Visualized Prostate Biopsy: An Intuitive Three-Dimensional User Interface for Systematic and Targeted Biopsy

Prostate biopsy false negative percentages are 21% to 47% and 16% to 30% for systematic and fused biopsy, respectively. An intuitive three-dimensional (3D) observed user interface may help reduce these percentages by providing real-time guidance and feedback during transrectal or transperineal biopsy. We track the moving prostate (including template locations and regions of interest), the transrectal ultrasound (TRUS) probe, and the biopsy device to construct a 3D environment. Users observe, aim, sample, and receive feedback in real time. Using a simulator with simulated TRUS, 48 participants performed freehand systematic prostate biopsy with traditional TRUS guidance and afterward with visualized prostate biopsy (vPBx). During simulated biopsy, vPBx reduced the false negative percentage for a 0.5-mL spherical apical lesion from 52% to 2% (p < 0.001). Preliminary results during simulated systematic biopsy warrant retrofitting the vPBx to actual TRUS equipment as a step toward clinical trials with patients.