Kaur Tejinder, Jiang Yun, Seiberlich Nicole, Hussain Hero, Wells Shane, Wei John, Caoili Elaine, Gulani Vikas
University of Michigan, Ann Arbor, USA.
Abdom Radiol (NY). 2025 Jan 11. doi: 10.1007/s00261-024-04783-x.
In-bore MRI-guided biopsy allows direct visualization of suspicious lesions, biopsy needles, and trajectories, allowing accurate sampling when MRI-ultrasound fusion biopsy is not feasible. However, its use has been limited. Wide-bore, lower-field, and lower-cost scanners could help address these issues, but their feasibility for prostate biopsy is unknown. The purpose of our study was to evaluate the feasibility of in-bore MRI-guided prostate biopsy using a large-bore (80 cm), 0.55T scanner.
Nineteen participants (68 ± 10 years) with suspected prostate cancer (PCa) were recruited for this Institutional Review Board (IRB) approved study (May 2023 -October 2024). Prebiopsy diagnostic scans and intra-procedural T2-weighted images were used for lesion localization. PSA levels, lesion sizes, cancer detection rates, positive core volume percentage, ISUP (International Society of Urological Pathology) grade groups (GG), positive volume cores, skin to target distances, and procedure durations were reported.
Seventeen participants underwent biopsies (four transrectal, thirteen percutaneous). Two participants were excluded. Twenty lesions (mean size 1.9 ± 1.2 cm) were biopsied which showed various GG cancers (GG1, GG2, GG3, GG4, and GG5), with positive cores ranging from 10 to 100%. 20% of the lesions were benign. Compared to previous biopsies, 22.2% (2/9) had new cancer detections, 22.2% (2/9) showed a GG upgrade, and 33.3% (3/9) had increased positive core volume, while 11.1% (1/9) showed no upgrade and 11.1% (1/9) had benign findings. Among biopsy-naïve participants, 75% (6/8) had cancer detected, and 25% (2/8) had benign findings. One new cancer was detected near a hip prosthesis due to reduced imaging artifacts. Average total procedure time was 77 ± 21 min for transrectal and 74 ± 22 min for percutaneous biopsies, with times to first core at 45 ± 15 and 53 ± 14 min, respectively.
Identifying and accurately targeting suspicious prostate lesions is feasible using a 0.55T MRI scanner.
孔内磁共振成像（MRI）引导下活检可直接观察可疑病变、活检针及其轨迹，在MRI-超声融合活检不可行时能实现精确取样。然而，其应用一直受限。大孔径、低场强且低成本的扫描仪可能有助于解决这些问题，但它们用于前列腺活检的可行性尚不清楚。本研究的目的是评估使用大孔径（80厘米）、0.55T扫描仪进行孔内MRI引导下前列腺活检的可行性。
本研究经机构审查委员会（IRB）批准（2023年5月至2024年10月），招募了19名疑似前列腺癌（PCa）的参与者（68±10岁）。活检前诊断扫描和术中T2加权图像用于病变定位。报告了前列腺特异性抗原（PSA）水平、病变大小、癌症检出率、阳性核心体积百分比、国际泌尿病理学会（ISUP）分级组（GG）、阳性体积核心、皮肤到靶点距离以及手术时长。
17名参与者接受了活检（4例经直肠，13例经皮）。2名参与者被排除。对20个病变（平均大小1.9±1.2厘米）进行了活检，这些病变显示出不同分级的癌症（GG1、GG2、GG3、GG4和GG5），阳性核心比例从10%到100%不等。20%的病变为良性。与之前的活检相比，22.2%（2/9）有新的癌症检出，22.2%（2/9）显示GG分级升级，33.3%（3/9）阳性核心体积增加，而11.1%（1/9）未升级，11.1%（1/9）有良性结果。在初次接受活检的参与者中，75%（6/8）检测到癌症，25%（2/8）有良性结果。由于成像伪影减少，在髋关节假体附近检测到1例新癌症。经直肠活检的平均总手术时间为77±21分钟，经皮活检为74±22分钟，获取第一针的时间分别为45±15分钟和53±14分钟。
使用0.55T MRI扫描仪识别并精确靶向可疑前列腺病变是可行的。
