@article {Singh2007a, title = {Patient selection determines the prostate cancer yield of dynamic contrast-enhanced magnetic resonance imaging-guided transrectal biopsies in a closed 3-Tesla scanner}, journal = {British Journal of Urology international}, volume = {101}, number = {2}, year = {2007}, month = {Jan}, pages = {181{\textendash}185}, publisher = {Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1642, USA Anurag Singh@RoswellPark org}, abstract = {

OBJECTIVE: To evaluate the cancer yield of transrectal prostate biopsies in a 3-T magnetic resonance imaging (MRI) scanner in patients with elevated prostate specific antigen (PSA) levels, recent negative transrectal ultrasonography (TRUS)-guided prostate biopsies PATIENTS AND METHODS: Between July 2004, November 2005, patients with at least one previous negative prostate biopsy within the previous 12 months had MRI-guided biopsy of the prostate in a 3-T MRI scanner Patients with previous positive biopsies for cancer were excluded Target selection was based on T2-weighted imaging, dynamic contrast-enhanced (DCE) imaging studies RESULTS: Thirteen patients were eligible; their median (range) age was 61 (47-74) years, PSA value 4 90 (1 3-12 3) ng/mL Most patients had one previous negative biopsy (range 1-4) Four patients had a family history of prostate cancer There were 37 distinct targets based on T2-weighted imaging Fifteen of 16 distinct DCE abnormalities were co-localized with a target based on T2-weighted imaging Despite this correlation, only one of 13 patients had a directed biopsy positive for cancer Including systematic biopsies, two of 13 patients had a biopsy positive for prostate cancer One patient had prostate intraepithelial neoplasia, one had atypical glands in the specimen CONCLUSION: The prostate-cancer yield of transrectal biopsies in a 3-T MRI scanner, among patients with recent negative TRUS-guided prostate biopsies, is similar to repeat systematic TRUS-guided biopsy DCE correlates with T2-imaging but does not appear to improve prostate cancer yield in this population

}, keywords = {Aged, Biopsy, blood, Cohort Studies, Contrast Media, diagnosis, Digital Rectal Examination, Humans, Interventional, Magnetic Resonance Imaging, Male, methods, Middle Aged, Needle, pathology, Patient Selection, Predictive Value of Tests, Prostate, Prostate-Specific Antigen, Prostatic Neoplasms, Sensitivity, Specificity, standards, Ultrasonography}, doi = {10 1111/j 1464-410X 2007 07219 x}, url = {http://dx doi org/10 1111/j 1464-410X 2007 07219 x}, author = {Anurag K. Singh and Axel Krieger and Jean-Baptiste Lattouf and Peter Guion and R.L. Grubb III and Paul Albert and Greg Metzger and Karen Ullman and Sharon Smith and Gabor Fichtinger and Iclal Ocak and Peter Choyke and Cynthia Menard and Jonathan Coleman} } @article {Susil2006, title = {Transrectal prostate biopsy and fiducial marker placement in a standard 1 5T magnetic resonance imaging scanner}, journal = {The Journal of Urology}, volume = {175}, number = {1}, year = {2006}, month = {Jan}, pages = {113{\textendash}120}, publisher = {Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA}, abstract = {

PURPOSE: We investigated the accuracy, feasibility of a system that provides transrectal needle access to the prostate concurrent with 1 5 Tesla MRI which previously has not been possible MATERIALS AND METHODS: In 5 patients with previously diagnosed prostate cancer, MRI guided intraprostatic placement of gold fiducial markers (4 procedures),/or prostate biopsy (3 procedures) was performed using local anesthesia RESULTS: Mean procedure duration was 76 minutes, all patients tolerated the intervention well Procedure related adverse events included self-limited hematuria, hematochezia following 3 of 8 procedures (all resolved in less than 1 week) Mean needle placement accuracy was 1 9 mm for the fiducial marker placement studies, 1 8 mm for the biopsy procedures Mean fiducial marker placement accuracy was 4 8 mm, the mean fiducial marker placement accuracy transverse to the needle direction was 2 6 mm All patients who underwent the procedure were able to complete their course of radiotherapy without delay or complication CONCLUSIONS: While studies of clinical usefulness are warranted, transrectal 1 5 T MRI guided prostate biopsy, fiducial marker placement is feasible using this system, providing new opportunities for image guided diagnostic, therapeutic prostate interventions

}, keywords = {Biopsy, Equipment Design, Feasibility Studies, Humans, instrumentation, instrumentation/methods, Magnetic Resonance Imaging, Male, Needle, pathology, Prostate, Prostatic Neoplasms}, doi = {10 1016/S0022-5347(05)00065-0}, url = {http://dx doi org/10 1016/S0022-5347(05)00065-0}, author = {Robert Susil and Cynthia Menard and Axel Krieger and Jonathan Coleman and Kevin Camphausen and Peter Choyke and Gabor Fichtinger and Whitcomb, Louis L. and Norman Coleman and Ergin Atalar} } @article {Cleary2005, title = {Precision placement of instruments for minimally invasive procedures using a "needle driver" robot}, journal = {international journal of medical robotics computer assisted surgery MRCAS}, volume = {1}, number = {2}, year = {2005}, month = {Jan}, pages = {40{\textendash}47}, abstract = {

Medical practice continues to move toward less invasive procedures Many of these procedures require the precision placement of a needle in the anatomy Over the past several years, our research team has been investigating the use of a robotic needle driver to assist the physician in this task This paper summarizes our work in this area The robotic system is briefly described, followed by a description of a clinical trial in spinal nerve blockade The robot was used under joystick control to place a 22 gauge needle in the spines of 10 patients using fluoroscopic imaging The results were equivalent to the current manual procedure We next describe our follow-up clinical application in lung biopsy for lung cancer screening under CT fluoroscopy The system concept is discussed, the results of a phantom study are presented A start-up company named ImageGuide has recently been formed to commercialize the robot Their revised robot design is presented, along with plans to install a ceiling-mounted version of the robot in the CT fluoroscopy suite at Georgetown University

}, keywords = {Biopsy, Cadaver, Equipment Design, Fluoroscopy, Humans, Imaging, instrumentation, instrumentation/methods, Lung, Lung Neoplasms, methods, Minimally Invasive, Needles, Nerve Block, pathology, pathology/radiography, Phantoms, Randomized Controlled Trials as Topic, Robotics, Spinal Nerves, Surgical Procedures, Tomography, X-Ray Computed}, doi = {10 1002/rcs 40}, url = {http://dx doi org/10 1002/rcs 40}, author = {Kevin Cleary and Vance Watson and David Lindisch and Russell H. Taylor and Gabor Fichtinger and Sheng Xu and Charles White and John Donlon and Michael Taylor and Alexandru Patriciu and Dumitru Mazilu and Dan Stoianovici} } @article {Shen2004a, title = {Optimized prostate biopsy via a statistical atlas of cancer spatial distribution}, journal = {Medical image analysis}, volume = {8}, number = {2}, year = {2004}, month = {Jun}, pages = {139{\textendash}150}, abstract = {

A methodology is presented for constructing a statistical atlas of spatial distribution of prostate cancer from a large patient cohort, and it is used for optimizing needle biopsy An adaptive-focus deformable model is used for the spatial normalization, registration of 100 prostate histological samples, which were provided by the Center for Prostate Disease Research of the US Department of Defense, resulting in a statistical atlas of spatial distribution of prostate cancer Based on this atlas, a statistical predictive model was developed to optimize the needle biopsy sites, by maximizing the probability of detecting cancer Experimental results using cross-validation show that the proposed method can detect cancer with a 99\% success rate using seven needles, in these samples

}, keywords = {Algorithms, Biological, Biopsy, Cohort Studies, Computer Simulation, Computer-Assisted, Forecasting, Humans, Image Processing, Imaging, Male, Models, Needle, pathology, Probability, Prostate, Prostatic Neoplasms, Reproducibility of Results, Statistical, statistics /\&/ numerical data, Three-Dimensional}, doi = {10 1016/j media 2003 11 002}, url = {http://dx doi org/10 1016/j media 2003 11 002}, author = {Dinggang Shen and Zhiqiang Lao and Jianchao Zeng and Wei Zhang and Isabel Sesterhenn and Leon Sun and Judd Moul and Edward Herskovits and Gabor Fichtinger and Christos Davatzikos} }