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Updated: Aug 6, 2026
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Development of a Custom 7-Degrees of Freedom Robotic Prostate Fusion Biopsy System Using 3-Point Volumetric
Aykut Recep Aktaş1, Mustafa Cetin2, Ali Erhan Eren3
1Radiology Department, Antalya Bilim University, Antalya, Turkey.
Purpose:
To introduce a 7-Degrees of Freedom (DOFDOF) robotic prostate biopsy system utilizing a "3-point volumetric fusion" algorithm and evaluate its clinical feasibility and comparative diagnostic yield against standard systematic biopsy.
Materials And Methods:
A prospective analysis was conducted on 48 biopsy-naïve patients with mpMRI lesions (Prostate Imaging Reporting and Data System ≥3) biopsied using a proprietary 7-DOF robotic system. The software integrates pre-operative MRI with real-time transrectal ultrasound (TRUS) using three internal anatomical landmarks to compensate for organ deformation. Patients underwent Robotic Targeted Biopsy (TB) followed by a 12-core Systematic Biopsy (SB) performed via the robot's joystick control. Primary outcomes were Overall Cancer Detection Rate (CDR) and quantitative tumor burden.
Results:
Prostate cancer was detected in 23 (47.9%) of 48 patients (mean age 64.5 years, PSA 7.2 ng/mL). The cancer detection rate was 47.9% for TB and 43.8% for SB, with a P-value of .48, indicating no statistically significant difference. In cancer-positive cases, the mean tumor involvement in Robotic TB cores was 68.5%, which was significantly greater than the 31.4% observed in Systematic SB cores (P < .01). Cancer was detected exclusively by Robotic TB in two biopsy-naive patients (8.7%) harboring anterior lesions.
Conclusions:
The 7-DOF robotic system demonstrated high safety and clinical feasibility. Consistent with the established advantages of image guidance, the targeted approach yielded substantially higher tumor volume samples than systematic biopsy.
