Trans-rectal interventional MRI: initial prostate biopsy experience

Bernadette M. Greenwood; Meliha R. Behluli; John F. Feller; Stuart T. May; Robert Princenthal; Alex Winkel; David B. Kaminsky

doi:10.1117/12.847045

23 February 2010 Trans-rectal interventional MRI: initial prostate biopsy experience

Bernadette M. Greenwood, Meliha R. Behluli, John F. Feller, Stuart T. May, Robert Princenthal, Alex Winkel, David B. Kaminsky

Author Affiliations +

Proceedings Volume 7625, Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling; 76252U (2010) https://doi.org/10.1117/12.847045
Event: SPIE Medical Imaging, 2010, San Diego, California, United States

Abstract

Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate gland when evaluated along with T2-weighted images, diffusion-weighted images (DWI) and their corresponding apparent diffusion coefficient (ADC) maps can yield valuable information in patients with rising or elevated serum prostate-specific antigen (PSA) levels₁. In some cases, patients present with multiple negative trans-rectal ultrasound (TRUS) biopsies, often placing the patient into a cycle of active surveillance. Recently, more patients are undergoing TRIM for targeted biopsy of suspicious findings with a cancer yield of ~59% compared to 15% for second TRUS biopsy₂ to solve this diagnostic dilemma and plan treatment. Patients were imaged in two separate sessions on a 1.5T magnet using a cardiac phased array parallel imaging coil. Automated CAD software was used to identify areas of wash-out. If a suspicious finding was identified on all sequences it was followed by a second imaging session. Under MRI-guidance, cores were acquired from each target region₃. In one case the microscopic diagnosis was prostatic intraepithelial neoplasia (PIN), in the other it was invasive adenocarcinoma. Patient 1 had two negative TRUS biopsies and a PSA level of 9ng/mL. Patient 2 had a PSA of 7.2ng/mL. He underwent TRUS biopsy which was negative for malignancy. He was able to go on to treatment for his prostate carcinoma (PCa)₄. MRI may have an important role in a subset of patients with multiple negative TRUS biopsies and elevated or rising PSA.

Citation Download Citation

Bernadette M. Greenwood, Meliha R. Behluli, John F. Feller, Stuart T. May, Robert Princenthal, Alex Winkel, and David B. Kaminsky "Trans-rectal interventional MRI: initial prostate biopsy experience", Proc. SPIE 7625, Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling, 76252U (23 February 2010); https://doi.org/10.1117/12.847045

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