2100 CANCER DETECTION RATES ON MR / ULTRASOUND (US) FUSED IMAGE GUIDED PROSTATE BIOPSIES DIRECTLY CORRELATES WITH MULTI-PARAMETRIC MRI (2010)

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20102100 CANCER DETECTION RATES ON MR / ULTRASOUND (US) FUSED IMAGE GUIDED PROSTATE BIOPSIES DIRECTLY CORRELATES WITH MULTI-PARAMETRIC MRI Paul H. Chung, Ardeshir R. Rastinehad, Angelo A. Baccala, Jochen Kruecker, Sheng Xu, Julia K. Locklin, Baris I. Turkbey, Joanna H. Shih, Heinric Williams, Gennady Bratslavsky, Neil D. Glossop, Peter L. Choyke, Bradford J. Wood, and Peter A. Pinto Paul H. ChungPaul H. Chung Bethesda, MD More articles by this author , Ardeshir R. RastinehadArdeshir R. Rastinehad Bethesda, MD More articles by this author , Angelo A. BaccalaAngelo A. Baccala Bethesda, MD More articles by this author , Jochen KrueckerJochen Kruecker Briarcliff Manor, NY More articles by this author , Sheng XuSheng Xu Briarcliff Manor, NY More articles by this author , Julia K. LocklinJulia K. Locklin Bethesda, MD More articles by this author , Baris I. TurkbeyBaris I. Turkbey Bethesda, MD More articles by this author , Joanna H. ShihJoanna H. Shih Bethesda, MD More articles by this author , Heinric WilliamsHeinric Williams Bethesda, MD More articles by this author , Gennady BratslavskyGennady Bratslavsky Bethesda, MD More articles by this author , Neil D. GlossopNeil D. Glossop Toronto, ON More articles by this author , Peter L. ChoykePeter L. Choyke Bethesda, MD More articles by this author , Bradford J. WoodBradford J. Wood Bethesda, MD More articles by this author , and Peter A. PintoPeter A. Pinto Bethesda, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2174AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The current standard for diagnosing prostate cancer is based on random biopsies utilizing gray scale ultrasound. Our novel platform combines the benefits combining MR imaging and MR/US fusion to perform directed biopsies with image guidance. We report our first 101 patients. METHODS A single radiologist (P.C.) reviewed multi-parametric MR images from patients with suspicion or diagnosis of prostate cancer, 101 patients entered our research protocol. The ecMRI of the prostate obtained T2, dynamic contrast enhanced (DCE), diffusion weighted images (DWI), and proton spectroscopy images. All lesions were then identified and graded by number of modalities positive: low (<2), mod (3) and high (4) suspicion. An electromagnetic field (EM) generator (Northern Digital Inc., Waterloo, Canada) was placed above the pelvis which allows for real-time tracking of a custom made biopsy probe with an embedded miniature electromagnetic tracking sensor (Traxtal Inc., A Philips Healthcare Company, Toronto, Canada) incorporated into the needle guide (Civco Inc, Kalona IA, USA). A 2D prostate sweep is performed manually to render a 3D ultrasound image that is then registered and fused to the pre-operative prostate MR images and assigned targets for biopsy. The protocol included a standard 12 core biopsy combined with MRI/US fusion biopsy of the suspicious MR targeted lesions utilizing EM tracking. RESULTS The mean age was 62.7 + 8.3 years with a median PSA 5.8, and 90.1% (91/101) were cT1c. The chi-squared analysis comparing degree of MR suspicion and incidence of cancer detected per patient, and per lesion was performed (p<0.05), (Table 1). There was a direct correlation between degree of suspicion and the yield of biopsied lesions, 14.1% (22/156), 35.2% (25/71), 72.2% (26/36) for low, moderate, and high suspicion respectively (Table 1). CONCLUSIONS Utilizing our novel platform to screen and diagnose patients with prostate cancer may be crucial in the emerging field of focal therapy and active surveillance. Using multi-parametric MR images of patients, we were able to quantitatively assess risk of detecting prostate cancer using our biopsy protocol. In the high suspicion group determined by MR, 17/19 (89.5 %) patients were found to have cancer. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e816-e817 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul H. Chung Bethesda, MD More articles by this author Ardeshir R. Rastinehad Bethesda, MD More articles by this author Angelo A. Baccala Bethesda, MD More articles by this author Jochen Kruecker Briarcliff Manor, NY More articles by this author Sheng Xu Briarcliff Manor, NY More articles by this author Julia K. Locklin Bethesda, MD More articles by this author Baris I. Turkbey Bethesda, MD More articles by this author Joanna H. Shih Bethesda, MD More articles by this author Heinric Williams Bethesda, MD More articles by this author Gennady Bratslavsky Bethesda, MD More articles by this author Neil D. Glossop Toronto, ON More articles by this author Peter L. Choyke Bethesda, MD More articles by this author Bradford J. Wood Bethesda, MD More articles by this author Peter A. Pinto Bethesda, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...