Real time MRI-ultrasound image guided stereotactic prostate biopsy.
To report a technique for target directed transperineal ultrasound guided biopsy using high resolution endorectal MRI images Ultrasound fusion. Two patients presented after external beam irradiation for prostate cancer with a rising PSA. An Endorectal MRI using a 1.5 Tesla scanner was obtained. Subsequently a Transrectal Ultrasound guided biopsy was performed. The Ultrasound probe was fixed to a stepper-stabilizer to provide a reference coordinate system for stereotaxic needle biopsy needle placement. The MRI image set was fused to the Ultrasound images in real time. Abnormal areas determined in the MR images were targeted for biopsy. Recurrent prostate carcinoma was detected pathologically in 3 of 4 stereotactic biopsies. Abnormal areas suspicious for cancer detected on T1 weighted images obtained in a strong field Endorectal MRI scan can be targeted for stereotactic biopsy using Transrectal Ultrasound. This image guide technique may be very useful in directing biopsies.
Department of Radiation Therapy, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. ikaplan@caregroup.harvard.edu
Irving
I
Kaplan
Nicklas E
NE
Oldenburg
Paul
P
Meskell
Michael
M
Blake
Paul
P
Church
Edward J
EJ
Holupka
D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy; D013238:Stereotaxic Techniques; D014463:Ultrasonography