title: Feasibility of a 2ndgeneration MR-compatible manipulator for transrectal prostate biopsy guidance.
abstract: OBJECTIVE
  To assess the feasibility of a 2ndgeneration MR-compatible, remote-controlled manipulator (RCM) as an aid to perform MR-guided transrectal prostate biopsy in males with suspicion of prostate cancer (PCa).
  
  
  METHODS
  This prospective phase I study was approved by the local ethical committee and written informed consent was obtained from each patient. Twenty patients with ≥1 cancer suspicious region (CSR) with a PI-RADS score of ≥3 detected on the diagnostic multi-parametric MRI and no prior prostate treatment underwent MR-guided biopsy with the aid of the RCM. Complications were classified according to the modified Clavien system for reporting surgical complications. For evaluation of the workflow, procedure- and manipulation times were recorded.
  
  
  RESULTS
  All CSR's (n=20) were reachable with the MR-compatible RCM and the cancer detection rate was 70 %. The median procedure time was 36:44 minutes (range, 23 - 61 minutes) and the median manipulation time for needle guide movement was 5:48 minutes (range, 1:15 - 18:35 minutes). Two Clavien grade 1 complications were reported.
  
  
  CONCLUSIONS
  It is feasible and safe to perform transrectal MR-guided prostate biopsy using a MR-compatible RCM as an aid. It is a fast and efficient way to biopsy suspicious prostate lesions with a minimum number of biopsies per patient.
  
  
  CONCLUSIONS
  • It is feasible to perform transrectal prostate biopsy using a MR-compatible RCM. • Using a RCM for MR-guided biopsy is safe, fast, and efficient. • All cancer suspicious regions were reachable with the RCM.
authors.affiliation: Department of Radiology, route 766, Radboud University Nijmegen Medical Center, P.O Box 9101, 6500HB, Nijmegen, The Netherlands. Joyce.Bomers@radboudumc.nl.
authors.forename: J G R
authors.initials: JGR
authors.lastname: Bomers
authors.affiliation: Department of Radiology, route 766, Radboud University Nijmegen Medical Center, P.O Box 9101, 6500HB, Nijmegen, The Netherlands.|Soteria Medical, Arnhem, The Netherlands.
authors.forename: D G H
authors.initials: DGH
authors.lastname: Bosboom
authors.affiliation: Soteria Medical, Arnhem, The Netherlands.
authors.forename: G H
authors.initials: GH
authors.lastname: Tigelaar
authors.affiliation: Soteria Medical, Arnhem, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Sabisch
authors.affiliation: Department of Radiology, route 766, Radboud University Nijmegen Medical Center, P.O Box 9101, 6500HB, Nijmegen, The Netherlands.|MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Fütterer
authors.affiliation: Department of Radiology, route 766, Radboud University Nijmegen Medical Center, P.O Box 9101, 6500HB, Nijmegen, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Yakar
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D065287:Robotic Surgical Procedures / Q000379:methods
keywords: Biopsy; Feasibility; MRI; Prostate cancer; Robotics