Documenting the location of prostate biopsies with image fusion.
Documenting the location of prostate biopsies with image fusion.
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DOI：
10.1111/j.1464-410x.2010.09483.x
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发表时间：
2011-01
影响因子：
4.5
通讯作者：
Pinto PA
中科院分区：
文献类型：
--
作者：
Turkbey B;Xu S;Kruecker J;Locklin J;Pang Y;Bernardo M;Merino MJ;Wood BJ;Choyke PL;Pinto PA
开发一种系统，通过将经直肠超声 (TRUS) 引导的前列腺活检的位置与活检前获得的 MRI 扫描融合来记录，因为前列腺活检的实际位置很少为人所知。 50 名中位前列腺特异性抗原 (PSA) 为 5.8 ng/ml 的患者（中位年龄 61 岁）在活检前接受了 3T 直肠内线圈 MRI。 3D TRUS 图像是在标准 TRUS 引导的 12 芯六分仪活检之前获得的，其中电磁定位装置连接到导针器和 TRUS 探头，以便跟踪每次针通过的位置。记录每次活检位置的 3D-TRUS 图像以电子方式与 T2 加权 MRI 融合。每个活检针轨迹都在 TRUS 图像上进行标记，然后将这些图像转置到 MRI 上。每个活检部位在病理学上被分类为癌症阳性或阴性，并确定格里森评分。 T2 加权 (T2W) MRI 成功记录了所有 (n = 605) 穿刺活检轨迹的位置。在 50 名患者中，20 名患者有 56 个阳性核心。在活检部位，56 个部位中有 34 个部位的 T2W 信号被认为是癌症“阳性”（即信号强度低）。通过使用电磁针跟踪将术前 TRUS 与直肠内线圈 MRI 融合，可以在术前 MRI 上记录 TRUS 引导的前列腺活检的位置。该程序可用于记录先前活检的位置，改善质量控制，从而避免前列腺采样不足以及将后续活检引导至先前未采样的前列腺区域。
To develop a system that documents the location of transrectal ultrasonography (TRUS)-guided prostate biopsies by fusing them to MRI scans obtained prior to biopsy, as the actual location of prostate biopsies is rarely known. Fifty patients (median age 61) with a median prostate-specific antigen (PSA) of 5.8 ng/ml underwent 3T endorectal coil MRI prior to biopsy. 3D TRUS images were obtained just prior to standard TRUS-guided 12-core sextant biopsies wherein an electromagnetic positioning device was attached to the needle guide and TRUS probe in order to track the position of each needle pass. The 3D-TRUS image documenting the location of each biopsy was fused electronically to the T2-weighted MRI. Each biopsy needle track was marked on the TRUS images and these were then transposed onto the MRI. Each biopsy site was classified pathologically as positive or negative for cancer and the Gleason score was determined. The location of all (n = 605) needle biopsy tracks was successfully documented on the T2-weighted (T2W) MRI. Among 50 patients, 20 had 56 positive cores. At the sites of biopsy, T2W signal was considered ‘positive’ for cancer (i.e. low in signal intensity) in 34 of 56 sites. It is feasible to document the location of TRUS-guided prostate biopsies on pre-procedure MRI by fusing the pre-procedure TRUS to an endorectal coil MRI using electromagnetic needle tracking. This procedure may be useful in documenting the location of prior biopsies, improving quality control and thereby avoiding under-sampling of the prostate as well as directing subsequent biopsies to regions of the prostate not previously sampled.