ). All of these methods depend on interpreting mp-MRI results as coordinates for directing biopsy needles to suspicious regions of interest (ROIs).…”