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Proceedings Paper

Trans-rectal interventional MRI: initial prostate biopsy experience
Author(s): Bernadette M. Greenwood; Meliha R. Behluli; John F. Feller; Stuart T. May; Robert Princenthal; Alex Winkel; David B. Kaminsky
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Paper Abstract

Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate gland when evaluated along with T2-weighted images, diffusion-weighted images (DWI) and their corresponding apparent diffusion coefficient (ADC) maps can yield valuable information in patients with rising or elevated serum prostate-specific antigen (PSA) levels1. In some cases, patients present with multiple negative trans-rectal ultrasound (TRUS) biopsies, often placing the patient into a cycle of active surveillance. Recently, more patients are undergoing TRIM for targeted biopsy of suspicious findings with a cancer yield of ~59% compared to 15% for second TRUS biopsy2 to solve this diagnostic dilemma and plan treatment. Patients were imaged in two separate sessions on a 1.5T magnet using a cardiac phased array parallel imaging coil. Automated CAD software was used to identify areas of wash-out. If a suspicious finding was identified on all sequences it was followed by a second imaging session. Under MRI-guidance, cores were acquired from each target region3. In one case the microscopic diagnosis was prostatic intraepithelial neoplasia (PIN), in the other it was invasive adenocarcinoma. Patient 1 had two negative TRUS biopsies and a PSA level of 9ng/mL. Patient 2 had a PSA of 7.2ng/mL. He underwent TRUS biopsy which was negative for malignancy. He was able to go on to treatment for his prostate carcinoma (PCa)4. MRI may have an important role in a subset of patients with multiple negative TRUS biopsies and elevated or rising PSA.

Paper Details

Date Published: 23 February 2010
PDF: 11 pages
Proc. SPIE 7625, Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling, 76252U (23 February 2010); doi: 10.1117/12.847045
Show Author Affiliations
Bernadette M. Greenwood, Invivo Corp. (United States)
Meliha R. Behluli, Invivo Corp. (United States)
John F. Feller, Desert Medical Imaging (United States)
Stuart T. May, Desert Medical Imaging (United States)
Robert Princenthal, Rolling Oaks MRI (United States)
Alex Winkel, Invivo-Germany (Germany)
David B. Kaminsky, Palm Springs Pathology Services (United States)

Published in SPIE Proceedings Vol. 7625:
Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling
Kenneth H. Wong; Michael I. Miga, Editor(s)

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