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Internal Fusion: exact correlation of transrectal ultrasound images of the prostate by detailed landmarks over time for targeted biopsies or follow-up

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Abstract

Purpose

Innovative imaging modalities are applied for diagnosing and follow-up of prostate cancer (PCa). To perform authentic targeted biopsies and evaluate prostate changes, it is essential to reliably identify and hit targets in their true anatomical location over time. A newly described image correlation method (Internal Fusion) allows precise correlation of serial transrectal ultrasound (TRUS) images in vitro and vivo. Identifiable morphologic structures such as prostatic calcifications define internal anchor points (Internal Landmarks) to facilitate exact correlation.

Methods

After verification of Internal Fusion in vitro, 83 patients were included from January to August 2017 with at least one prior series of 5-mm spaced TRUS images stored as computed tomographic (US-CT) online data set. Two experienced operators collected new images in correlation with each cross-section of the previous examinations based on Internal Landmarks.

Results

Of the 83 patients, fifty (60%) had prior negative biopsies. Fourteen (17%) wished US-CT targeted biopsies and PCa were detected in 7/14 patients (50%). Overall, accurate imaging correlations were attained in 369/397 slices (93%). In initial and repeat biopsy, 31/31 and 35/35 images could be correlated detecting PCa in 5/8 (63%) and 2/6 patients (33%). The longest observation of prostate changes over time (Trend Monitoring) with accurate image correlation was 8 years and 6 months.

Conclusions

Internal Fusion by Internal Landmarks ensures exact correlation in long-term follow-up. It is possible to precisely monitor trends in prostate tissue changes. In case of PCa suspicion, biopsies could be targeted with high accuracy by Internal Fusion, even over time.

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Authors and Affiliations

  1. Urologische Klinik des Ev. Luth. Diakonissenkrankenhauses, Akademisches Lehrkrankenhaus der Christian-Albrechts-Universität zu Kiel, Knuthstraße 1, 24939, Flensburg, Germany

    Yanqi Xie, Björn Grabski & Tillmann Loch

  2. Department of Urology and Andrology, General Hospital Hall i.T., Hall in Tirol, Austria

    Theodoros Tokas

Authors
  1. Yanqi Xie
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  2. Theodoros Tokas
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  3. Björn Grabski
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  4. Tillmann Loch
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Contributions

YX data collection or management, data analysis, and manuscript writing; TT manuscript editing; BG data collection or management; TL protocol/project development, and manuscript editing

Corresponding author

Correspondence to Yanqi Xie.

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Conflict of interest

Tillmann Loch is inventor of the ANNA/C-TRUS method and shareholder of ANNA Technologies/Deutschland; have received consultation fees from ANNA Technologies and have received teaching equipment from BK Medical. All other authors declare that they have no conflict of interest.

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For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Xie, Y., Tokas, T., Grabski, B. et al. Internal Fusion: exact correlation of transrectal ultrasound images of the prostate by detailed landmarks over time for targeted biopsies or follow-up. World J Urol 36, 693–698 (2018). https://doi.org/10.1007/s00345-017-2161-y

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  • DOI: https://doi.org/10.1007/s00345-017-2161-y

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