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Updated: Jun 16, 2026
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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Repeat prostate biopsy accuracy: simulator-based comparison of two- and three-dimensional transrectal US modalities
Derek W Cool1, Michael J Connolly, Shi Sherebrin
1Imaging Research Laboratories, Robarts Research Institute, University of Western Ontario, London, Canada. dcool2011@meds.uwo.ca
Radiology
|January 23, 2010
Summary
Guided 3D transrectal US significantly improves repeat prostate biopsy accuracy compared to 2D and conventional 3D methods. This advanced technique offers a higher probability of successfully sampling targets in repeat prostate biopsy procedures.
Area of Science:
- Urology
- Medical Imaging
- Prostate Cancer Diagnostics
Background:
- Repeat prostate biopsies are crucial for accurate cancer staging.
- Traditional two-dimensional (2D) transrectal ultrasonography (US) guided biopsies have limitations in accuracy.
- Three-dimensional (3D) US offers potential for improved visualization and guidance.
Purpose of the Study:
- To compare the accuracy of repeat prostate biopsy guidance using 2D transrectal US, conventional 3D transrectal US, and guided 3D transrectal US.
- To evaluate the effectiveness of these modalities in a simulated repeat prostate biopsy setting.
Main Methods:
- A prostate biopsy simulator was used with images from 10 patients.
- Five residents and five experts performed simulated repeat biopsies using 2D US, conventional 3D US, and guided 3D US.
- Accuracy and time per biopsy were measured, with a focus on guiding biopsies to specific targets.
Main Results:
- Guided 3D transrectal US demonstrated significantly higher accuracy (0.86 mm) compared to 2D (3.68 mm) and conventional 3D (3.60 mm) US.
- The probability of sampling a prior biopsy target volume approached 100% with guided 3D US, versus 70% with 2D US.
- While experts were faster, biopsy accuracy did not significantly differ between experts and residents for any modality.
Conclusions:
- Guided 3D transrectal US significantly enhances the accuracy of repeat prostate biopsies.
- Conventional 3D transrectal US did not improve biopsy accuracy over 2D transrectal US.
- Guided 3D transrectal US is a valuable tool for improving repeat prostate biopsy procedures.
