Targeted MRI/TRUS fusion-guided biopsy in men with previous negative prostate biopsies: initial experience.

Transcription

1 Targeted MRI/TRUS fusion-guided biopsy in men with previous negative prostate biopsies: initial experience. Poster No.: C-0382 Congress: ECR 2016 Type: Scientific Exhibit Authors: A. I. Gromov 1, V. V. Kapustin 2, D. Koshurnikov 1, V. Shirokorad 1 ; 1 Moscow/RU, 2 Moscow Oblast/RU Keywords: Cancer, Biopsy, Ultrasound, MR, Image manipulation / Reconstruction, Pelvis, Oncology, Interventional non-vascular DOI: /ecr2016/C-0382 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 8

2 Aims and objectives Background. The morphological verification of prostate cancer in certain cases presents a difficult diagnostic problem. Recently, concern over the increasing risk of antibioticresistant infection has prompted a re-evaluation of patient preparation, as well as the number and frequency of prostate biopsies [1]. Several studies about different types of MRI/US fusion via software-based image coregistration without requiring the MRI for prostate cancer diagnostics and local treatment appeared recently [2-5]. The aim of our study was to determine a possibility of simultaneous transrectal ultrasound and MRI imaging technique ("sensor-based" MR-TRUS Fusion) for biopsy guidance in those cases where a prostate cancer was suspected, but reiterated previous biopsies have failed. Page 2 of 8

3 Methods and materials 36 patients with suspected prostate cancer with no histological verification after multiply (from twice to sixfold) US-guided sextant or saturation biopsies were included in the study. Multiparametric high-field (1.5T) MRI with a torso phased-array surface coil were performed and showed "suspicious" prostate focuses in all cases. Simultaneous sensor based MR and real-time TRUS images formations were performed ("Virtual Navigator" Esaote, Italy; "Smart Fusion" Toshiba, Japan). After high accuracy ( cm) of images superposition was achieved, core-needle biopsies (16-18G) of suspicious foci were executed. Page 3 of 8

4 Images for this section: Fig. 1: MR/TRUS image of prostate. A - TRUS image of prostate with Power Doppler; B - Axial T2WI reconstruction: suspicious focus with low MR-signal intensity in left peripheral zone. Ultrasound diagnostic, Moscow Oncological Hospital # 62 - Moscow Oblast/RU Page 4 of 8

5 Results Use of MR/TRUS-Fusion technique ensured the verification of prostate cancer in 27 cases. Benign hyperplasia, chronic prostatitis and PIN were revealed in 9 cases. Page 5 of 8

6 Images for this section: Fig. 2: Targeted biopsy under MR-TRUS Fusion navigation. The needle tip was visualized in the suspicious focus (arrow). Prostate adenocarcinoma (Gleeson 7) was verified. Ultrasound diagnostic, Moscow Oncological Hospital # 62 - Moscow Oblast/RU Fig. 3: Targeted biopsy under MR-TRUS Fusion navigation. The needle tip was visualized in the suspicious focus (blue circle). Benign hyperplasia was revealed histologically. Ultrasound diagnostic, Moscow Oncological Hospital # 62 - Moscow Oblast/RU Page 6 of 8

7 Conclusion Application of MRI/TRUS-Fusion technology may be helpful for precise guidance of target core-needle biopsy in cases where prostate cancer is suspected, but standard systematic biopsy technique was inefficient. Future studies will be needed to evaluate the clinical implications of MR/TRUS targeted biopsy. Page 7 of 8

8 References 1. Logan J.K., Rais-Bahrami S., Turkbey B. et al. Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies // BJU Int Nov; 114(5): Cornud F., Brolis L., Delongchamps N.B. et al. TRUS-MRI image registration: a paradigm shift in the diagnosis of significant prostate cancer // Abdom Imaging. 2013; 38(6): de Gorski A., Rouprêt M., Peyronnet B., et al. Accuracy of Magnetic Resonance Imaging/Ultrasound Fusion Targeted Biopsies to Diagnose Clinically Significant Prostate Cancer in Enlarged Compared to Smaller Prostates // J Urol. 2015; 194(3): Delongchamps N.B., Lefèvre A., Bouazza N. et al. Detection of significant prostate cancer with magnetic resonance targeted biopsies--should transrectal ultrasound-magnetic resonance imaging fusion guided biopsies alone be a standard of care? // J Urol Apr; 193(4): Puech P., Ouzzane A., Gaillard V. et al. Multiparametric MRI-targeted TRUS prostate biopsies using visual registration // Biomed Res Int. 2014; 2014: Page 8 of 8