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. 2017 Feb;5(1):29-43.
doi: 10.1007/s40336-016-0214-7. Epub 2016 Dec 1.

Molecular imaging and fusion targeted biopsy of the prostate

Baowei Fei  1   2   3 , Peter T Nieh  4 , Viraj A Master  4 , Yun Zhang  1 , Adeboye O Osunkoya  3   4   5   6 , David M Schuster  1
Affiliations

Molecular imaging and fusion targeted biopsy of the prostate

Baowei Fei et al. Clin Transl Imaging. 2017 Feb.

Abstract

Purpose: This paper provides a review on molecular imaging with positron emission tomography (PET) and magnetic resonance imaging (MRI) for prostate cancer detection and its applications in fusion targeted biopsy of the prostate.

Methods: Literature search was performed through the PubMed database using the keywords "prostate cancer", "MRI/ultrasound fusion", "molecular imaging", and "targeted biopsy". Estimates in autopsy studies indicate that 50% of men older than 50 years of age have prostate cancer. Systematic transrectal ultrasound (TRUS) guided prostate biopsy is considered the standard method for prostate cancer detection and has a significant sampling error and a low sensitivity. Molecular imaging technology and new biopsy approaches are emerging to improve the detection of prostate cancer.

Results: Molecular imaging with PET and MRI shows promising results in the early detection of prostate cancer. MRI/TRUS fusion targeted biopsy has become a new clinical standard for the diagnosis of prostate cancer. PET molecular image-directed, three-dimensional ultrasound-guided biopsy is a new technology that has great potential for improving prostate cancer detection rate and for distinguishing aggressive prostate cancer from indolent disease.

Conclusion: Molecular imaging and fusion targeted biopsy are active research areas in prostate cancer research.

Keywords: Image registration; Image segmentation; Magnetic resonance imaging (MRI); Molecular imaging; Positron emission tomography (PET); Prostate cancer; Targeted biopsy.

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Figures

Fig. 1
Fig. 1
Multiparametric MRI of the prostate: T2-weighted MRI (left), DCE-MRI (middle), and diffusion-weighted MRI (right) of the same patient
Fig. 2
Fig. 2
PET/ultrasound fusion targeted biopsy. Top the PET/CT images with fluciclovine were acquired from a human subject. PET/CT images show a focal lesion within the prostate (white arrow). The 3D visualization of the pelvis and the prostate were used to aid the planning of the biopsy to a suspicious tumor target. Bottom during biopsy, a mechanically assisted navigation device, was used to acquire 3D TRUS images from patients. The prostate boundaries on TRUS images were segmented and were used to generate a 3D model of the prostate. The 3D prostate model and real-time TRUS images are used to guide the biopsy in patients [96]
Fig. 3
Fig. 3
Clinical workflow for the PET/ultrasound fusion targeted biopsy
Fig. 4
Fig. 4
Setup for the molecular image-directed, 3D ultrasound-guided biopsy system that includes a commercial ultrasound scanner and an end firing probe from B&K Medical, the Artemis system, and a workstation for image fusion
Fig. 5
Fig. 5
3D visualization of the automatically segmented prostate (red) as compared with the manual segmentation gold standard (gold color) in four different views (a–d) of the same human prostate Reprint from Akbari et al. [98]
See this image and copyright information in PMC

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