1458 FUSION OF NON-CONTRAST-3TESLA-MRI AND TRUS-IMAGING: IMPLEMENTATION OF A NEW BIOPSY TECHNIQUE TO DETECT PROSTATE CANCER
2012-04-01

You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 20121458 FUSION OF NON-CONTRAST-3TESLA-MRI AND TRUS-IMAGING: IMPLEMENTATION OF A NEW BIOPSY TECHNIQUE TO DETECT PROSTATE CANCER Severine Banek, Ulrich Kramer, Saladin Alloussi, Sascha Kaufmann, Christian Schwentner, Arnulf Stenzl, and david schilling Severine BanekSeverine Banek Tuebingen, Germany More articles by this author , Ulrich KramerUlrich Kramer Tuebingen, Germany More articles by this author , Saladin AlloussiSaladin Alloussi Tuebingen, Germany More articles by this author , Sascha KaufmannSascha Kaufmann Tuebingen, Germany More articles by this author , Christian SchwentnerChristian Schwentner Tuebingen, Germany More articles by this author , Arnulf StenzlArnulf Stenzl Tuebingen, Germany More articles by this author , and david schillingdavid schilling Tuebingen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1952AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES MRI-guided biopsy of the prostate for individuals with previous negative TRUS biopsy has been established in our department more than five years ago. To translate the advantages of this method into a urologic office setting we aimed to fuse 3 Tesla pelvic MRI with TRUS-imaging. This pilot study shows the first steps for implementation of this novel method in a clinical setting. METHODS Images of a 3 Tesla MRI (TRIO, Siemens, Erlangen) were exported and digitally aligned with TRUS imaging (HIVISION Preirus Hitachi Medical Systems, Wiesbaden) applying an integrated imaging software. First image fusion and digital alignment were established using a modulated plastic dummy resembling pelvic anatomy. After the fusion algorithm had been established, fusion imaging was undertaken in vivo. All patients underwent 3 Tesla pelvic MRI before the procedure. Imaging on 6 patients under general anesthesia undergoing transurethral resection of the prostate was undertaken to further optimize the fusion process. Finally, 3 patients with previous negative biopsy and persisting suspicion for prostate cancer underwent prostate biopsy: All suspicious lesions on MRI were digitally marked before image fusion with TRUS. All patients received a targeted biopsy of the suspicious lesions, followed by a 12-core systematic biopsy. Results for targeted and systematic biopsy were recorded. RESULTS Dummy experiments and the initial fusion attempts in patients under general anaesthesia showed the necessity to assign at least 3 to 4 anatomic landmarks optimize fusion of MRI and TRUS. Average duration for digital fusion of MRI and TRUS images was 10 min (8-11) for MRI-TRUS-fusion. Two of the 3 biopsy patients showed a suspicious lesion on MRI. In both patients targeted biopsy detected prostate-cancer (both Gleason 7), whereas systematic biopsy did not detect cancer in neither of the patients. CONCLUSIONS MRI and TRUS fusion imaging can effectively be undertaken and be applied for prostate biopsies in an office setting. The efficacy of the method to detect clinically significant prostate cancer has to be shown in prospective studies. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e591 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Severine Banek Tuebingen, Germany More articles by this author Ulrich Kramer Tuebingen, Germany More articles by this author Saladin Alloussi Tuebingen, Germany More articles by this author Sascha Kaufmann Tuebingen, Germany More articles by this author Christian Schwentner Tuebingen, Germany More articles by this author Arnulf Stenzl Tuebingen, Germany More articles by this author david schilling Tuebingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...