Target detection: magnetic resonance imaging-ultrasound fusion-guided prostate biopsy.
Recent advances in multiparametric magnetic resonance imaging (MRI) have enabled image-guided detection of prostate cancer. Fusion of MRI with real-time ultrasound (US) allows the information from MRI to be used to direct biopsy needles under US guidance in an office-based procedure. Fusion can be performed either cognitively or electronically, using a fusion device. Fusion devices allow superimposition (coregistration) of stored MRI images on real-time US images; areas of suspicion found on MRI can then serve as targets during US-guided biopsy. Currently available fusion devices use a variety of technologies to perform coregistration: robotic tracking via a mechanical arm with built-in encoders (Artemis/Eigen, BioJet/Geoscan); electromagnetic tracking (UroNav/Philips-Invivo, Hi-RVS/Hitachi); or tracking with a 3D US probe (Urostation/Koelis). Targeted fusion biopsy has been shown to identify more clinically significant cancers and fewer insignificant cancers than conventional biopsy. Fusion biopsy appears to be a major advancement over conventional biopsy because it allows (1) direct targeting of suspicious areas not seen on US and (2) follow-up biopsy of specific cancerous sites in men undergoing active surveillance.
Department of Urology, Stanford University, Stanford, CA.
Geoffrey A
GA
Sonn
Department of Radiology, University of California, Los Angeles, CA.
Daniel J
DJ
Margolis
Department of Urology, University of California, Los Angeles, CA. Electronic address: lmarks@mednet.ucla.edu.
Leonard S
LS
Marks
D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
Biopsy; Magnetic resonance imaging; Prostatic neoplasms; Ultrasonography