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Magnetic Resonance Materials in Physics, Biology and Medicine

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01-10-2019 | Research Article

In-bore biopsies of the prostate assisted by a remote-controlled manipulator at 1.5 T

Authors: Nicolas Linder, Alexander Schaudinn, Tim-Ole Petersen, Nikolaos Bailis, Patrick Stumpp, Lars-Christian Horn, Jens-Uwe Stolzenburg, Thomas Kahn, Michael Moche, Harald Busse

Published in: Magnetic Resonance Materials in Physics, Biology and Medicine | Issue 5/2019

Abstract

Purpose

To evaluate the technical and clinical utility of a fully MRI-compatible, pneumatically driven remote-controlled manipulator (RCM) for targeted biopsies of the prostate at 1.5 T.

Materials and methods

The data of the first 22 patients that were biopsied under robotic assistance were analyzed. Interventional planning relied on T2-weighted (T2w) turbo spin-echo (TSE) images (axial and sagittal) with a high-b-value diffusion-weighted acquisition added in selected cases. Alignment of the needle guide was controlled with a short balanced SSFP sequence in two oblique planes along the MR-visible sheath. Signals were acquired with a combination of elements from a 30-channel body and a 32-channel spine coil. Biopsy samples were taken with a fully automatic 18-G biopsy gun with a length of 150 or 175 mm.

Results

Mean age was 66.6 years and average PSA level was 11.5 ng/ml. Fourteen out of 22 patients (63%) had received prior biopsies under transrectal ultrasound guidance. Diagnostic MRI reports (before biopsy) involved 17 cases with a single suspicious finding (four PI-RADS 3, one PI-RADS 3–4, eight PI-RADS 4 and nine PI-RADS 5 cases). The median effective procedure time was 33.9 (range 25.0–55.9) min for 16 cases with one CSR and 63.4 (52.7–81.8) min for 5 cases with two CSRs. The biopsy with three CSRs took 74.0 min. Histopathologic examination revealed prostate cancer in 14 of 22 cases.

Conclusion

MR-targeted, transrectal biopsy of the prostate could be reliably performed with a robotic manipulator at a field strength of 1.5 T. Balanced SSFP imaging is considered a viable option for fast procedural control. Follow-up work needs to evaluate to what extent in-bore adjustments and workflow enhancements will contribute to shorter procedure times or higher patient comfort.

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Title: In-bore biopsies of the prostate assisted by a remote-controlled manipulator at 1.5 T
Authors: Nicolas Linder
Alexander Schaudinn
Tim-Ole Petersen
Nikolaos Bailis
Patrick Stumpp
Lars-Christian Horn
Jens-Uwe Stolzenburg
Thomas Kahn
Michael Moche
Harald Busse
Publication date: 01-10-2019
Publisher: Springer International Publishing
Published in: Magnetic Resonance Materials in Physics, Biology and Medicine / Issue 5/2019
Print ISSN: 0968-5243
Electronic ISSN: 1352-8661
DOI: https://doi.org/10.1007/s10334-019-00751-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

In-bore biopsies of the prostate assisted by a remote-controlled manipulator at 1.5 T

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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