Skip to main content
Top
Published in: European Radiology 4/2017

Open Access 01-04-2017 | Urogenital

Feasibility of a 2nd generation MR-compatible manipulator for transrectal prostate biopsy guidance

Authors: J. G. R. Bomers, D. G. H. Bosboom, G. H. Tigelaar, J. Sabisch, J. J. Fütterer, D. Yakar

Published in: European Radiology | Issue 4/2017

Login to get access

Abstract

Objectives

To assess the feasibility of a 2nd generation MR-compatible, remote-controlled manipulator (RCM) as an aid to perform MR-guided transrectal prostate biopsy in males with suspicion of prostate cancer (PCa).

Methods

This prospective phase I study was approved by the local ethical committee and written informed consent was obtained from each patient. Twenty patients with ≥1 cancer suspicious region (CSR) with a PI-RADS score of ≥3 detected on the diagnostic multi-parametric MRI and no prior prostate treatment underwent MR-guided biopsy with the aid of the RCM. Complications were classified according to the modified Clavien system for reporting surgical complications. For evaluation of the workflow, procedure- and manipulation times were recorded.

Results

All CSR’s (n=20) were reachable with the MR-compatible RCM and the cancer detection rate was 70 %. The median procedure time was 36:44 minutes (range, 23 – 61 minutes) and the median manipulation time for needle guide movement was 5:48 minutes (range, 1:15 – 18:35 minutes). Two Clavien grade 1 complications were reported.

Conclusions

It is feasible and safe to perform transrectal MR-guided prostate biopsy using a MR-compatible RCM as an aid. It is a fast and efficient way to biopsy suspicious prostate lesions with a minimum number of biopsies per patient.

Key Points

• It is feasible to perform transrectal prostate biopsy using a MR-compatible RCM.
• Using a RCM for MR-guided biopsy is safe, fast, and efficient.
• All cancer suspicious regions were reachable with the RCM.
Literature
1.
go back to reference Chun FK, Epstein JI, Ficarra V et al (2010) Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol 58:851–864CrossRefPubMed Chun FK, Epstein JI, Ficarra V et al (2010) Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol 58:851–864CrossRefPubMed
2.
go back to reference Hambrock T, Hoeks C, Hulsbergen-van de Kaa C et al (2012) Prospective assessment of prostate cancer aggressiveness using 3-T diffusion-weighted magnetic resonance imaging-guided biopsies versus a systematic 10-core transrectal ultrasound prostate biopsy cohort. Eur Urol 61:177–184CrossRefPubMed Hambrock T, Hoeks C, Hulsbergen-van de Kaa C et al (2012) Prospective assessment of prostate cancer aggressiveness using 3-T diffusion-weighted magnetic resonance imaging-guided biopsies versus a systematic 10-core transrectal ultrasound prostate biopsy cohort. Eur Urol 61:177–184CrossRefPubMed
3.
go back to reference Djavan B, Milani S, Remzi M (2005) Prostate biopsy: who, how and when. An update. Can J Urol 12:44–48, discussion 99-100PubMed Djavan B, Milani S, Remzi M (2005) Prostate biopsy: who, how and when. An update. Can J Urol 12:44–48, discussion 99-100PubMed
4.
go back to reference Sciarra A, Barentsz J, Bjartell A et al (2011) Advances in magnetic resonance imaging: how they are changing the management of prostate cancer. Eur Urol 59:962–977CrossRefPubMed Sciarra A, Barentsz J, Bjartell A et al (2011) Advances in magnetic resonance imaging: how they are changing the management of prostate cancer. Eur Urol 59:962–977CrossRefPubMed
5.
go back to reference Hoeks CM, Schouten MG, Bomers JG et al (2012) Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 62:902–909CrossRefPubMed Hoeks CM, Schouten MG, Bomers JG et al (2012) Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 62:902–909CrossRefPubMed
6.
go back to reference Hambrock T, Somford DM, Hoeks C et al (2010) Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol 183:520–527CrossRefPubMed Hambrock T, Somford DM, Hoeks C et al (2010) Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol 183:520–527CrossRefPubMed
7.
go back to reference Moore CM, Robertson NL, Arsanious N et al (2013) Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol 63:125–140CrossRefPubMed Moore CM, Robertson NL, Arsanious N et al (2013) Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol 63:125–140CrossRefPubMed
8.
go back to reference Pokorny MR, de Rooij M, Duncan E et al (2014) Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol 66:22–29CrossRefPubMed Pokorny MR, de Rooij M, Duncan E et al (2014) Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol 66:22–29CrossRefPubMed
9.
go back to reference Yakar D, Schouten MG, Bosboom DGH, Barentsz JO, Scheenen TWJ, Futterer JJ (2011) Feasibility of a pneumatically actuated MR-compatible robot for transrectal prostate biopsy guidance. Radiology 260:241–247CrossRefPubMed Yakar D, Schouten MG, Bosboom DGH, Barentsz JO, Scheenen TWJ, Futterer JJ (2011) Feasibility of a pneumatically actuated MR-compatible robot for transrectal prostate biopsy guidance. Radiology 260:241–247CrossRefPubMed
10.
go back to reference Tokuda J, Fischer GS, DiMaio SP et al (2010) Integrated navigation and control software system for MRI-guided robotic prostate interventions. Comput Med Imaging Graph Off J Comput Med Imaging Soc 34:3–8CrossRef Tokuda J, Fischer GS, DiMaio SP et al (2010) Integrated navigation and control software system for MRI-guided robotic prostate interventions. Comput Med Imaging Graph Off J Comput Med Imaging Soc 34:3–8CrossRef
12.
go back to reference Weinreb JC, Barentsz JO, Choyke PL et al (2016) PI-RADS prostate imaging - reporting and data system: 2015, version 2. Eur Urol 69:16–40CrossRefPubMed Weinreb JC, Barentsz JO, Choyke PL et al (2016) PI-RADS prostate imaging - reporting and data system: 2015, version 2. Eur Urol 69:16–40CrossRefPubMed
13.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral
14.
go back to reference Overduin CG, Futterer JJ, Barentsz JO (2013) MRI-guided biopsy for prostate cancer detection: a systematic review of current clinical results. Curr Urol Rep 14:209–213CrossRefPubMed Overduin CG, Futterer JJ, Barentsz JO (2013) MRI-guided biopsy for prostate cancer detection: a systematic review of current clinical results. Curr Urol Rep 14:209–213CrossRefPubMed
15.
go back to reference Valerio M, Donaldson I, Emberton M et al (2015) Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: a systematic review. Eur Urol 68:8–19CrossRefPubMed Valerio M, Donaldson I, Emberton M et al (2015) Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: a systematic review. Eur Urol 68:8–19CrossRefPubMed
16.
go back to reference Brock M, Loppenberg B, Roghmann F et al (2015) Impact of real-time elastography on magnetic resonance imaging/ultrasound fusion guided biopsy in patients with prior negative prostate biopsies. J Urol 193:1191–1197CrossRefPubMed Brock M, Loppenberg B, Roghmann F et al (2015) Impact of real-time elastography on magnetic resonance imaging/ultrasound fusion guided biopsy in patients with prior negative prostate biopsies. J Urol 193:1191–1197CrossRefPubMed
17.
go back to reference Arsov C, Rabenalt R, Blondin D et al (2015) Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. Eur Urol 68:713–720CrossRefPubMed Arsov C, Rabenalt R, Blondin D et al (2015) Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. Eur Urol 68:713–720CrossRefPubMed
18.
go back to reference Zamecnik P, Schouten MG, Krafft AJ et al (2014) Automated real-time needle-guide tracking for fast 3-T MR-guided transrectal prostate biopsy: a feasibility study. Radiology 273:879–886CrossRefPubMed Zamecnik P, Schouten MG, Krafft AJ et al (2014) Automated real-time needle-guide tracking for fast 3-T MR-guided transrectal prostate biopsy: a feasibility study. Radiology 273:879–886CrossRefPubMed
19.
go back to reference Lepor H, Llukani E, Sperling D, Futterer JJ (2015) Complications, recovery, and early functional outcomes and oncologic control following in-bore focal laser ablation of prostate cancer. Eur Urol 68(6):924–926 Lepor H, Llukani E, Sperling D, Futterer JJ (2015) Complications, recovery, and early functional outcomes and oncologic control following in-bore focal laser ablation of prostate cancer. Eur Urol 68(6):924–926
20.
go back to reference Bomers JG, Yakar D, Overduin CG et al (2013) MR imaging-guided focal cryoablation in patients with recurrent prostate cancer. Radiology 268:451–460CrossRefPubMed Bomers JG, Yakar D, Overduin CG et al (2013) MR imaging-guided focal cryoablation in patients with recurrent prostate cancer. Radiology 268:451–460CrossRefPubMed
Metadata
Title
Feasibility of a 2nd generation MR-compatible manipulator for transrectal prostate biopsy guidance
Authors
J. G. R. Bomers
D. G. H. Bosboom
G. H. Tigelaar
J. Sabisch
J. J. Fütterer
D. Yakar
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4504-2

Other articles of this Issue 4/2017

European Radiology 4/2017 Go to the issue