V14-07 TRANSPERINEAL ULTRASOUND WITH TRANSPERINEAL NEEDLES FOR MRI FUSION PROSTATE BIOPSY: DEMONSTRATION OF A NOVEL TECHNIQUE

Abstract

You have accessJournal of UrologyProstate Oncology II & Testis Oncology & Misc. Oncology (V14)1 Sep 2021V14-07 TRANSPERINEAL ULTRASOUND WITH TRANSPERINEAL NEEDLES FOR MRI FUSION PROSTATE BIOPSY: DEMONSTRATION OF A NOVEL TECHNIQUE Luke P. O'Connor, Patrick T. Gomella, Michael A. Daneshvar, Cheyenne Williams, Nabila Khondakar, Jeunice Owens-Walton, Nitin K. Yerram, Sandeep Gurram, Michael Ahdoot, Nicole Varble, Sheng Xu, Baris Turkbey, Peter A. Pinto, and Bradford J. Wood Luke P. O'ConnorLuke P. O'Connor More articles by this author , Patrick T. GomellaPatrick T. Gomella More articles by this author , Michael A. DaneshvarMichael A. Daneshvar More articles by this author , Cheyenne WilliamsCheyenne Williams More articles by this author , Nabila KhondakarNabila Khondakar More articles by this author , Jeunice Owens-WaltonJeunice Owens-Walton More articles by this author , Nitin K. YerramNitin K. Yerram More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , Michael AhdootMichael Ahdoot More articles by this author , Nicole VarbleNicole Varble More articles by this author , Sheng XuSheng Xu More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter A. PintoPeter A. Pinto More articles by this author , and Bradford J. WoodBradford J. Wood More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002111.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There has been a push towards transperineal approaches for prostate biopsy to help reduce risk of sepsis related complications seen in transrectal ultrasound (TRUS) guided procedures. Current commercial platforms allow urologists to perform transperineal MRI/TRUS fusion biopsies (TRUS-TP); however, this requires the use of a TRUS probe which can be a source of discomfort to patients leading to avoidance of repeat surveillance biopsies. We pioneered a novel technique that allows a completely TP approach, without any entry into the rectum. In this video, we demonstrate the transperineal freehand ultrasound and guided needle TP (TPUS-TP) biopsy technique using our custom in-house software. METHODS: We present the case of a 64-year-old-male who was self-referred to our institution for a second opinion regarding his Grade Group (GG) 1 prostate cancer. He has been on active surveillance after initial standard biopsy revealed GG1 disease in 1/14 biopsy cores. After repeat MRI at our institution, the patient was found to have two suspicious lesions. He underwent a subsequent TP biopsy given the anterior location of these lesions. RESULTS: The patient first underwent systematic TP biopsy using a modified 12 core Barzell template followed by targeted fusion biopsy via a standard TRUS-TP with grid. The patient then underwent a TPUS-TP guided biopsy as demonstrated in this video. In this technique, the TPUS ultrasound probe and guided biopsy needle are placed directly on the perineum. The patient was discharged home same-day without any post-operative complications. Upon pathologic review, TPUS-TP biopsy detected GG2 cancer in both targeted lesions with TRUS-TP showing GG2 in only one target and atypical glands in the other. CONCLUSIONS: Transperineal freehand ultrasound and guided needle transperineal (TPUS-TP) prostate biopsy utilizing our custom in-house software offers a novel way to sample the prostate without the use of a transrectal ultrasound probe. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1167-e1167 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luke P. O'Connor More articles by this author Patrick T. Gomella More articles by this author Michael A. Daneshvar More articles by this author Cheyenne Williams More articles by this author Nabila Khondakar More articles by this author Jeunice Owens-Walton More articles by this author Nitin K. Yerram More articles by this author Sandeep Gurram More articles by this author Michael Ahdoot More articles by this author Nicole Varble More articles by this author Sheng Xu More articles by this author Baris Turkbey More articles by this author Peter A. Pinto More articles by this author Bradford J. Wood More articles by this author Expand All Advertisement Loading ...