ABSTRACT
Objective
To demonstrate the key steps to perform robot-assisted magnetic resonance imaging-ultrasound
fusion transperineal prostate biopsy.
Materials and methods
Men with suspicion of prostate cancer underwent 3-Tesla multi-parametric MRI and were
assigned a Prostate Imaging Reporting and Data System v2 score (PI-RADS). The prostate
outline and suspicious lesions were marked by our radiologist using our software to
produce a 3-dimensional prostate MRI model. All biopsies were performed under general
anaesthesia and the real-time transrectal ultrasound model is created and subsequently
fused with the MRI model using non-rigid software fusion. Transperineal targeted and
systematic biopsy were then performed under stereotactic guidance using our robot-assisted
prostate biopsy platform. Our clinically significant prostate cancer (Grade group
≥2) detection rates were previously described.
1
Results
Out of the 433 patients who underwent targeted and systematic biopsy, clinically-significant
cancer detection rate was 46% (85% for PI- RADS 5 vs 38% for PI-RADS 4 vs 16% for
PI-RADS 3; P < .001). Our overall complication rate was 13%, out of which the majority were Clavien-Dindo
I (99%). The most common complications encountered were urinary retention (10%) and
significant gross hematuria requiring bladder irrigation (2%). A higher prostate volume
was associated with greater odds of urinary retention (OR 1.4, 95% CI: 1.21-1.65,
P < .001 for every 10 mL increase in prostate volume). There was only 1 reported case
of mild urinary tract infection.
Conclusion
Robot-assisted transperineal prostate biopsy has established itself as a reliable
and accurate method of prostate cancer detection with minimal morbidity.
Keywords
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References
- Multiparametric MRI-ultrasonography software fusion prostate biopsy: initial results using a stereotactic robotic-assisted transperineal prostate biopsy platform comparing systematic vs targeted biopsy.BJU Int. 2020; 126: 568-576https://doi.org/10.1111/bju.15118
Article info
Publication history
Published online: June 26, 2021
Accepted:
June 12,
2021
Received:
June 10,
2021
Footnotes
This manuscript is currently not submitted to any other journals for consideration of publication.
Disclosure of potential conflicts of interest: Dr Christopher Cheng, Henry Ho and John Yuen are co-inventors, and medical advisors of the iSR'obot Mona LisaTM (Biobot Surgical, Singapore).
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
