Transperineal prostate biopsy under magnetic resonance image guidance: A needle placement accuracy study

Blumenfeld, Philip; Hata, Nobuhiko; DiMaio, Simon P.; Zou, Kelly H.; Haker, Steven; Fichtinger, Gabor; Tempany, Clare M.

doi:10.1002/jmri.21067

Cited by 72 publications

(62 citation statements)

References 29 publications

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“…The accuracy study demonstrates that the integrated system provided sufficient registration accuracy for prostate biopsy and brachytherapy compared with the clinical significant size (0.5 cc) and traditional grid spacing (5 mm). The result is also comparable with the accuracy study on clinical targeted biopsy by Blumenfeld et al (6.5 mm) [15]. Since mechanical error was excluded from the condition in the presented report, the study must be continued to evaluate the overall accuracy of targeting using the robotic device guided by the system.…”

Section: Discussionsupporting

confidence: 84%

Software Strategy for Robotic Transperineal Prostate Therapy in Closed-Bore MRI

Tokuda

Fischer

Csoma

et al. 2008

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008

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A software strategy to provide intuitive navigation for MRI-guided robotic transperineal prostate therapy is presented. In the system, the robot control unit, the MRI scanner, and open-source navigation software are connected to one another via Ethernet to exchange commands, coordinates, and images. Six states of the system called "workphases" are defined based on the clinical scenario to synchronize behaviors of all components. The wizard-style user interface allows easy following of the clinical workflow. On top of this framework, the software provides features for intuitive needle guidance: interactive target planning; 3D image visualization with current needle position; treatment monitoring through real-time MRI. These features are supported by calibration of robot and image coordinates by the fiducial-based registration. The performance test shows that the registration error of the system was 2.6 mm in the prostate area, and it displayed real-time 2D image 1.7 s after the completion of image acquisition.

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Section: Discussionsupporting

confidence: 84%

Software Strategy for Robotic Transperineal Prostate Therapy in Closed-Bore MRI

Tokuda

Fischer

Csoma

et al. 2008

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2008

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“…13 Blumenfeld et al researched needle placement accuracy of MRI-guided core needle biopsy of the prostate using 2 needle designs-symmetrical and asymmetrical beveled tip. 11 A total of 10 biopsies in patients with prostate cancer were performed with 18-G core biopsy needle via a percutaneous transperineal approach. Needle placement error (NPE) was calculated by comparing the coordinates of preprocedural targets with the needle tip measured from the live intraprocedural coherent gradient echo images.…”

Section: Discussionmentioning

confidence: 99%

Deflection Analysis of Different Needle Designs for Prostate Biopsy and Focal Therapy

Stone

Mouraviev

Schechter³

et al. 2016

Technol Cancer Res Treat

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Objective: The biopsy needles currently used were designed for a transrectal biopsy and are known to experience significant deflection from the point of entry into the gland to the needle tip. Methods: Five designs were selected for testing: 18-gauge Bard, 15-gauge lancet tip needle with 12 vet-point cannula, and trocar tip needle with 12 , 15 , and 20 vet-point cannulas. The 15-gauge needle was designed to take a variable specimen sample between 20 and 60 mm, whereas the Bard needle specimen bed was fixed at 20 mm. The needles were bench tested on a spring-loaded platform and fired into gelatin matrix with modulus of elasticity similar to human prostate. Results: The Bard device with lancet tip needle deflected an average of 0.9 mm (range 0.3-1.3 mm) and 1.9(range 0.6 -2.8 ). Increasing needle diameter from 18-gauge Bard to 15-gauge variable with the same lancet tip needle design resulted in an average deflection across the 3 test lengths of 0.9 mm (range 0-2.0 mm) and 0.9 (range 0 -2.0 ) with no significant difference. On the contrary, the use of the 3-point trocar tip needles with 12, 15 , and 20 vet-point cannulas demonstrated significant reduction in the extent of deflection in both millimeters and degrees. There was no deflection at the 2-and 4-cm shots for both spring loads and preloads for the 3 vet tip angles tested. At 6 cm, the 20 vet tip performed the best. Conclusion: We proposed a mechanism that provides more accurate prostate sampling by combining a 3-point trocar tip on the needle with a 20 vet tip on the cutting cannula. Using the phantom, mimicking prostate gland tissue density, no deflection was revealed between 20-and 60-mm biopsy lengths, which should permit a straight sample in the majority of prostate glands and improve cancer localization for focal therapy planning.

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“…Furthermore, biologic-metabolic MRI imaging methods like spectroscopy, dynamic contrastenhanced studies, and diffusion-weighted images are able to visualize the intraprostatic lesion, which makes targeted interventions, partial radiation dose delivery and dose painting possible [9][10][11]. The utility and clinical efficacy of MR-guided prostate BT has been demonstrated by an increasing number of groups [12][13][14][15][16][17][18][19].…”

Section: Hdrmentioning

confidence: 97%

Open MR-Guided High-Dose-Rate (HDR) Prostate Brachytherapy: Feasibility and Initial Experiences Open MR-Guided High-Dose-Rate (HDR) Prostate Brachytherapy

Lakosi

Antal

Vandulek

et al. 2011

Pathol. Oncol. Res.

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The aim of our pilot study was to demonstrate the feasibility and dosimetric quality of MR-guided HDR prostate brachytherapy in a low-field 0.35T open MRI scanner and to present our initial clinical experiences. 16 patients with intermediate- to high-risk localized prostate cancer were treated with 46-60 Gy of external beam radiotherapy preceded and/or followed by an 8 Gy MR-guided HDR boost. For interventions an MR compatible custom-made system, coaxial needles and plastic catheters were used. Template reconstruction, trajectory planning, image guidance, contouring and treatment planning were exclusively based on MR images. For treatment planning, dose-point- and anatomy-based inverse planning optimization was used. Image quality was found to be good to excellent in almost all cases. The mean catheter placement accuracy modeled by Rayleigh distribution was 2.9 mm with a sigma value of 2.3 mm. The mean and standard deviation (SD) of the dosimetric results for the target volume were the following: V100: 94.2 ± 4.3%, V150: 43.9 ± 6.8%, V200: 18.5 ± 5.9%. The mean D(0.1), D(1) and D1 values for the intraprostatic urethra were 117.6 ± 12.5%, 98.5 ± 19.9% and 122.3 ± 16.4%, respectively. Regarding the rectal wall the mean D(0.1), D(1) and D(2) values were 77.3 ± 7.2%, 64.8 ± 7.5%, and 53.2 ± 9.1%, respectively. The mean maximum dose for the inner rectal surface was 53.5 ± 9.2%. No RTOG Grade 3 or worse acute toxicities were observed. Our method seems to be a promising approach for performing feasible, accurate and high-quality MR-guided HDR prostate brachytherapy. To determine the long term side effects and outcome higher number of patients, additional follow-up is needed.

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Transperineal prostate biopsy under magnetic resonance image guidance: A needle placement accuracy study

Cited by 72 publications

References 29 publications

Software Strategy for Robotic Transperineal Prostate Therapy in Closed-Bore MRI

Software Strategy for Robotic Transperineal Prostate Therapy in Closed-Bore MRI

Deflection Analysis of Different Needle Designs for Prostate Biopsy and Focal Therapy

Open MR-Guided High-Dose-Rate (HDR) Prostate Brachytherapy: Feasibility and Initial Experiences Open MR-Guided High-Dose-Rate (HDR) Prostate Brachytherapy

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