Guidance and Tracking System for More Precise Prostate Biopsy

Improves Biopsy Core Placement Accuracy and Ease of Use Via Real-Time 3D Visualization of the Prostate, Biopsy Device, TRUS probe, Template Locations and Regions of Interest

This 3D-visualization precision biopsy system visually assists urologists in accurately sampling a desired location within the prostate, whether the location is a template location (freehand systematic prostate biopsy, sPBx) or a region of interest or target (targeted biopsy). Treatment cannot begin without a positive diagnosis of prostate cancer from pathology exam of biopsied samples. An earlier diagnosis offers more options for treatment or cure. Traditional TransRectal UltraSound (TRUS) guided freehand systematic prostate biopsy, and to a lesser extent targeted PBx via MRI/TRUS fusion, can miss cancerous lesions that are present and undesirably produce a false negative diagnosis. A false negative will delay initial treatment for prostate cancer by over 6 months, if a repeat biopsy is performed (and samples the lesion) or else the cancer is completely missed, complicating treatment and greatly diminishing patient outcomes. Prostate biopsy is spatially challenging because the commonly used TRUS image is 2D and properly interpreting the TRUS image requires mental rotations from the clinician.

Researchers at the University of Florida have developed a 3D, 6 degrees of freedom (6DOF) tracking, guidance, and visualization system to increase precision and ease of use during TRUS-guided prostate biopsy via the transrectal or transperineal route. The system enables urologists to capture tissue samples accurately from the entire prostate to avoid missing potentially malignant tissue. This will ensure an earlier diagnosis of prostate cancer compared to current technology, if malignancy is present, that allows for better treatment or cure options for the patient.

Application

An intuitive, 3D-visualization guidance system for freehand systematic or targeted prostate biopsy that assists urologists and provides real-time feedback in accurately placing biopsy cores at the desired locations via the transrectal or transperineal route

Advantages

• Displays a virtual 3D TRUS probe and biopsy environment in real time, improving a urologist’s precision in sampling desired prostate locations
• Does not require an MRI scan and service of a radiologist, achieving precision with lower costs and fewer hospital visits
• Accurately samples prostate regions during biopsy, reducing false negative diagnoses upon pathology exam of the biopsied prostate tissue

Technology

This biopsy system displays a virtual TRUS probe and biopsy needle through real-time 6 DOF tracking and 3D visualization. A prostate catheter with a tracking sensor is anchored into the prostatic urethra to track the prostate location and orientation in real time. A user-interface software depicts the prostate and the location of the TRUS probe and biopsy needle to help guide the urologist during the procedure. An echogenic liquid filling the catheter ensures clear visualization of the catheter during ultrasonography. This helps to prevent unintended sampling of the catheter or tracking sensor. The urologist can then manually trace the outline of multiple cross-sections of the prostate and input them into the software to create a segmented 3D prostate that displays the locations to be sampled.