title: Transperineal prostate biopsy with ECHO-MRI fusion. Biopsee system. Initial experience.
abstract: OBJECTIVE
  The aim of this study is to present our initial experience with the stereotactic echo-MRI fusion system for diagnosing prostate cancer.
  
  
  METHODS
  Between September 2014 and January 2015, we performed 50 prostate biopsies using the stereotactic echo-MRI fusion system. The 3-Tesla multiparameter MR images were superimposed using this image fusion system on 3D echo images obtained with the Biopsee system for the exact locating of areas suspected of prostate cancer. The lesions were classified using the Prostate Imaging Report and Date System.
  
  
  RESULTS
  We assessed a total of 50 patients, with a mean age of 63 years (range, 45-79), a mean prostate-specific antigen level of 8 ng/mL (range, 1.9-20) and a mean prostate volume of 52mL (range, 12-118). Prostate cancer was diagnosed in 69% of the patients and intraepithelial neoplasia in 6%. The results of the biopsy were negative for 24% of the patients. The results of the biopsy and MRI were in agreement for 62% of the patients; however, 46% also had a tumour outside of the suspicious lesion. We diagnosed 46% anterior tumours and 33% apical tumours. One patient had a haematuria, another had a haematoma and a third had acute urine retention.
  
  
  CONCLUSIONS
  Multiparametric prostatic MRI helps identify prostate lesions suggestive of cancer. The Biopsee echo-MRI fusion system provides for guided biopsy and increases the diagnostic performance, reducing the false negatives of classical biopsies and increasing the diagnosis of anterior tumours. Transperineal access minimises the risk of prostatic infection and sepsis.
authors.affiliation: Servicio de Urología del Instituto de Cirugía Urológica Avanzada (ICUA), Clínica Cemtro, Madrid, España. Electronic address: Eromeroselas78@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Romero-Selas
authors.affiliation: Enfermera de Instituto de Cirugía Urológica Avanzada, Madrid, España.
authors.forename: V
authors.initials: V
authors.lastname: Cuadros
authors.affiliation: Centro anatomo-patológico, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Montáns
authors.affiliation: Servicio de Radiología, Clínica Cemtro, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Sánchez
authors.affiliation: Departamento de Estadística, Clínica Cemtro, Madrid, España.
authors.forename: J M
authors.initials: JM
authors.lastname: López-Alcorocho
authors.affiliation: Servicio de Urología del Instituto de Cirugía Urológica Avanzada (ICUA), Clínica Cemtro, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Gómez-Sancha
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010502:Perineum; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D014463:Ultrasonography
keywords: Biopsia; Biopsia de próstata; Biopsy; Cáncer de próstata; Diagnosis; Diagnóstico; Ecografía; Fusión de imagen; Image fusion; Imágenes de resonancia magnética; Magnetic resonance imaging; Mapeo prostático; Prostate; Prostate biopsy; Prostate cancer; Prostate mapping; Próstata; Ultrasonography