INTRODUCTION AND OBJECTIVE:Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) is reported to improve urinary functional outcomes faster over standard RARP. However, there are reports of...

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I1 Apr 2017MP52-08 TECHNIQUE AND CASE SERIES OF MRI GUIDED IN-BORE BIOPSY FOR PATIENTS WITHOUT RECTUM Dordaneh Sugano, Abhinav Sidana, Collier Wright, Brian Calio, Mahir Maruf, Amit Jain, Maria Merino, Peter Choyke, Baris Turkbey, Bradford Wood, and Peter Pinto Dordaneh SuganoDordaneh Sugano More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Collier WrightCollier Wright More articles by this author , Brian CalioBrian Calio More articles by this author , Mahir MarufMahir Maruf More articles by this author , Amit JainAmit Jain More articles by this author , Maria MerinoMaria Merino More articles by this author , Peter ChoykePeter Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1638AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES MRI targeted biopsy has changed the evaluation paradigm of patients with elevated PSA. However, in patients without a rectum, the fusion platforms to target suspicious lesions on MRI cannot be utilized due to inability to use transrectal ultrasound. In-bore MRI guided biopsy is a potential alternative for targeting specific lesions in these patients. This report outlines the techniques used in a series of five patients undergoing in-bore MRI guided prostate biopsy using registration with the Visualase® (Medtronic) MRI guided laser ablation platform. METHODS Patients without rectum with presence of suspicious lesions on prostate mpMRI were scheduled for biopsy in the MRI suite. Patients were placed under general anesthesia and prepped and draped on the MRI table in the frog-leg position. The biopsy grid was positioned to be flush with the perineum. T2W MR images of the prostate were obtained, transferred to the Visualase platform, and registered to the fiducials using the Visualase system. Serial T1W MR images were used to identify the location and depth of the lesion and then to confirm the location of the biopsy needles. A total of 2-8 cores were obtained from each patient. After completion of the procedure, patients were transferred to the recovery area in stable condition. RESULTS Four patients with suspicion of prostate cancer on prostate mpMRI and surgical absence of rectum underwent prostate biopsy by above technique. The median age was 72 (58-77) years and median PSA was 4.28ng/ml (3.6-6.73). Patient 1 had ileoanal anastomosis and Patients 2-4 had APR, due to UC in Patients 1-3 and rectal cancer in Patient 4. Patient 1 was found to have Gleason 8 and patient 4 had Gleason 7(3+4). Patient 2 and 3 had negative targeted biopsy. No complications from in-bore biopsy were noted. CONCLUSIONS ″In bore″ MRI guidance as a technique during prostate biopsy has been in use since 2002. We report the technique of MRI targeted biopsy using the Visualase MRI guided laser ablation platform, which has traditionally been used for focal laser ablation. Use of this platform allows for accurate registration and targeting of the lesions in patients not eligible for MRI-TRUS fusion. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e706 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Dordaneh Sugano More articles by this author Abhinav Sidana More articles by this author Collier Wright More articles by this author Brian Calio More articles by this author Mahir Maruf More articles by this author Amit Jain More articles by this author Maria Merino More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...