Abstract
Transperineal mapping biopsy (TPMB) is a substantial improvement over transrectal ultrasound guided biopsy (TRUS) in accurate grading and lesion identification, yet lacks standardization and in its current form utilizes antiquated technology. Theoretical models demonstrate that sampling the prostate at 5 mm intervals with a 15-gauge biopsy needle would detect 2.5 mm lesions with excellent accuracy. In practice, this approach is problematic due to deflection of biopsy needles during travel into the gland, movement of the gland during respiration, and technological constraints requiring multiple sampling attempts along the same needle path to cover the full length of the prostate. To help solve these problems, a software program was created to provide a real-time 3D image of the prostate generated from intraoperative axial (transverse) image capture. This software both generates a biopsy plan designed to provide complete coverage of the gland and subsequently monitors sampling in real-time to ensure adequate coverage is obtained. Moreover, if a patient is found to have cancer amenable to targeted focal therapy, the 3D map can be utilized in the OR to locate the sites to be ablated. What follows is a detailed description of how the software works and what additional changes are necessary to overcome the current challenges facing TPMB. The increased sampling accuracy that can be obtained with 3D mapping biopsy (MB) is necessary for proper risk stratification allowing improved selection of surveillance candidates.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kepner GR, Kepner JV. Transperineal prostate biopsy: analysis of a uniform core sampling pattern that yields data on tumor volume limits in negative biopsies. Theor Biol Med Model. 2010;17(7):23.
Stone NN, Roy J, Hong S, Lo YC, Stock RG. Prostate gland motion and deformation caused by needle placement during brachytherapy. Brachytherapy. 2002;1:154–60.
Brede CM, Douville NJ, Jones S. Variable correlation of grid coordinates to core location in template prostate biopsy. Curr Urol. 2013;6(4):194–8. doi:10.1159/000343538.
Huo ASY, Hossack T, Symons JLP, et al. Accuracy of primary systematic template guided transperineal biopsy of the prostate for locating prostate cancer: a comparison with radical prostatectomy specimens. J Urol. 2012;187(6):2044–9. doi:10.1016/j.juro.2012.01.066.
Brawer MK. The influence of prostate volume on prostate cancer detection. Eur Urol Suppl. 2002;1(6):35–9. doi:10.1016/S1569-9056(02)00055-6.
Symons JL, Huo A, Yuen CL, et al. Outcomes of transperineal template‐guided prostate biopsy in 409 patients. BJU Int. 2013;112(5):585–93. doi:10.1111/j.1464-410X.2012.11657.x.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
(Fig. 6.8): Overview of the three-dimensional mapping biopsy procedure and software functionality (MP4 178,387 kb)
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Krughoff, K., Stone, N.N., Elliott, J., Baer, C., Arangua, P., Crawford, E.D. (2016). 3D Biopsy: A New Method to Diagnose Prostate Cancer. In: Stone, N., Crawford, E. (eds) The Prostate Cancer Dilemma. Springer, Cham. https://doi.org/10.1007/978-3-319-21485-6_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-21485-6_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-21484-9
Online ISBN: 978-3-319-21485-6
eBook Packages: MedicineMedicine (R0)