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1.
J Urol ; 186(4): 1281-5, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21849184

ABSTRACT

PURPOSE: A novel platform was developed that fuses pre-biopsy magnetic resonance imaging with real-time transrectal ultrasound imaging to identify and biopsy lesions suspicious for prostate cancer. The cancer detection rates for the first 101 patients are reported. MATERIALS AND METHODS: This prospective, single institution study was approved by the institutional review board. Patients underwent 3.0 T multiparametric magnetic resonance imaging with endorectal coil, which included T2-weighted, spectroscopic, dynamic contrast enhanced and diffusion weighted magnetic resonance imaging sequences. Lesions suspicious for cancer were graded according to the number of sequences suspicious for cancer as low (2 or less), moderate (3) and high (4) suspicion. Patients underwent standard 12-core transrectal ultrasound biopsy and magnetic resonance imaging/ultrasound fusion guided biopsy with electromagnetic tracking of magnetic resonance imaging lesions. Chi-square and within cluster resampling analyses were used to correlate suspicion on magnetic resonance imaging and the incidence of cancer detected on biopsy. RESULTS: Mean patient age was 63 years old. Median prostate specific antigen at biopsy was 5.8 ng/ml and 90.1% of patients had a negative digital rectal examination. Of patients with low, moderate and high suspicion on magnetic resonance imaging 27.9%, 66.7% and 89.5% were diagnosed with cancer, respectively (p <0.0001). Magnetic resonance imaging/ultrasound fusion guided biopsy detected more cancer per core than standard 12-core transrectal ultrasound biopsy for all levels of suspicion on magnetic resonance imaging. CONCLUSIONS: Prostate cancer localized on magnetic resonance imaging may be targeted using this novel magnetic resonance imaging/ultrasound fusion guided biopsy platform. Further research is needed to determine the role of this platform in cancer detection, active surveillance and focal therapy, and to determine which patients may benefit.


Subject(s)
Biopsy, Needle , Magnetic Resonance Imaging, Interventional , Magnetic Resonance Imaging , Prostate/pathology , Prostatic Neoplasms/diagnosis , Ultrasonography, Interventional , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged
2.
J Ultrasound Med ; 30(2): 253-6, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21266564

ABSTRACT

This case illustrates the ability of electromagnetic tracking navigation to localize difficult targets in real time during biopsy or ablation of lesions that are only transiently apparent on arterial phase computed tomography and may be unapparent on sonography. Readily available technology enabling multimodality registration to sonography allows for the use of positron emission tomographic, magnetic resonance imaging, and computed tomographic information during sonographically guided procedures and examinations.


Subject(s)
Biopsy, Needle/methods , Electromagnetic Fields , Liver Neoplasms/pathology , Tomography, X-Ray Computed , Ultrasonography, Interventional/methods , Female , Fiducial Markers , Humans , Liver/diagnostic imaging , Liver/pathology , Liver Neoplasms/diagnostic imaging , Middle Aged
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