Prostate MRI–TRUS fusion biopsy: a review of the state of the art procedure

Das, Chandan Jyoti; Razik, Abdul; Netaji, Arjunlokesh; Verma, Sadhna

doi:10.1007/s00261-019-02391-8

Cited by 22 publications

(28 citation statements)

References 18 publications

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“…There are concerns about the risk of missing tumors of the anterior prostate and apex when performing a biopsy through the transrectal approach. However, there are studies that reported MRI-targeted TRUS biopsy can sample the anterior prostate and apex with significant torque [ 12 , 13 ]. In our study, experienced radiologists performed MRI-targeted TRUS biopsy, and the probability of missing biopsy of the suspicious region of interest was thought to be low.…”

Section: Methodsmentioning

confidence: 99%

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

Lee

Choi

Sung

et al. 2021

JCM

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Background: To identify the role of combination biopsy, which consists of both targeted and additional systematic cores, in the diagnosis of clinically significant prostate cancer (csPCa). Methods: We retrospectively reviewed patients with PSA levels 2.5–15 ng/mL who have a suspicious prostate lesion (with the Prostate Imaging Reporting and Data System (PI-RADS) ≥ 3) on multiparametric MRI (mpMRI) between January 2016 and December 2018. We analyzed biopsy results by PI-RADS score and biopsy methods (systematic, targeted, and combination biopsy). Results: Of the 711 total patients, an average of 4.0 ± 1.8 targeted and 8.6 ± 3.1 additional systematic biopsies were performed. The additional systematic biopsies were sampled outside the targeted biopsy area. The combination biopsies detected more csPCa (201 patients, 28.3%) than did the targeted (175 patients, 24.6%) or systematic (124 patients, 17.4%) biopsies alone (p < 0.001). In the initial biopsy samples, there was a 7% increase in the detection of csPCa than in targeted biopsy (62% to 69%). It increased by 11% in repeat biopsy (46% to 57%). There was no statistical significance in both groups (p = 0.3174). Conclusions: Combination biopsy has the benefit of detecting csPCa in both initial and repeat biopsy when there is a suspicious lesion on mpMRI.

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Section: Methodsmentioning

confidence: 99%

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

Lee

Choi

Sung

et al. 2021

JCM

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“…We derive the proposed system from the current most advanced implementation of PBx, “fusion biopsy” (a.k.a. “real-time virtual sonography”), which entails the registration of MRI and TRUS [ 13 , 14 ]. The main advantages of MRI lie in two key functions for determining and accessing the biopsy targets: (1) showing the intraprostatic anatomy for systematic sampling and (2) showing cancer-suspicious locations for additional sampling.…”

Section: System Design and Architecturementioning

confidence: 99%

“…The outcomes are worse in Senegal, where it is reported that among all patients referred for PBx, cancer was found in only 30%, even though over 60% of Senegalese patients have advanced disease [ 12 ], showing the need for improvements in how the biopsy procedure is delivered in Senegal. In high-income countries, “fusion biopsy”, also known as “real-time virtual sonography” (i.e., spatial navigation that registers ultrasound with multi-parametric MRI), has emerged as a method for improving prostate biopsy [ 13 , 14 ]. This approach is not feasible in West Africa, where fewer than 40 high-field MRI units serve a population larger than North America, with Senegal having just 2 suitable MRI units [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Design of an Ultrasound-Navigated Prostate Cancer Biopsy System for Nationwide Implementation in Senegal

et al. 2021

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This paper presents the design of NaviPBx, an ultrasound-navigated prostate cancer biopsy system. NaviPBx is designed to support an affordable and sustainable national healthcare program in Senegal. It uses spatiotemporal navigation and multiparametric transrectal ultrasound to guide biopsies. NaviPBx integrates concepts and methods that have been independently validated previously in clinical feasibility studies and deploys them together in a practical prostate cancer biopsy system. NaviPBx is based entirely on free open-source software and will be shared as a free open-source program with no restriction on its use. NaviPBx is set to be deployed and sustained nationwide through the Senegalese Military Health Service. This paper reports on the results of the design process of NaviPBx. Our approach concentrates on “frugal technology”, intended to be affordable for low–middle income (LMIC) countries. Our project promises the wide-scale application of prostate biopsy and will foster time-efficient development and programmatic implementation of ultrasound-guided diagnostic and therapeutic interventions in Senegal and beyond.

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“…For instance, Shah et al has shown that MRI findings can be correlated with the prostatectomy specimen by employing the prostate segmentation [2]. Moreover, it is often used to facilitate radiotherapy planning [3] and targeted biopsy with MRI-TRUS (transrectal ultrasound) fusion [4,5]. Because neighboring structures as seminal vesicles, bladder, neurovascular bundles, and the external sphincter are essential for the erectile function and urine continence of men, the segmentation should be as precise as possible for the planning of prostate cancer therapy.…”

Section: Introductionmentioning

confidence: 99%

Anisotropic 3D Multi-Stream CNN for Accurate Prostate Segmentation from Multi-Planar MRI

Meyer,

Chlebus,

Rak

et al. 2020

Preprint

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Background and Objective: Accurate and reliable segmentation of the prostate gland in MR images can support the clinical assessment of prostate cancer, as well as the planning and monitoring of focal and loco-regional therapeutic interventions. Despite the availability of multi-planar MR scans due to standardized protocols, the majority of segmentation approaches presented in the literature consider the axial scans only. Methods: We propose an anisotropic 3D multi-stream CNN architecture, which processes additional scan directions to produce a higher-resolution isotropic prostate segmentation. We investigate two variants of our architecture, which work on two (dual-plane) and three (triple-plane) image orientations, respectively. We compare them with the standard baseline (single-plane) used in literature, i.e., plain axial segmentation. To realize a fair comparison, we employ a hyperparameter optimization strategy to select optimal configurations for the individual approaches. Results: Training and evaluation on two datasets spanning multiple sites obtain statistical significant improvement over the plain axial segmentation (p < 0.05 on the Dice similarity coefficient). The improvement can be observed especially at the base (0.898 single-plane vs. 0.906 triple-plane) and apex (0.888 singleplane vs. 0.901 dual-plane). Conclusion: This study indicates that models employing two or three scan directions are superior to plain axial segmentation. The knowledge of precise boundaries of the prostate is crucial for the conservation of risk structures. Thus, the

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Prostate MRI–TRUS fusion biopsy: a review of the state of the art procedure

Cited by 22 publications

References 18 publications

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

The Role of Prostate Combination Biopsy Consisting of Targeted and Additional Systematic Biopsy

Design of an Ultrasound-Navigated Prostate Cancer Biopsy System for Nationwide Implementation in Senegal

Anisotropic 3D Multi-Stream CNN for Accurate Prostate Segmentation from Multi-Planar MRI

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