A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• Transrectal ultrasound (TRUS)-guided prostate biopsy has limitations in detecting early-stage prostate cancer due to imprecise lesion targeting.
• Existing methods often lack the sensitivity and specificity required for accurate diagnosis.

Purpose of the Study:

• To introduce and evaluate an improved cognitive fusion-guided prostate biopsy method for enhanced lesion targeting.
• To assess the diagnostic accuracy, reproducibility, and clinical utility of this novel biopsy technique.

Main Methods:

• Integration of three key prostate multiparametric MRI (mpMRI) parameters (rotation angle α, distance from rectal wall X, distance from prostate apex Y) into TRUS images.
• Real-time cognitive application of these mpMRI parameters during TRUS-guided prostate needle biopsy.
• Clinical application in a cohort of 423 patients.

Main Results:

• Achieved a prostate cancer detection rate of 73.5%, with 62.9% of detected cancers classified as clinically significant.
• Demonstrated enhanced diagnostic accuracy and improved reproducibility compared to traditional methods.
• Showcased cost-effectiveness and practicality, suitable for broader clinical adoption.

Conclusions:

• The cognitive fusion-guided biopsy method offers a practical and effective alternative to traditional TRUS biopsy for prostate cancer detection.
• This technique improves diagnostic yield and reduces operator dependency, making it a valuable tool for urologists.
• Potential for integration with other advanced imaging modalities like ⁶⁸Ga-PSMA PET/CT can further enhance detection rates, particularly in high-risk cases.