Multiparametric MRI-Targeted TRUS Prostate Biopsies Using Visual Registration
Table 1
Seven-step protocol for prostate biopsies performed under TRUS guidance with mp-MRI targeting.
Actors
Steps
Summary
Description
MRI room
Radiologist
1
Target detection
Detection of mp-MRI lesions having a cancer suspicion score ≥3 and a significant size. A mean of two targets is a good compromise, with a primary target clearly identified.
2
Target reporting
Transmission of intelligible and accurate information to the physician that will perform the biopsy procedure.
TRUS biopsy room
Urologist/radiologist/both
3
Intermodality fusion
Registration (or “fusion”) of static, asynchronous, and multiparametric MRI data with that of a real-time and dynamic TRUS data.
4
TRUS guidance to target(s)
Guidance of the biopsy needle gun to the correct location of the mp-MRI target within the TRUS image volume.
5
Sampling simulation
Simulation the sampling helps the physician assess the quality of the sampled core, as well as the safety of the sampling.
6
Tissue sampling
Tissue sampling is usually performed using a semiautomatic needle biopsy gun triggered by the physician.
7
TRUS biopsy report and quality insurance
Reporting of the biopsy procedure, including the location of this additional cores and the correspondence with suspicious mp-MRI image.