Development of a Device-to-Image Registration Free Needle Guide for Magnetic Resonance Imaging-Guided Targeted Prostate Biopsy

2020 ◽  
Vol 14 (4) ◽  
Author(s):  
Pankaj Kulkarni ◽  
Sakura Sikander ◽  
Pradipta Biswas ◽  
Sumit Laha ◽  
Heather Cornnell ◽  
...  

Abstract Significant research has been done in the past decade for the development of magnetic resonance imaging (MRI) guided needle guide (NG) systems for prostate intervention. Most of these systems have been restricted to application in the lab environment with lack of progress toward clinical application. Bulky and complex designs can be attributed to this practice. These systems also demand complex technical setup and usage procedures, which require extra technical personnel during the intervention in addition to specialized training for physicians. Moreover, “device-to-image” registration, essential for accurate and precise targeting, further complicates the overall process while increasing total time for intervention. In order to address these limitations, a simplified, MRI-guided, transperineal prostate biopsy NG system was designed and developed for rapid adoption into the clinical environment. The system consists of a NG device and a software toolkit. It does not require any special intraprocedural technical expertise or dedicated training. Also, to simplify and shorten total procedure time, the device uses the unique concept of “fixed coordinate device” eliminating the need for any device-to-image registration making it clinically friendly. To verify the NG design along with the registration free feature, image quality tests and agar phantom-based targeting experiments were performed under the guidance of 3T MRI scanner. The imaging tests resulted in a distortion of less than 1% in presence of the device and an average change of 1.3% in signal-to-noise ratio. For targeting experiments, maximum in-plane error distance of 3.8 mm with a mean of 2.2 mm and standard deviation of 0.8 mm was observed. The results show that an MRI-compatible simplified intervention device without the need of device-to-image registration is technically feasible.

2021 ◽  
Vol 14 (3) ◽  
pp. 86-93
Author(s):  
R.A. Romanov ◽  
◽  
A.V. Koryakin ◽  
A.V. Sivkov ◽  
B.Ya. Alekseev ◽  
...  

Introduction. Significant improvement in the quality of visualization of the prostate using magnetic resonance imaging (MRI), as well as the development of technologies for virtual combination of MRI and ultrasound images opens new horizons in the diagnosis of prostate cancer. The introduction of the PI-RADS system has allowed the standardization of MRI findings, and the development of fusion biopsy systems seeks to make diagnostics more accurate and less operator-dependent. Materials and methods. In this literature review, we evaluate the effectiveness of various biopsy approaches and discuss the prospects for targeted biopsies. The search for publications was carried out in the databases PubMed, e-library, Web of Scince et al. For citation, 55 literature sources were selected that met the search criteria for the keywords, «prostate cancer», «biopsy», «MRI», «TRUS», «fusion». Results. Diagnosis of prostate cancer using MRI. Modern technologies for radiological diagnosis of prostate cancer using magnetic resonance imaging (MRI) are based on the standardized PI-RADS protocol, using different modes (T2, diffusion-weighted images and contrast enhancement), which provides the best visualization of tumor-suspicious nodes in the prostate gland, allowing determination of lesion localization and size for subsequent targeted biopsy. Options for performing a prostate biopsy to diagnose prostate cancer. A description of the methods and effectiveness of transrectal and transperineal biopsy under ultrasound guidance is carried out - due to the fact that ultrasound diagnostics of prostate cancer has a rather low sensitivity due to small differences in the ultrasound structure of normal and tumor tissue of the prostate, an extended template biopsy technique was proposed, which involves puncture of the prostate through a special lattice. It also describes the technology of fusion biopsy and also provides literature data comparing the diagnostic accuracy of standard TRUS and fusion prostate biopsy, as well as the importance of transrectal / transperineal access. Questions for further study. Given the desire to reduce the number of biopsies while maintaining or even increasing the accuracy of diagnosing prostate cancer, data from studies investigating the feasibility of combining polyfocal (non-targeted) and targeted (targeted) biopsies are presented. Conclusion. The existing methods of non-targeted biopsy (polyfocal, saturation, template) and targeted (fusion biopsy) have their advantages and disadvantages, which currently do not allow making certain recommendations for their use, but a significant number of authors prefer MRI-as sisted, fusion -biopsy.


2017 ◽  
Vol 11 (3) ◽  
Author(s):  
Felix Güttler ◽  
Andreas Heinrich ◽  
Peter Krauß ◽  
Jonathan Guntermann ◽  
Maximilian de Bucourt ◽  
...  

The purpose of this study was to evaluate the suitability of a novel radio-frequency identification (RFID)-based tracking system for intraoperative magnetic resonance imaging (MRI). A RFID tracking system was modified to fulfill MRI-compatibility and tested according to ASTM and NEMA. The influence of the RFID tracking system on MRI was analyzed in a phantom study using a half-Fourier acquisition single-shot turbospin echo (HASTE) and true fast imaging with steady-state precession sequence (TrueFISP) sequence. The RFID antenna was gradually moved closer to the isocenter of the MR scanner from 90 to 210 cm to investigate the influence of the distance. Furthermore, the RF was gradually changed between 865 and 869 MHz for a distance of 90 cm, 150 cm, and 210 cm to the isocenter of the magnet to investigate the influence of the frequency. The specific spatial resolution was measured with and without a permanent line of sight (LOS). After the modification of the reader, no significant change of the signal-to-noise ratio (SNR) could be observed with increasing distance of the RFID tracking system to the isocenter of the MR scanner. Also, different radio frequencies of the RFID tracking system did not influence the SNR of the MR-images significantly. The specific spatial resolution deviated on average by 8.97 ± 7.33 mm with LOS and 11.23 ± 12.03 mm without LOS from the reference system. The RFID tracking system had no relevant influence on the MR-image quality. RFID tracking solved the LOS problem. However, the spatial accuracy of the RFID tracking system has to be improved for medical usage.


2021 ◽  
Vol 15 (9) ◽  
Author(s):  
James Ryan ◽  
Mark P. Broe ◽  
Diarmaid Moran ◽  
David Mulvin ◽  
Eric Heffernan ◽  
...  

Introduction: The use of multiparametric magnetic resonance imaging (MRI) with targeted biopsies of the prostate improves the diagnosis of clinically significant prostate cancer. Recent studies have shown that targeted prostate biopsies also more accurately predict final histopathology after radical prostatectomy (RP). There are three broad techniques for performing MRI-targeted prostate biopsy: cognitive MRI/ultrasound (US) fusion, software MRI/US fusion, and in-bore MRI-guided. Current practices recommend that a standard systematic 12-core prostate biopsy be performed, as well as targeted biopsies in patients with positive MRI findings. This study aimed to evaluate the accuracy of histological grading of cognitive MRI/US fusion prostate biopsy by comparing the histology from the targeted biopsy specimens (TB), standard systematic specimens (SB), and the combination of both (CB) specimens with the final histological grade from subsequent prostatectomy. Methods: A retrospective, single-center review of 115 patients who underwent standard systematic and cognitive MRI/US-targeted biopsy of the prostate before undergoing a RP between 2016 and 2019 was performed. MRI findings, biopsy, final histology International Society of Urological Pathology (ISUP) grades, and patient demographics were collected. Cochran’s Q test and McNemar test were used to compare the differences in upgrading, downgrading, and concordance between each biopsy group. Results: The concordance between SB, TB, and CB biopsy were 28.7%, 49.6%, and 50.4%, respectively. There was no significant difference in concordance between TB and CB. Patients were more likely to be downgraded on the final histology when comparing CB with TB alone (26.1% vs. 16.5%, p<0.05). In cases where an ISUP grade 1 cancer was diagnosed on TB (n=24), there was a 62.5% chance that the final histology would be upgraded. In the same sample, when combined with a SB, the risk of upgrading on final histology reduced to 37.5%. Conclusions: Although grading concordance between TB and CB were similar, the concomitant use of a SB significantly reduced the rate of upgrading in the final RP histopathology. CB may result in better decision-making regarding treatment options and also have implications for intraoperative planning.


2019 ◽  
Author(s):  
Christoph Vogelbacher ◽  
Miriam H. A. Bopp ◽  
Verena Schuster ◽  
Peer Herholz ◽  
Andreas Jansen ◽  
...  

AbstractImage characteristics of magnetic resonance imaging (MRI) data (e.g. signal-to-noise ratio, SNR) may change over the course of a study. To monitor these changes a quality assurance (QA) protocol is necessary. QA can be realized both by performing regular phantom measurements and by controlling the human MRI datasets (e.g. noise detection in structural or movement parameters in functional datasets). Several QA tools for the assessment of MRI data quality have been developed. Many of them are freely available. This allows in principle the flexible set-up of a QA protocol specifically adapted to the aims of one’s own study.However, setup and maintenance of these tools bind time, in particular since the installation and operation often require a fair amount of technical knowledge. In this article we present a light-weighted virtual machine, named LAB-QA2GO, which provides scripts for fully automated QA analyses of phantom and human datasets. This virtual machine is ready for analysis by starting it the first time. With minimal configuration in the guided web-interface the first analysis can start within 10 minutes, while adapting to local phantoms and needs is easily possible. The usability and scope of LAB–QA2GO is illustrated using a data set from the QA protocol of our lab. With LAB–QA2GO we hope to provide an easy-to-use toolbox that is able to calculate QA statistics without high effort.


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