Department of Radiology, Otto von Guericke University, Medical School, Leipziger Str. 44, 39120, Magdeburg, Germany.
Philips Healthcare, Philips GmbH Innovative Technologies, Hamburg, Germany.
Eur Radiol. 2018 Jun;28(6):2690-2699. doi: 10.1007/s00330-017-5187-z. Epub 2018 Jan 17.
The aim of our study was (1) to establish an in-bore targeted biopsy of suspicious prostate lesions, avoiding bowel penetration using a transgluteal approach and (2) to assess operator setup, patient comfort and safety aspects in the clinical setting for freehand real-time MR-guidance established for percutaneous procedures in an open MR-scanner.
30 patients with suspect prostate lesions were biopsied in a cylindrical 3T-MRI system using a transgluteal approach in freehand technique. One to three biopsies were sampled using continuous dynamic imaging. Size, location and visibility of the lesion, intervention time, needle artefact size, interventional complications and histopathological diagnosis were recorded.
All biopsies were technically successful. Nineteen patients showed evidence of prostate carcinoma. Cancer detection rate was 50 % in patients with previously negative TRUS-biopsy. The average intervention time was 26 min including a learning curve as the time was 13 min by the end of the study. No antibiotic prophylaxis was performed as none of the patients showed signs of infection.
MR-guided targeted freehand biopsies of prostate lesions using a transgluteal approach are both technically feasible and time efficient in a standard closed-bore 3T-MR scanner as well as safe for the individual patient.
• Open-bore freehand interventional principles were adapted to closed-bore systems. • Prostate MR-guided freehand biopsies were feasible in a clinical setting. • A transgluteal approach provides a short and simplified work flow. • An inoculation of the prostate with bowel flora is avoided. • The intervention time is comparable to the stereotactic approach.
我们研究的目的是（1）通过经臀入路建立可疑前列腺病变的管内靶向活检，避免肠穿透，（2）评估开放式磁共振扫描仪中经皮程序建立的自由手实时磁共振引导的操作者设置、患者舒适度和安全性方面。
30 例可疑前列腺病变患者在圆柱形 3T-MRI 系统中使用经臀入路的自由手技术进行活检。使用连续动态成像对 1-3 个活检进行采样。记录病变的大小、位置和可观察性、干预时间、针道伪影大小、介入并发症和组织病理学诊断。
所有活检均技术成功。19 例患者有前列腺癌证据。在之前经直肠超声活检阴性的患者中，癌症检出率为 50%。平均干预时间为 26 分钟，包括学习曲线，因为在研究结束时时间为 13 分钟。由于没有患者出现感染迹象，因此未进行抗生素预防。
使用经臀入路的磁共振引导靶向自由手活检对前列腺病变在标准闭孔 3T-MR 扫描仪中具有技术可行性和时间效率，并且对个体患者安全。
• 开放式自由手介入原则适用于闭孔系统。• 前列腺磁共振引导自由手活检在临床环境中可行。• 经臀入路提供了简短而简化的工作流程。• 避免了粪便菌群接种前列腺。• 干预时间与立体定向方法相当。
