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Updated: Jan 20, 2026

Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy

Published on: April 9, 2019

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68Ga-PSMA-PET/CT and Diffusion MRI Targeting for Cone-Beam CT-Guided Bone Biopsies of Castration-Resistant Prostate

T R F van Steenbergen1, M Smits2, T W J Scheenen3

  • 1Department of Radiology and Nuclear Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Thomas.vansteenbergen@radboudumc.nl.

Cardiovascular and Interventional Radiology
|August 25, 2019
PubMed
Abstract

Insights

Advanced biopsy techniques improve molecular analysis success in metastatic prostate cancer bone lesions. This approach enhances tumor cell yield, potentially improving treatment outcomes for patients with mCRPC.

Area of Science:

  • Oncology
  • Radiology
  • Molecular Diagnostics

Background:

  • Metastatic castration-resistant prostate cancer (mCRPC) treatment relies on precision medicine targeting genetic aberrations.
  • Bone metastases in mCRPC often yield insufficient tumor cells for molecular analysis via standard biopsies.
  • Current CT-guided bone biopsies have limited success rates for molecular profiling.

Purpose of the Study:

  • To assess the feasibility of advanced target planning and needle guidance for bone biopsies in mCRPC.
  • To determine if this enhanced biopsy method increases tumor cell yield and molecular analysis success.
  • To compare the outcomes with standard CT-guided biopsy techniques.

Main Methods:

  • A pilot study involved ten mCRPC patients undergoing 68Ga-PSMA-PET/CT and diffusion-weighted MRI for biopsy planning.
  • Image fusion was used to target metastatic lesions with high tumor density.
  • Biopsies were performed using cone-beam CT (CBCT) guidance for precise needle placement.

Main Results:

  • The advanced target planning and CBCT needle guidance were feasible.
  • Nine out of ten biopsies (90%) contained prostate cancer cells, with median tumor cell percentages of 39% and 40%.
  • Molecular analysis success rate was 80% (8/10 patients), significantly higher than reported rates for CT-guided biopsies (33-44%).
  • Druggable genetic aberrations were identified in two patients.

Conclusions:

  • Advanced biopsy techniques integrating imaging fusion and CBCT guidance are feasible for mCRPC bone metastases.
  • This method significantly increases the success rate of molecular analysis compared to conventional approaches.
  • The improved molecular profiling has the potential to enhance treatment selection and outcomes for mCRPC patients.
Keywords:
Bone biopsyCastration resistant prostate cancerCone-beam CTDiffusion MRIMolecular analysisPSMA-PET/CT

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