Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study

Importance Targeted magnetic resonance (MR)/ultrasound fusion prostate biopsy has been shown to detect prostate cancer. The implications of targeted biopsy alone vs standard extended-sextant biopsy or the 2 modalities combined are not well understood. Objective To assess targeted vs standard biopsy and the 2 approaches combined for the diagnosis of intermediate- to high-risk prostate cancer. Design, setting, and participants Prospective cohort study of 1003 men undergoing both targeted and standard biopsy concurrently from 2007 through 2014 at the National Cancer Institute in the United States. Patients were referred for elevated level of prostate-specific antigen (PSA) or abnormal digital rectal examination results, often with prior negative biopsy results. Risk categorization was compared among targeted and standard biopsy and, when available, whole-gland pathology after prostatectomy as the "gold standard." Interventions Patients underwent multiparametric prostate magnetic resonance imaging to identify regions of prostate cancer suspicion followed by targeted MR/ultrasound fusion biopsy and concurrent standard biopsy. Main outcomes and measures The primary objective was to compare targeted and standard biopsy approaches for detection of high-risk prostate cancer (Gleason score ≥ 4 + 3); secondary end points focused on detection of low-risk prostate cancer (Gleason score 3 + 3 or low-volume 3 + 4) and the biopsy ability to predict whole-gland pathology at prostatectomy. Results Targeted MR/ultrasound fusion biopsy diagnosed 461 prostate cancer cases, and standard biopsy diagnosed 469 cases. There was exact agreement between targeted and standard biopsy in 690 men (69%) undergoing biopsy. Targeted biopsy diagnosed 30% more high-risk cancers vs standard biopsy (173 vs 122 cases, P Conclusions and relevance Among men undergoing biopsy for suspected prostate cancer, targeted MR/ultrasound fusion biopsy, compared with standard extended-sextant ultrasound-guided biopsy, was associated with increased detection of high-risk prostate cancer and decreased detection of low-risk prostate cancer. Future studies will be needed to assess the ultimate clinical implications of targeted biopsy. Trial registration clinicaltrials.gov Identifier: NCT00102544.

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Comparison of MR/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer

https://www.europeanurology.com/article/S0302-2838(15)00036-6/pdf/can-clinically-significant-prostate-cancer-be-detected-with-multiparametric-magnetic-resonance-imaging-a-systematic-review-of-the-literature

Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature

Medical image fusion is the process of registering and combining multiple images from single or multiple imaging modalities to improve the imaging quality and reduce randomness and redundancy in order to increase the clinical applicability of medical images for diagnosis and assessment of medical problems. Multi-modal medical image fusion algorithms and devices have shown notable achievements in improving clinical accuracy of decisions based on medical images. This review article provides a factual listing of methods and summarizes the broad scientific challenges faced in the field of medical image fusion. We characterize the medical image fusion research based on (1) the widely used image fusion methods, (2) imaging modalities, and (3) imaging of organs that are under study. This review concludes that even though there exists several open ended technological and scientific challenges, the fusion of medical images has proved to be useful for advancing the clinical reliability of using medical imaging for medical diagnostics and analysis, and is a scientific discipline that has the potential to significantly grow in the coming years.

Medical Image Fusion: A survey of the state of the art

https://www.europeanurology.com/article/S0302-2838(12)00695-1/pdf/image-guided-prostate-biopsy-using-magnetic-resonance-imaging-x02013-derived-targets-a-systematic-review

Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review.

Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging

This case illustrates the ability of electromagnetic tracking navigation to localize difficult targets in real time during biopsy or ablation of lesions that are only transiently apparent on arterial phase computed tomography and may be unapparent on sonography. Readily available technology enabling multimodality registration to sonography allows for the use of positron emission tomographic, magnetic resonance imaging, and computed tomographic information during sonographically guided procedures and examinations.

Real-time sonography with electromagnetic tracking navigation for biopsy of a hepatic neoplasm seen only on arterial phase computed tomography.

846 mri/us fusion prostate biopsies: cancer detection rates

Letters to the Editor/Erratum Re: Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging

Carey Buckner

Papers

Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging

Real-time sonography with electromagnetic tracking navigation for biopsy of a hepatic neoplasm seen only on arterial phase computed tomography.

846 mri/us fusion prostate biopsies: cancer detection rates

Letters to the Editor/Erratum Re: Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy and Correlates With Multiparametric Magnetic Resonance Imaging