MRI-Guided, Transperineal Prostate Biopsy Using Fixed Coordinate Needle Guide: Initial Feasibility Study

Most of the existing MRI guided robotic needle guide systems have been limited to research purposes and have not progressed towards clinical applications due to complex and bulky structures. The ‘device-to-image’ registration step further complicates the operation and significantly increases the overall procedure time. To address limitations, we developed an MRI guided transperineal prostate biopsy guide system that uses the concept of a ‘fixed coordinate device’ to simplify the overall biopsy procedure and eliminate the registration step, making the procedure more clinically friendly. We performed proof-of-concept targeting experiments using an agar phantom under 3T MRI. The targeting results were analyzed, and initial results prove that the simplified intervention concept would well be feasible. We plan to extend the study further to identify error components.

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

Journal of Medical Devices ◽

10.1115/1.4047874 ◽

2020 ◽

Vol 14 (4) ◽

Author(s):

Pankaj Kulkarni ◽

Sakura Sikander ◽

Pradipta Biswas ◽

Sumit Laha ◽

Heather Cornnell ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Image Registration ◽

Prostate Biopsy ◽

Signal To Noise Ratio ◽

Clinical Environment ◽

Resonance Imaging ◽

Transperineal Prostate Biopsy ◽

Mri Guided ◽

Magnetic Resonance Imaging Mri

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.

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