You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 20102142 FREE HAND 3D-TRUS PROSTATE BIOPSIES MAPPING Pierre Mozer, Michael Baumann, Grégoire Chevreau, Matthieu Bordenave, Frédéric Thibault, Pierre Conort, Marc-Olivier Bitker, and Jocelyne Troccaz Pierre MozerPierre Mozer Paris, France More articles by this author , Michael BaumannMichael Baumann Grenoble, France, Metropolitan More articles by this author , Grégoire ChevreauGrégoire Chevreau Paris, France, Metropolitan More articles by this author , Matthieu BordenaveMatthieu Bordenave Paris, France, Metropolitan More articles by this author , Frédéric ThibaultFrédéric Thibault Paris, France, Metropolitan More articles by this author , Pierre ConortPierre Conort Paris, France More articles by this author , Marc-Olivier BitkerMarc-Olivier Bitker Paris, France, Metropolitan More articles by this author , and Jocelyne TroccazJocelyne Troccaz Grenoble, France, Metropolitan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2243AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present a new prostate imaging assistant that intra-operatively displays and records the 3D spatial distribution of transrectal prostate biopsies with reference to an initial location of the prostate. METHODS The method is based on 3D transrectal ultrasound (3D TRUS). We use a 3D TRUS probe on a Sonoace X8 scanner (Medison, Korea), linked to the computer with a network cable. The 3D cartography is based on an automatic registration method. The clinical workflow is unchanged meaning that biopsies are performed under local anesthesia with the patient on the left side. An initial “reference” 3D image of the prostate is recorded before starting the biopsy sampling. The biopsy tract is guided by real time 2D TRUS. After every biopsy gun shot, the needle is left in the prostate less than 3 seconds while a 3D TRUS image is transferred to the computer, and displayed in 3D on the reference prostate. The clinician may rotate, zoom or reslice the 3D prostate and biopsies using a trackball. Alternatively, a 3D TRUS image may be transferred before a biopsy shot in order to check the actual biopsy target, that can be reached afterwards providing the probe is unmoved. Once histological results are known, one may eventually integrate them to the patient's data file to visualize the positive biopsy locations with respect to the patient's prostate (Fig - Distribution of the biopsies inside a “reference” 3D TRUS image. B=Base, A=Apex, L=Left, R=Right. Green : Negative biopsies. Red : Positive biopsies). RESULTS 12 minutes was needed on average to perform 12 biopsies per patient. The registration accuracy was validated on 1515 3D images from 103 patients. The success rate was 97% based on visual validation. Using fiducials (calcifications inside the prostate), the average error was 1.4mm and max error 3.8mm on 278 biopsies. No post-biopsy complication was reported. CONCLUSIONS The system allows the clinician to perform regular or targeted biopsy sampling. In addition to being very useful to improve the biopsies distribution, the potential of this system is above all the possibility to create for each patient a precise map of sampled areas without significant change in routine clinical practice. That can be used in the near future in order to merge repeated biopsy sessions or to plan an accurate focal therapy treatment. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e833 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pierre Mozer Paris, France More articles by this author Michael Baumann Grenoble, France, Metropolitan More articles by this author Grégoire Chevreau Paris, France, Metropolitan More articles by this author Matthieu Bordenave Paris, France, Metropolitan More articles by this author Frédéric Thibault Paris, France, Metropolitan More articles by this author Pierre Conort Paris, France More articles by this author Marc-Olivier Bitker Paris, France, Metropolitan More articles by this author Jocelyne Troccaz Grenoble, France, Metropolitan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...