title: In-bore setup and software for 3T MRI-guided transperineal prostate biopsy.
abstract: MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 T MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with a Z-frame that gives a physician access to the perineum of the patient at the imaging position and allows the physician to perform MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right-left (RP) and anterior-posterior (AP) axes were 1.1 ± 0.8 and 1.4 ± 1.1 mm, respectively, while the rotational errors around the RL, AP and superior-inferior axes were (0.8 ± 1.0)°, (1.7 ± 1.6)° and (0.0 ± 0.0)°, respectively. The 2D root-mean-square (RMS) needle-placement error was 3 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle-placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop setup and software, which supports manual needle placement without moving the patient out of the magnet.
authors.affiliation: Department of Radiology, Brigham and Womens Hospital and Harvard Medical School, Boston, MA, USA. tokuda@bwh.harvard.edu
authors.forename: Junichi
authors.initials: J
authors.lastname: Tokuda
authors.forename: Kemal
authors.initials: K
authors.lastname: Tuncali
authors.forename: Iulian
authors.initials: I
authors.lastname: Iordachita
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Song
authors.forename: Andriy
authors.initials: A
authors.lastname: Fedorov
authors.forename: Sota
authors.initials: S
authors.lastname: Oguro
authors.forename: Andras
authors.initials: A
authors.lastname: Lasso
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Fennessy
authors.forename: Clare M
authors.initials: CM
authors.lastname: Tempany
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hata
mesh_terms: D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009339:Needles; D010502:Perineum; D011467:Prostate / Q000473:pathology*; D015203:Reproducibility of Results; D012449:Safety; D012984:Software