Optimizing Patient Population for MP-MRI and Fusion Biopsy for Prostate Cancer Detection

Frye, Thomas; Pinto, Peter A.; George, Arvin

doi:10.1007/s11934-015-0521-y

Cited by 18 publications

(7 citation statements)

References 53 publications

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“…MP-MRI allows for imaging-based identification and characterization of PCa, improving diagnostic accuracy [ 13 , 14 ]. Yet, few studies have determined the value of MP-MRI as a non-invasive means for the prediction of BCR.…”

Section: Discussionmentioning

confidence: 99%

“…Advances in multiparametric MRI (MP-MRI), consisting of T2-weighted (T2W), diffusion-weighted (DW), and dynamic contrast enhanced (DCE) imaging have improved detection and localization of clinically significant PCa [ 13 , 14 ]. Although MP-MRI has been extensively studied for its diagnostic capabilities, its significance in predicting postoperative outcomes is less well understood [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical Prostatectomy

Siddiqui

George

et al. 2016

PLoS ONE

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ObjectivesTo evaluate the utility of preoperative multiparametric magnetic resonance imaging (MP-MRI) in predicting biochemical recurrence (BCR) following radical prostatectomy (RP).Materials/MethodsFrom March 2007 to January 2015, 421 consecutive patients with prostate cancer (PCa) underwent preoperative MP-MRI and RP. BCR-free survival rates were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to identify clinical and imaging variables predictive of BCR. Logistic regression was performed to generate a nomogram to predict three-year BCR probability.ResultsOf the total cohort, 370 patients met inclusion criteria with 39 (10.5%) patients experiencing BCR. On multivariate analysis, preoperative prostate-specific antigen (PSA) (p = 0.01), biopsy Gleason score (p = 0.0008), MP-MRI suspicion score (p = 0.03), and extracapsular extension on MP-MRI (p = 0.03) were significantly associated with time to BCR. A nomogram integrating these factors to predict BCR at three years after RP demonstrated a c-index of 0.84, outperforming the predictive value of Gleason score and PSA alone (c-index 0.74, p = 0.02).ConclusionThe addition of MP-MRI to standard clinical factors significantly improves prediction of BCR in a post-prostatectomy PCa cohort. This could serve as a valuable tool to support clinical decision-making in patients with moderate and high-risk cancers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical Prostatectomy

Siddiqui

George

et al. 2016

PLoS ONE

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“…The future of fusion biopsy technologies seems promising; significant investment in commercially available fusion platforms continues and adoption is expanding. The challenge we face is appropriate utilization in the patient population that will benefit the most (64, 65). …”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging-Ultrasound Fusion-Guided Prostate Biopsy: Review of Technology, Techniques, and Outcomes

et al. 2016

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Transrectal ultrasound (TRUS)-guided (12–14 core) systematic biopsy of the prostate is the recommended standard for patients with suspicion of prostate cancer (PCa). Advances in imaging have led to the application of magnetic resonance imaging (MRI) for the detection of PCa with subsequent development of software-based co-registration allowing for the integration of MRI with real-time TRUS during prostate biopsy. A number of fusion-guided methods and platforms are now commercially available with common elements in image and analysis and planning. Implementation of fusion-guided prostate biopsy has now been proven to improve the detection of clinically significant PCa in appropriately selected patients.

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“…Fusion biopsy, however, is a non-disruptive advance over the standard TRUS technique, is logistically simpler than the direct method, and clinical studies have already shown approx. 30% increase in the detection of high-risk cancers than untargeted methods [8, 9]. However, targeting accuracy relative to MRI is unknown, and it remains questionable if this method is sufficiently accurate.…”

Section: Introductionmentioning

confidence: 99%

MR Safe Robot, FDA Clearance, Safety and Feasibility of Prostate Biopsy Clinical Trial

Stoianovici

Kim

Petrisor

et al. 2017

IEEE/ASME Trans. Mechatron.

101

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Compatibility of mechatronic devices with the MR environment has been a very challenging engineering task. After over a decade of developments, we report the successful translation to clinical trials of our MR Safe robot technology. MrBot is a 6-degree-of-freedom, pneumatically actuated robot for transperineal prostate percutaneous access, built exclusively of electrically nonconductive and nonmagnetic materials. Its extensive pre-clinical tests have been previously reported. Here, we present the latest technology developments, an overview of the regulatory protocols, and technically related results of the clinical trial. The FDA has approved the MrBot for the biopsy trial, which was successfully performed in 5 patients. With no trajectory corrections, and no unsuccessful attempts to target a site, the robot achieved an MRI based needle targeting accuracy of 2.55 mm. To the best of our knowledge, this is the first robot approved by the FDA for the MR environment. The results confirm that it is possible to perform safe and accurate robotic manipulation in the MRI scanner, and the development of MR Safe robots is no longer a daunting technical challenge.

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Optimizing Patient Population for MP-MRI and Fusion Biopsy for Prostate Cancer Detection

Cited by 18 publications

References 53 publications

Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical Prostatectomy

Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical Prostatectomy

Magnetic Resonance Imaging-Ultrasound Fusion-Guided Prostate Biopsy: Review of Technology, Techniques, and Outcomes

MR Safe Robot, FDA Clearance, Safety and Feasibility of Prostate Biopsy Clinical Trial

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