MRI/TRUS fusion-guided biopsy using UroNav

The video above, as well as videos from Arvin George, MD, and Andre L. Abreu, MD, illustrate techniques for performing transperineal prostate biopsy. Commentary on the videos is provided by Amir H. Lebastchi, MD, clinical fellow in urologic oncology, Urologic Oncology Branch, National Cancer Institute, Bethesda, MD.

Pinto and colleagues provide an overview of MRI/TRUS fusion-guided transperineal biopsy utilizing the UroNav platform. The various components of the biopsy module include a stepper, biopsy grid, ultrasound probe, and endocavity balloon (for elevation of the prostate into the image field). The patient is positioned in dorsal lithotomy position with the electromagnetic field generator just above the pelvis. After the prostate is outlined and aligned with the patient MRI, the targeted lesion is delineated over the ultrasound image. The endocavity balloon is then inflated to appropriately position the prostate within the region of the biopsy grid. Several cores are taken from the targeted region to ensure sufficient sampling of the target. Following biopsy of the targeted lesion, the prostate is then systemically biopsied using an extended sextant systematic 12-core biopsy.

Amir H. Lebastchi, MD

Peter A. Pinto, MD

Lebastchi is a clinical fellow in urologic oncology, O’Connor is a medical student, and Pinto is an investigator and head of the Prostate Cancer Section, Urologic Oncology Branch, National Cancer Institute, Bethesda, MD.

'Y'tube Section Editor James M. Hotaling, MD, MS, is assistant professor of surgery (urology) at the Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City.