12 March 2014 Workflow assessment of 3T MRI-guided transperineal targeted prostate biopsy using a robotic needle guidance
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Magnetic resonance imaging (MRI) guided transperineal targeted prostate biopsy has become a valuable instrument for detection of prostate cancer in patients with continuing suspicion for aggressive cancer after transrectal ultrasound guided (TRUS) guided biopsy. The MRI-guided procedures are performed using mechanical targeting devices or templates, which suffer from limitations of spatial sampling resolution and/or manual in-bore adjustments. To overcome these limitations, we developed and clinically deployed an MRI-compatible piezoceramic-motor actuated needle guidance device, Smart Template, which allows automated needle guidance with high targeting resolution for use in a wide closed-bore 3-Tesla MRI scanner. One of the main limitations of the MRI-guided procedure is the lengthy procedure time compared to conventional TRUS-guided procedures. In order to optimize the procedure, we assessed workflow of 30 MRI-guided biopsy procedures using the Smart Template with focus on procedure time. An average of 3.4 (range: 2~6) targets were preprocedurally selected per procedure and 2.2 ± 0.8 biopsies were performed for each target with an average insertion attempt of 1.9 ± 0.7 per biopsy. The average technical preparation time was 14 ± 7 min and the in-MRI patient preparation time was 42 ± 7 min. After 21 ± 7 min of initial imaging, 64 ± 12 min of biopsy was performed yielding an average of 10 ± 2 min per tissue sample. The total procedure time occupying the MRI suite was 138 ± 16 min. No noticeable tendency in the length of any time segment was observed over the 30 clinical cases.
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Sang-Eun Song, Sang-Eun Song, Kemal Tuncali, Kemal Tuncali, Junichi Tokuda, Junichi Tokuda, Andriy Fedorov, Andriy Fedorov, Tobias Penzkofer, Tobias Penzkofer, Fiona Fennessy, Fiona Fennessy, Clare Tempany, Clare Tempany, Kitaro Yoshimitsu, Kitaro Yoshimitsu, John Magill, John Magill, Nobuhiko Hata, Nobuhiko Hata, "Workflow assessment of 3T MRI-guided transperineal targeted prostate biopsy using a robotic needle guidance", Proc. SPIE 9036, Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling, 903612 (12 March 2014); doi: 10.1117/12.2043766; https://doi.org/10.1117/12.2043766

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