Initial series of magnetic resonance imaging (MRI)-fusion targeted prostate biopsy using the first transperineal targeted platform available in the USA

Abstract

Objectives: To describe a step-by-step guide for using the first transperineal targeted prostate biopsy platform available in the USA.

Patients and methods: A total of 32 men with elevated prostate-specific antigen (PSA) levels were diagnosed with a region of interest on multiparametric magnetic resonance imaging (mpMRI) between February 2017 and January 2018. The transperineal targeted prostate biopsy procedure was accomplished via a transperineal approach and used a stepper, combined with advanced mpMRI/transrectal ultrasound fusion software, to perform targeted prostate biopsy. The detection of overall and clinically significant prostate cancer (PCa) was assessed as well as the rate of complications.

Results: The median patient age was 68.0 years and the median PSA was 8.0 ng/mL. Two patients (6%) were active surveillance candidates and 16 (50%) had a prior negative prostate biopsy. The detection rates for overall and clinically significant PCa were 81% and 59%, respectively. The two candidates for active surveillance and eight of the patients with a prior negative prostate biopsy had clinically significant PCa confirmed on targeted biopsy. There were no peri-operative complications.

Conclusion: These results demonstrate the promising potential of the first transperineal targeted prostate biopsy platform in the USA as an alternative diagnostic method for PCa.

Trial registration: ClinicalTrials.gov NCT03044197.

Keywords: UroNav; magnetic resonance imaging; prostate biopsy; targeted; transperineal.

Conflict of interest statement

Conflict of Interest: None

© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Figures

Figure 1

Patient placed in the dorsal lithotomy position. UroNav mpMRI/ultrasound fusion device (Invivo®, Gainesville, FL, USA), transducer type 8848 ultrasound probe (BK Medical®, Peabody, MA, USA) and transperineal stepper with brachytherapy-like grid (CIVCO®, Peabody, MA, USA).

Figure 2

Lesion sampled transperineal in the sagittal plane.

Figure 3

The steps in performing an mpMRI/ultrasound fusion transperineal biopsy.