51. Quantifying the effect of biopsy lateral decubitus patient positioning compared to supine prostate MRI scanning on prostate translocation and distortion
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Žiga Snoj, Leonardo Rundo, Tristan Barrett, Andrew B. Gill, Rundo, Leonardo [0000-0003-3341-5483], Gill, Andrew [0000-0002-9287-9563], Barrett, Tristan [0000-0002-1180-1474], and Apollo - University of Cambridge Repository
- Subjects
Urologic Diseases ,Supine position ,Prostate biopsy ,Urology ,32 Biomedical and Clinical Sciences ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Prostate ,Clinical Research ,Distortion ,Biopsy ,medicine ,Lateral Decubitus Position ,3202 Clinical Sciences ,Cancer ,medicine.diagnostic_test ,business.industry ,Prostate Cancer ,Ultrasound ,Magnetic resonance imaging ,3211 Oncology and Carcinogenesis ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Biomedical Imaging ,business ,Nuclear medicine - Abstract
Introduction: More than a quarter of tumors are missed by magnetic resonance imaging/ultrasound (MRI/US) fusion-guided biopsy, the majority due to software-based misregistration. Transrectal approaches to biopsy are typically performed in the lateral decubitus position; conversely, diagnostic MRI is performed with the patient lying supine. Any position-related difference in prostate location or gland deformation could potentially exacerbate misregistration at subsequent biopsy. Methods: Fifteen healthy male volunteers (mean age 35.9 years, range 27–53) were included in this prospective, institutional review board-approved study. Each volunteer had an MRI performed in the supine position, followed by the second in the lateral decubitus position (mimicking a typical biopsy position). MRI images were co-registered and analyzed in order to assess prostate translocation and distortion. Results: Whole prostate translocation of ≥5 mm was observed in 20% of patients and ≥3 mm in 60% of patients. When dividing the prostate into prostatic sectors, the prostatic base demonstrated the largest positional difference. When plotting the translocation directions with relative volume difference, there was a moderate negative correlation trend in the latero-lateral direction. Only minimal distortion was observed, with similar distortion among all prostatic sectors. Conclusions: Positional change affects the prostate translocation, however, the effect on prostate distortion appears to be negligible. Prostate translocation in latero-lateral direction can be minimized with larger bladder volumes. Thereby, prostate translocation needs to be considered alongside software misregistration error; however, positional change should not affect software registration of MRI/US fusion-guided prostate biopsy.
- Published
- 2019
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