Prostate Cancer Diagnosis: Multiparametric MR-targeted Biopsy with Cognitive and Transrectal US–MR Fusion Guidance versus Systematic Biopsy—Prospective Multicenter Study

Abstract

Prebiopsy MR imaging combined with transrectal US-guided TB increases biopsy performance in detecting PCa, especially clinically significant PCa. No significant difference was observed between TB-FUS and TB-COG for TB guidance.

Multiparametric Magnetic Resonance Imaging in the Detection of Prostate Cancer

“…Navigation is facilitated by detection of the urethra, prominent hyperplastic nodules, or cysts. Peuch et al were able to detect 15 % more clinically relevant cancers per TRUS biopsy in their study by viewing the MRI images immediately prior to biopsy [48]. However, the cognitive fusion can be expected to be highly examinerdependent.…”

“…The procedure is similar for cognitive fusion in which ultrasound-guided biopsy is performed immediately after viewing the MRI scan. The objective here is to evaluate the regions suspicious on MRI in a targeted manner and to identify focal lesions on the B-mode image [48]. The prostate must be viewed in both modalities on the same (or at least comparable) image plane.…”

“…Software on the latest ultrasound devices can fuse previously imported MRI datasets three-dimensionally and in real time with the B-mode image of an ultrasound examination. An electromagnetic unit that is coupled to the ultrasound probe and can track the movements of the probe is positioned next to the patient table during the biopsy for this purpose [48,49]. By selecting individual reference points on the MRI images and the B-mode image, the MRI images are adjusted and moved in parallel with the ultrasound scan ( • " Fig.…”

“…This makes it possible to use the ultrasound probe to navigate to and biopsy lesions evaluated as suspicious for cancer in the preceding multiparametric MRI scan [48]. Softwaresupported 3 D real-time fusion is currently under intense evaluation.…”

Active Surveillance-Factors Affecting the Treatment Decision: 3M: “Marker”, “Mapping”, “MRI”

“…Tamamen ultrasoundu yapan kişiye bağlıdır ve ek eğitim ve cihaz gerektirmeyen bir yöntemdir. Bir çalışmada kognitif füzyon ve cihaz ile füzyon MR biyopsilerinin tümör tespit oranlarının benzer, her iki yönteminde kör alınan sistemik prostat biyopsilerden daha iyi olduğu bildirilmiştir (37). Üçüncü yöntem device (cihaz) füzyon görüntülemede ise daha önceden elde edilmiş MR görüntülerini "real-time" USG ile elde edilen görüntüler ile digital rekonstrüksiyon yapan bir programla bilgisayar ekranında 3 boyutlu görüntü elde edilmesini sağlamaktadır.…”