Transrectal prostate biopsy and fiducial marker placement in a standard 1.5T magnetic resonance imaging scanner.
OBJECTIVE
We investigated the accuracy and feasibility of a system that provides transrectal needle access to the prostate concurrent with 1.5 Tesla MRI which previously has not been possible.


METHODS
In 5 patients with previously diagnosed prostate cancer, MRI guided intraprostatic placement of gold fiducial markers (4 procedures) and/or prostate biopsy (3 procedures) was performed using local anesthesia.


RESULTS
Mean procedure duration was 76 minutes and all patients tolerated the intervention well. Procedure related adverse events included self-limited hematuria and hematochezia following 3 of 8 procedures (all resolved in less than 1 week). Mean needle placement accuracy was 1.9 mm for the fiducial marker placement studies and 1.8 mm for the biopsy procedures. Mean fiducial marker placement accuracy was 4.8 mm and the mean fiducial marker placement accuracy transverse to the needle direction was 2.6 mm. All patients who underwent the procedure were able to complete their course of radiotherapy without delay or complication.


CONCLUSIONS
While studies of clinical usefulness are warranted, transrectal 1.5 T MRI guided prostate biopsy and fiducial marker placement is feasible using this system, providing new opportunities for image guided diagnostic and therapeutic prostate interventions.
Susil
Robert C
RC
Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ménard
Cynthia
C
Krieger
Axel
A
Coleman
Jonathan A
JA
Camphausen
Kevin
K
Choyke
Peter
P
Fichtinger
Gabor
G
Whitcomb
Louis L
LL
Coleman
C Norman
CN
Atalar
Ergin
E
D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D008297:Male; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*