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Ultrasound MRI Fusion Biopsy in Prostate Gland

  • Francesco PorpigliaEmail author
  • Matteo Manfredi
Chapter

Abstract

The introduction of multiparametric magnetic resonance imaging (mp-MRI) permitted physicians to direct prostate biopsies to suspicious lesions rather than randomly. This chapter relates to the MRI/ultrasound (US) fusion software-based targeted biopsy, describing its main features, indications, and performance against the other sampling methods. The MRI acquisition and reporting by the radiologist is the initial step of the procedure. Different fusion devices allow to align the pre-biopsy MR images with intraoperative transrectal US in order to enable the urologist to perform targeted biopsy directed toward MR-visible lesions. The main indications of MRI/US fusion software-based targeted biopsy are re-biopsy in men with persistent suspicious of prostate cancer (PCa) after first negative standard biopsy and the follow-up of patients under active surveillance (AS). Some studies have compared MRI/US fusion software-based targeted versus standard biopsy, concluding that targeted biopsy seems to detect equal or more men with clinically significant PCa as compared to standard biopsy. Only few studies directly compared MRI/US fusion software-based targeted biopsy with MRI/US fusion visual targeted biopsy and in-bore MRI biopsy, thus indicating the need for further studies. In conclusion, the MRI/US fusion software-based targeted approach seems to have valuable features to be added in the standard diagnostic pathway of PCa for achieving accurate risk stratification.

Keywords

Prostate Biopsy Suspicious Lesion Rigid Registration Target Biopsy Multiparametric Magnetic Resonance Imaging 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 55.1

Targeted biopsies directed to mp-MRI-suspicious lesions: Transrectal approach (MP4 71778 kb)

Video 55.2

Targeted biopsies directed to mp-MRI-suspicious lesions: Transperineal approach (MP4 93071 kb)

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Division of Urology, Department of OncologyUniversity of Turin, “San Luigi” HospitalOrbassano (Turin)Italy

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