Login to Access Video or Poster Abstract: MP52-14
Sources of Funding: Study supported by the Patrick C. Walsh Prostate Cancer Research Fund. The ultrasound equipment used in this study was provided by Hitachi Aloka Medical America, Inc.

Introduction

A freehand TRUS-guided prostate biopsy has significant limitations with spatially clustered and poorly targeted biopsy cores (J Urol. 2012 Dec;188(6):2404-9.) We have developed a novel, 4 degree of freedom (DoF) robotic TRUS probe manipulator (TRUS Robot) (Urology 2011; 77:502-7). Here, we examined the feasibility of image-guided navigation during prostate biopsy using TRUS Robot by obtaining TRUS images of the prostate gland and guiding the biopsy using a geometrically distributed biopsy cores._x000D_

Methods

TRUS Robot was updated to allow handling of an end-fire TRUS probe and an easy passage of the prostate biopsy needle. Three-dimensional (3-D) image reconstruction, navigation, and core placement software were also developed to allow the geometric core distribution and to align the probe on target for biopsy with minimal motion of the probe around the prostate and between the biopsy cores. _x000D_

Results

After IRB approval and informed consent were obtained, 3 subjects underwent TRUS Robot-guided prostate biopsy without complications. The TRUS Robot allowed a steady handling and remote manipulation of the TRUS probe during biopsy. After a manual positioning of the TRUS probe, an automated spin motion of TRUS Robot allowed the acquisition of the entire gland and its 3-D reconstruction. Selection of the extended sextant biopsy core locations was done in the images. Then, the robot oriented the TRUS probe on each target and biopsy cores were obtained manually through the needle guide under direct ultrasound visualization. TRUS Robot and software allowed a smooth and minimal movement between biopsy cores. The accuracy and precision of core targeting according to the plan were 0.49 and 0.22mm, respectively._x000D_

Conclusions

TRUS Robot-guided prostate biopsy is safe and feasible. It helps define a biopsy plan, provides a mechanism to accurately sample the gland accordingly, and gives a quantitative quality control on the actual distribution of the cores. A successful TRUS Robot-guided prostate procedure provides crucial spatial information of the biopsy cores for improved cancer detection, treatment, and monitoring._x000D_

Funding

Study supported by the Patrick C. Walsh Prostate Cancer Research Fund. The ultrasound equipment used in this study was provided by Hitachi Aloka Medical America, Inc.