Fast 3-T MR-guided transrectal prostate biopsy using an in-room tablet device for needle guide alignment: a feasibility study

• Published in: European radiology Vol. 28; no. 11; pp. 4824 - 4831
• Main Authors: Overduin, Christiaan G., Heidkamp, Jan, Rothgang, Eva, Barentsz, Jelle O., de Lange, Frank, Fütterer, Jurgen J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2018; Springer Nature B.V
• Subjects: Aged; Alignment; Biopsy; Biopsy, Large-Core Needle - methods; Cancer; Complications; Diagnostic Radiology; Diagnostic systems; Equipment Design; Feasibility Studies; Fluoroscopy; Humans; Image-Guided Biopsy - instrumentation; Imaging; Internal Medicine; Interventional; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging, Interventional - instrumentation; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Grading; Neuroradiology; Patients; Prostate; Prostate cancer; Prostatic Neoplasms - pathology; Radiology; Ultrasound; Image-guided biopsy; Operative time; Magnetic resonance imaging; Prostate cancer; Tablet computers
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-018-5497-9

Objectives To assess the feasibility of adding a tablet device inside the scanner room to assist needle-guide alignment during magnetic resonance (MR)-guided transrectal prostate biopsy. Methods Twenty patients with one cancer-suspicious region (CSR) with PI-RADS score ≥ 4 on diagnostic multiparametric MRI were prospectively enrolled. Two orthogonal scan planes of an MR fluoroscopy sequence (~3 images/s) were aligned to the CSR and needle-guide pivoting point. Targeting was achieved by manipulating the needle-guide under MR fluoroscopy feedback on the in-room tablet device. Technical feasibility and targeting success were assessed. Complications and biopsy procedure times were also recorded. Results Needle-guide alignment with the in-room tablet device was technically successful in all patients and allowed sampling after a single alignment step in 19/20 (95%) CSRs (median size 14 mm, range: 4-45). Biopsy cores contained cancer in 18/20 patients. There were no per-procedural or post-biopsy complications. Using the tablet device, the mean time to first biopsy was 5.8 ± 1.0 min and the mean total procedure time was 23.7 ± 4.1 min. Conclusions Use of an in-room tablet device to assist needle-guide alignment was feasible and safe during MR-guided transrectal prostate biopsy. Initial experience indicates potential for procedure time reduction. Key Points • Performing MR-guided prostate biopsy using an in-room tablet device is feasible. • CSRs could be sampled after a single alignment step in 19/20 patients. • The mean procedure time for biopsy with the tablet device was 23.7 min.