To evaluate the potential clinical and technical utility to manage in practice the use of a robotic MRI in-bore-targeted prostate biopsies in the current work-up of prostate cancer diagnosis.
Thirty patients with a single cancer suspicious lesion interpreted on MRI using PI-RADSv2.1 category ≥ 3 underwent in-bore robotic transrectal MRI remote-controlled-guided biopsy. It was analyzed the technical success, clinical details, biopsy findings in correlation with the MRI examination, complications and cancer detection rate (CDR).
The overall CDR for any cancer was 73% (22/30). It was 86% (19/22) for significant tumors (Gleason score of more than 6 or maximum cancer core length greater than 3 mm for Gleason 6) and 77% (17/22) for tumors with Gleason > 6. CDR for biopsy-naïve patients was 89% (16/18) and 50% (6/12) for patients with prior negative transrectal ultrasound-guided biopsies. The CDR for PI-RADS > 3 was 92% (22/24). All the lesions (n = 30) were reachable with the robotic MRI device. A self-limited rectal hemorrhagic complication was reported.
This initial data show that a robotic MRI-guided biopsy could be useful, efficient and feasible procedure in the new paradigm to diagnose significant prostate cancer in selected patients.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
O’Connor LP, Lebastchi AH, Horuz R, et al (2020) Role of multiparametric prostate MRI in the management of prostate cancer. World J Urol. https://doi.org/10.1007/s00345-020-03310-z
Professionals S-O EAU Guidelines: Prostate Cancer. In: Uroweb. https://uroweb.org/guideline/prostate-cancer/. Accessed 22 Mar 2020
NCCN Guidelines for Prostate Cancer. 2019. https://www.nccn.org/about/news/ebulletin/ebulletindetail.aspx?ebulletinid=161. Accessed 2 Jul 2020
Padhani AR, Barentsz J, Villeirs G, et al (2019) PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway. Radiology 182946. https://doi.org/10.1148/radiol.2019182946
Kasivisvanathan V, Rannikko AS, Borghi M, et al (2018) MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med 378:1767–1777. https://doi.org/10.1056/NEJMoa1801993
Ahmed HU, El-Shater Bosaily A, Brown LC, et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389:815–822. https://doi.org/10.1016/S0140-6736(16)32401-1
Schoots IG, Padhani AR, Rouvière O, et al (2020) Analysis of Magnetic Resonance Imaging-directed Biopsy Strategies for Changing the Paradigm of Prostate Cancer Diagnosis. Eur Urol Oncol 3:32–41. https://doi.org/10.1016/j.euo.2019.10.001
Wegelin O, Exterkate L, van der Leest M, et al (2019) The FUTURE Trial: A Multicenter Randomised Controlled Trial on Target Biopsy Techniques Based on Magnetic Resonance Imaging in the Diagnosis of Prostate Cancer in Patients with Prior Negative Biopsies. Eur Urol 75:582–590. https://doi.org/10.1016/j.eururo.2018.11.040
Beyersdorff D, Winkel A, Hamm B, et al (2005) MR Imaging–guided Prostate Biopsy with a Closed MR Unit at 1.5 T: Initial Results. Radiology 234:576–581. https://doi.org/10.1148/radiol.2342031887
Bomers JGR, Bosboom DGH, Tigelaar GH, et al (2017) Feasibility of a 2nd generation MR-compatible manipulator for transrectal prostate biopsy guidance. Eur Radiol 27:1776–1782. https://doi.org/10.1007/s00330-016-4504-2
Barral M, Lefevre A, Camparo P, et al (2019) In-Bore Transrectal MRI-Guided Biopsy With Robotic Assistance in the Diagnosis of Prostate Cancer: An Analysis of 57 Patients. AJR Am J Roentgenol 1–9. https://doi.org/10.2214/AJR.19.21145
Linder N, Schaudinn A, Petersen T-O, et al (2019) In-bore biopsies of the prostate assisted by a remote-controlled manipulator at 1.5 T. MAGMA 32:599–605. https://doi.org/10.1007/s10334-019-00751-5
PI-RADS. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/PI-RADS. Accessed 13 Jun 2019
Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
Ahmed HU, Hu Y, Carter T, et al (2011) Characterizing clinically significant prostate cancer using template prostate mapping biopsy. J Urol 186:458–464. https://doi.org/10.1016/j.juro.2011.03.147
Meermeier NP, Foster BR, Liu J-J, et al (2019) Impact of Direct MRI-Guided Biopsy of the Prostate on Clinical Management. AJR Am J Roentgenol 213:371–376. https://doi.org/10.2214/AJR.18.21009
Felker ER, Lee-Felker SA, Feller J, et al (2016) In-bore magnetic resonance-guided transrectal biopsy for the detection of clinically significant prostate cancer. Abdom Radiol (NY) 41:954–962. https://doi.org/10.1007/s00261-016-0750-7
Schouten MG, Bomers JGR, Yakar D, et al (2012) Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies. Eur Radiol 22:476–483. https://doi.org/10.1007/s00330-011-2259-3
Schouten MG, van der Leest M, Pokorny M, et al (2017) Why and Where do We Miss Significant Prostate Cancer with Multi-parametric Magnetic Resonance Imaging followed by Magnetic Resonance-guided and Transrectal Ultrasound-guided Biopsy in Biopsy-naïve Men? Eur Urol 71:896–903. https://doi.org/10.1016/j.eururo.2016.12.006
Delongchamps NB, Peyromaure M, Schull A, et al (2013) Prebiopsy magnetic resonance imaging and prostate cancer detection: comparison of random and targeted biopsies. J Urol 189:493–499. https://doi.org/10.1016/j.juro.2012.08.195
Ahdoot M, Wilbur AR, Reese SE, et al (2020) MRI-Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis. N Engl J Med 382:917–928. https://doi.org/10.1056/NEJMoa1910038
Kasivisvanathan V, Stabile A, Neves JB, et al (2019) Magnetic Resonance Imaging-targeted Biopsy Versus Systematic Biopsy in the Detection of Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol 76:284–303. https://doi.org/10.1016/j.eururo.2019.04.043
Gorin MA, Walsh PC (2018) Magnetic Resonance Imaging Prior to First Prostate Biopsy-Are we there yet? Eur Urol 74:409–410. https://doi.org/10.1016/j.eururo.2018.05.018
Ploussard G, Borgmann H, Briganti A, et al (2019) Positive pre-biopsy MRI: are systematic biopsies still useful in addition to targeted biopsies? World J Urol 37:243–251. https://doi.org/10.1007/s00345-018-2399-z
Garcia Bennett J, Vilanova JC, Gumà Padró J, et al (2017) Evaluation of MR imaging-targeted biopsies of the prostate in biopsy-naïve patients. A single centre study. Diagn Interv Imaging 98:677–684. https://doi.org/10.1016/j.diii.2017.06.010
Delongchamps NB, Lefèvre A, Bouazza N, et al (2015) Detection of significant prostate cancer with magnetic resonance targeted biopsies–should transrectal ultrasound-magnetic resonance imaging fusion guided biopsies alone be a standard of care? J Urol 193:1198–1204. https://doi.org/10.1016/j.juro.2014.11.002
de Rooij M, Crienen S, Witjes JA, et al (2014) Cost-effectiveness of magnetic resonance (MR) imaging and MR-guided targeted biopsy versus systematic transrectal ultrasound-guided biopsy in diagnosing prostate cancer: a modelling study from a health care perspective. Eur Urol 66:430–436. https://doi.org/10.1016/j.eururo.2013.12.012
Pahwa S, Schiltz NK, Ponsky LE, et al (2017) Cost-effectiveness of MR Imaging-guided Strategies for Detection of Prostate Cancer in Biopsy-Naive Men. Radiology 285:157–166. https://doi.org/10.1148/radiol.2017162181
The authors state that this work has not received any funding.
The scientific guarantor of this publication is Joan C Vilanova.
Conflict of interest
The authors of this manuscript declare relationships with the following companies: Soteria Medical: Martijn Hoogenboom. The authors: Joan C. Vilanova, Anna Pérez de Tudela, Josep Puig, Joaquim Barceló, Montse Planas, Sònia Sala, Santiago Thio-Henestrosa of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Vilanova, J.C., Pérez de Tudela, A., Puig, J. et al. Robotic-assisted transrectal MRI-guided biopsy. Technical feasibility and role in the current diagnosis of prostate cancer: an initial single-center experience. Abdom Radiol 45, 4150–4159 (2020). https://doi.org/10.1007/s00261-020-02665-6
- Prostate cancer
- Magnetic resonance imaging