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.
MRI room	Radiologist	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.