System for prostate brachytherapy and biopsy in a standard 1.5 T MRI scanner

Susil, Robert C.; Camphausen, Kevin; Choyke, Peter L.; McVeigh, Elliot R.; Gustafson, Gary; Ning, Holly; Miller, Robert W.; Atalar, Ergin; Coleman, C. Norman; Ménard, Cynthia

doi:10.1002/mrm.20138

Cited by 120 publications

(107 citation statements)

References 19 publications

(17 reference statements)

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“…To improve visualization in and around the prostate, all images were intensity corrected, producing uniform signal images, as described previously. 12 With the needle in place, the prostate was imaged again using a T1-weighted fast spin-echo sequence, allowing for confirmation of needle placement accuracy ( fig. 5, column 2).…”

Section: Resultsmentioning

confidence: 99%

Transrectal Prostate Biopsy and Fiducial Marker Placement in a Standard 1.5T Magnetic Resonance Imaging Scanner

et al. 2006

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Purpose:We investigated the accuracy and feasibility of a system that provides transrectal needle access to the prostate concurrent with 1.5 Tesla MRI which previously has not been possible. Materials and Methods: In 5 patients with previously diagnosed prostate cancer, MRI guided intraprostatic placement of gold fiducial markers (4 procedures) and/or prostate biopsy (3 procedures) was performed using local anesthesia. Results: Mean procedure duration was 76 minutes and all patients tolerated the intervention well. Procedure related adverse events included self-limited hematuria and hematochezia following 3 of 8 procedures (all resolved in less than 1 week). Mean needle placement accuracy was 1.9 mm for the fiducial marker placement studies and 1.8 mm for the biopsy procedures. Mean fiducial marker placement accuracy was 4.8 mm and the mean fiducial marker placement accuracy transverse to the needle direction was 2.6 mm. All patients who underwent the procedure were able to complete their course of radiotherapy without delay or complication. Conclusions: While studies of clinical usefulness are warranted, transrectal 1.5 T MRI guided prostate biopsy and fiducial marker placement is feasible using this system, providing new opportunities for image guided diagnostic and therapeutic prostate interventions.

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Section: Resultsmentioning

confidence: 99%

Transrectal Prostate Biopsy and Fiducial Marker Placement in a Standard 1.5T Magnetic Resonance Imaging Scanner

et al. 2006

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“…The same team from Johns Hopkins University and the National Institutes of Health also performed transperineal biopsy procedures (33). All procedures were again performed under local anesthesia.…”

Section: Mr-guided Biopsymentioning

confidence: 99%

MR‐guided prostate interventions

Tempany

Straus

Hata

et al. 2008

Magnetic Resonance Imaging

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In this article the current issues of diagnosis and detection of prostate cancer are reviewed. The limitations for current techniques are highlighted and some possible solutions with MR imaging and MR-guided biopsy approaches are reviewed. There are several different biopsy approaches under investigation. These include transperineal open magnet approaches to closed-bore 1.5T transrectal biopsies. The imaging, image processing, and tracking methods are also discussed. In the arena of therapy, MR guidance has been used in conjunction with radiation methods, either brachytherapy or external delivery. The principles of the radiation treatment, the toxicities, and use of images are outlined. The future role of imaging and image-guided interventions lie with providing a noninvasive surrogate for cancer surveillance or monitoring treatment response. The shift to minimally invasive focal therapies has already begun and will be very exciting when MR-guided focused ultrasound surgery reaches its full potential.

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“…The operator can easily scout the subject, identify a target, and set the insertion path. This capability may also provide the means for compensation of needle bending, a major source of error [12], [22]- [24], because the operator can use dynamic imaging and direct maneuvering to appropriately react and correct the bending. The feature of having the tool always at the same position and orientation relative to the FOV provides a straightforward way of directing the tool, while a simple software routine can place a line of sight on any frame without additional image processing.…”

Section: Freehand/manual Controlmentioning

confidence: 99%

“…The first is whether MRI-guided and robot-assisted procedures indeed offer substantial benefits to patient management compared with current interventional practices and whether they can facilitate new procedures not possible with the available modalities. Identification of clinically viable applications for MR-compatible interventional robotic systems has already started with clinical studies in the breast [23], [24], spine [13], and prostate [22]. Only extensive multicenter trials can assess this.…”

Section: Looking Into the Futurementioning

confidence: 99%

A General-Purpose MR-Compatible Robotic System

Tsekos

Christoforou

Özcan

2008

IEEE Eng. Med. Biol. Mag.

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Magnetic resonance imaging (MRI) is a versatile imaging modality and an indispensable tool in modern diagnostic medicine, with a wide range of applications in clinical and basic science research. As a result of its broad applicability and noninvasive nature, it is being developed for diagnostic and therapeutic image-guided interventions (IGIs) [1]- [4]. An impediment to this advancement, however, is the limited access to the patient, especially with the high-field cylindrical magnetic resonance (MR) scanners. To address the limited patient accessibility and facilitate real-time guidance of IGI, remotely actuated and controlled MR-compatible manipulators have been introduced. The concept of MR compatibility is discussed in the guest editorial of this special issue [29]. Several examples of MR-compatible manipulators have been developed, including a system for brain biopsies [5], two systems for breast interventions [6]- [8], one system for general use with the special "double-donut" scanners [9], [10], an endoscope positioner [11], two systems for prostate procedures [10], [12], and two general-purpose devices for use with standard cylindrical MR scanners [13], [14]. We review the development of a general-purpose robotic system at the Washington University for performing minimally invasive interventions with real-time MR guidance [14]- [17].Our motivation for this work originates from the essential features of MRI that both compliment and improve current diagnostic and therapeutic IGIs that use X-ray fluoroscopy, computed tomography, or ultrasound. A major advantage of MRI is that it is minimally invasive, both for the patient and the medical staff. Another advantage is that MRI offers a wide range of soft-tissue contrast mechanisms (e.g., standard T1/T2 contrast, perfusion, angiography, and diffusion), which can be used to both delineate the target and characterize the effects of the intervention. MRI is also the only true three-dimensional (3-D) modality that allows oblique 3-D or multislice imaging. This property, combined with the capability of the modern MR scanners for on-the-fly adjustment of the imaging planes, offers some highly promising approaches for performing real-time IGIs.In the following sections, we first present the criteria upon which the system was based, and an overview of its components, the design, and prototyping of the robotic manipulator are also discussed. Then, we present its control components and their general integration and logic. The human-machine interface and the practice of performing MR-guided interventions are described later. Finally, certain perspectives of this technology will be discussed. Design Criteria and Overview of the SystemThe development of our system adhered to five primary design criteria. First, the robot must be compatible with the MR environment both in that its operation is not affected by the MR scanner and that it does not deteriorate the MR images such that they are inappropriate for real-time MR-guided procedures. Second, the robot must operate safely ...

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System for prostate brachytherapy and biopsy in a standard 1.5 T MRI scanner

Cited by 120 publications

References 19 publications

Transrectal Prostate Biopsy and Fiducial Marker Placement in a Standard 1.5T Magnetic Resonance Imaging Scanner

Transrectal Prostate Biopsy and Fiducial Marker Placement in a Standard 1.5T Magnetic Resonance Imaging Scanner

MR‐guided prostate interventions

A General-Purpose MR-Compatible Robotic System

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