You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I1 Apr 2017MP52-13 TRANSPERINEAL MR-GUIDED PROSTATE NEEDLE INTERVENTIONS USING A PATIENT-SPECIFIC TEMPLATE Dordaneh Sugano, Sheng Xu, Reza Seifabadi, Ivane Bakhutashvili, Neil Glossop, Peter Choyke, Peter Pinto, and Reto Bale Dordaneh SuganoDordaneh Sugano More articles by this author , Sheng XuSheng Xu More articles by this author , Reza SeifabadiReza Seifabadi More articles by this author , Ivane BakhutashviliIvane Bakhutashvili More articles by this author , Neil GlossopNeil Glossop More articles by this author , Peter ChoykePeter Choyke More articles by this author , Peter PintoPeter Pinto More articles by this author , and Reto BaleReto Bale More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1643AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of the study is to test the feasibility of a low cost, patient-specific template that allows for angulated insertion of needles during transperineal MR-guided biopsy and treatment for prostate cancer. Currently, transperineal MR-guided biopsy can be performed with a standard straight grid, or with a robotic device. The straight grid does not incorporate information on patient-specific anatomy or disease, and renders it difficult to avoid structures such as the pubic arch. Robotic devices are not currently in widespread use due to regulatory issues, and can be prohibitively expensive. We propose a two-plate template in which guide holes drilled mid-procedure, using an MR image registered with 3D imaging software, allow for accurate direction of biopsy needles to specific tumor locations. METHODS The two-plate template was attached to a platform in a fixed position relative to a prostate phantom. A 3T MR image of the template (with gadolinium fiducials) and the phantom was obtained, and the template and phantom were registered to MRI coordinates. The MR images were uploaded onto a custom-made module in 3D slicer. Four fiducials were localized in the image and registered to their physical locations on the template, allowing the user to plan needle trajectories and calculate insertion depths to the targets. These trajectories can be manually translocated as necessary in order to minimize contact with other trajectories and nearby structures. The disposable plates were placed into a portable milling machine, which then drilled the corresponding guide holes according to the plan. The plates were replaced into the template frame, and biopsy needles were inserted into the phantom at the angle constrained by the guide holes. The phantom, template, and needles were imaged via CT scan for confirmation of placement accuracy. RESULTS Three MRI-visible targets were identified in the image. Mean and standard deviation of error was 2.83mm ±1.42 for user 1 and 4.70mm ±3.66 for user 2. CONCLUSIONS It is feasible to use a patient-specific template for low-cost, angulated transperineal MR-guided prostate biopsy. The method has potential applications not only in prostate biopsy, but also in other forms of targeted therapy. Future studies will consider further tests of accuracy, efficiency, convenience, and applicability. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e708-e709 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Dordaneh Sugano More articles by this author Sheng Xu More articles by this author Reza Seifabadi More articles by this author Ivane Bakhutashvili More articles by this author Neil Glossop More articles by this author Peter Choyke More articles by this author Peter Pinto More articles by this author Reto Bale More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...