madman
Super Moderator
Abstract
Multiparametric magnetic resonance imaging (MRI) and MRI-guided prostate biopsy have become the standard for prostate cancer diagnosis. As their implementation is relatively recent, experience is still limited in various centers. An MRI-guided biopsy requires basic knowledge in prostate MRI and ultrasound (US), but also in the image processing protocol specific for each device. Standardization of the method is needed to ensure the best results in terms of diagnostic accuracy. We hereby present our technique for MRI-US fusion-guided prostate biopsy and the outcomes after performing more than 600 procedures.
Introduction
Multiparametric magnetic resonance imaging (MRI) and MRI-guided prostate biopsy has become an integral part of prostate cancer (PCa) diagnosis. Currently, the European Association of Urology (EAU) Guidelines recommend MRI-guided prostate biopsy both in the initial and repeat biopsy setting [1]. Despite leading to significant improvement in the diagnosis of PCa [2], their implementation worldwide has been hampered by the increased costs [3]. As such, experience is still limited in various centers [4].
MRI-ultrasound (US) fusion biopsy entails that the ultrasound machine is able to perform a real-time overlay of the MRI and US volumes in order to assist a targeted biopsy. These systems are the most widely used due to the best cost/effectiveness ratio [3,5]. MRI-US fusion biopsy requires basic knowledge of prostate MRI and US, together with image processing protocol, which is specific for each device. Prostate MRI is a relatively new addition to the urologic practice and urologists, who are performing the biopsy, are frequently inexperienced in interpretation. Thus, the learning curve of the procedure might be cumbersome [6]. Therefore, minimal training in MRI reading and standardization of the MRI-US fusion technique has the potential to ensure good diagnostic accuracy.
*The aim of the current paper is to present our standardized technique and outcomes of MRI-US fusion-guided prostate biopsy. A real-time software-based MRI-US fusion system with rigid registration was employed in all cases.
*Prostate MRI
*Indications of MRI-guided biopsy
*MRI-US fusion biopsy technique
-Preparation of the MRI images
-Performing the procedure
-Our experience
Conclusion
MRI-guided prostate biopsy has recently become the standard for the diagnosis of PCa. As MRI-US fusion systems are most commonly used for guidance, standardization of the technique is necessary to ensure high diagnostic accuracy from the beginning of the learning curve.
Multiparametric magnetic resonance imaging (MRI) and MRI-guided prostate biopsy have become the standard for prostate cancer diagnosis. As their implementation is relatively recent, experience is still limited in various centers. An MRI-guided biopsy requires basic knowledge in prostate MRI and ultrasound (US), but also in the image processing protocol specific for each device. Standardization of the method is needed to ensure the best results in terms of diagnostic accuracy. We hereby present our technique for MRI-US fusion-guided prostate biopsy and the outcomes after performing more than 600 procedures.
Introduction
Multiparametric magnetic resonance imaging (MRI) and MRI-guided prostate biopsy has become an integral part of prostate cancer (PCa) diagnosis. Currently, the European Association of Urology (EAU) Guidelines recommend MRI-guided prostate biopsy both in the initial and repeat biopsy setting [1]. Despite leading to significant improvement in the diagnosis of PCa [2], their implementation worldwide has been hampered by the increased costs [3]. As such, experience is still limited in various centers [4].
MRI-ultrasound (US) fusion biopsy entails that the ultrasound machine is able to perform a real-time overlay of the MRI and US volumes in order to assist a targeted biopsy. These systems are the most widely used due to the best cost/effectiveness ratio [3,5]. MRI-US fusion biopsy requires basic knowledge of prostate MRI and US, together with image processing protocol, which is specific for each device. Prostate MRI is a relatively new addition to the urologic practice and urologists, who are performing the biopsy, are frequently inexperienced in interpretation. Thus, the learning curve of the procedure might be cumbersome [6]. Therefore, minimal training in MRI reading and standardization of the MRI-US fusion technique has the potential to ensure good diagnostic accuracy.
*The aim of the current paper is to present our standardized technique and outcomes of MRI-US fusion-guided prostate biopsy. A real-time software-based MRI-US fusion system with rigid registration was employed in all cases.
*Prostate MRI
*Indications of MRI-guided biopsy
*MRI-US fusion biopsy technique
-Preparation of the MRI images
-Performing the procedure
-Our experience
Conclusion
MRI-guided prostate biopsy has recently become the standard for the diagnosis of PCa. As MRI-US fusion systems are most commonly used for guidance, standardization of the technique is necessary to ensure high diagnostic accuracy from the beginning of the learning curve.
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