Real-time Virtual Sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data
Real-time Virtual Sonography for navigation during targeted prostate biopsy using magnetic resonance imaging data
复制标题
DOI：
10.1111/j.1442-2042.2010.02612.x
复制
发表时间：
2010-10-01
影响因子：
2.6
通讯作者：
Mitake, Tsuyoshi
中科院分区：
文献类型：
--
作者：
Miyagawa, Tomoaki;Ishikawa, Satoru;Mitake, Tsuyoshi
目的：评价实时虚拟超声（RVS）医学导航技术在前列腺活检中的应用价值。方法：85例疑似前列腺癌病变的磁共振成像（MRI）患者为研究对象。所有入选的患者在既往经直肠活检中至少有一次阴性结果。采集的MRI体积数据被加载到安装有RVS软件的个人电脑上，该软件记录MRI和实时超声数据之间的体积，以便实时显示。在同一台计算机显示器上，将配准的MRI图像与超声矢状图相邻显示。t2加权图像上可疑病变用红圈标记。首先在RVS实时导航下对疑似病变进行经会阴活检，然后在脊髓麻醉下进行常规经直肠和经会阴活检。结果：患者中位年龄69岁（56 ~ 84岁），前列腺特异性抗原水平9.9 ng/mL(4.0 ~ 34.2)，前列腺体积37.2 mL（18 ~ 141）。52例（61%）患者检出前列腺癌。使用RVS获得的活检标本显示45/52例（87%）前列腺癌阳性。使用RVS共获得192个活检芯。其中62例（32%）前列腺癌阳性，而常规随机活检仅在75/833例（9%）中发现前列腺癌（P < 0.01）。结论：RVS前列腺活检对MRI病变的诊断是非常有效的。该技术只需要额外的计算机和RVS软件，因此是经济有效的。因此，rvs引导下的前列腺活检对于更好地治疗前列腺癌患者具有很大的潜力。
Objectives:To evaluate the effectiveness of the medical navigation technique, namely, Real-time Virtual Sonography (RVS), for targeted prostate biopsy.Methods:Eighty-five patients with suspected prostate cancer lesions using magnetic resonance imaging (MRI) were included in this study. All selected patients had at least one negative result on the previous transrectal biopsies. The acquired MRI volume data were loaded onto a personal computer installed with RVS software, which registers the volumes between MRI and real-time ultrasound data for real-time display. The registered MRI images were displayed adjacent to the ultrasonographic sagittal image on the same computer monitor. The suspected lesions on T2-weighted images were marked with a red circle. At first suspected lesions were biopsied transperineally under real-time navigation with RVS and then followed by the conventional transrectal and transperineal biopsy under spinal anesthesia.Results:The median age of the patients was 69 years (56-84 years), and the prostate-specific antigen level and prostate volume were 9.9 ng/mL (4.0-34.2) and 37.2 mL (18-141), respectively. Prostate cancer was detected in 52 patients (61%). The biopsy specimens obtained using RVS revealed 45/52 patients (87%) positive for prostate cancer. A total of 192 biopsy cores were obtained using RVS. Sixty-two of these (32%) were positive for prostate cancer, whereas conventional random biopsy revealed cancer only in 75/833 (9%) cores (P < 0.01).Conclusions:Targeted prostate biopsy with RVS is very effective to diagnose lesions detected with MRI. This technique only requires additional computer and RVS software and thus is cost-effective. Therefore, RVS-guided prostate biopsy has great potential for better management of prostate cancer patients.