Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2025 Mar;47(2):79-92.
doi: 10.1177/01617346241311901. Epub 2025 Jan 6.

Clinical Feasibility of 3-D Acoustic Radiation Force Impulse (ARFI) Imaging for Targeted Prostate Biopsy Guidance

Derek Y Chan  1 , Spencer R Moavenzadeh  1 , Wren E Wightman  1 , Mark L Palmeri  1 , Thomas J Polascik  2 , Kathryn R Nightingale  1
Affiliations
Clinical Trial

Clinical Feasibility of 3-D Acoustic Radiation Force Impulse (ARFI) Imaging for Targeted Prostate Biopsy Guidance

Derek Y Chan et al. Ultrason Imaging. 2025 Mar.

Abstract

We have developed a 3-D acoustic radiation force impulse (ARFI) prostate imaging system to identify regions suspicious for cancer and guide a targeted prostate biopsy in a single visit. The system uses a side-fire transrectal probe and an automated rotation stage to acquire ARFI and B-mode image volumes, combined with 3-D visualization and targeting software to enable biopsy target identification and guide a transperineal (TP) biopsy. The system was tested in the first clinical trial of its kind, with subjects serially undergoing ARFI-guided targeted TP biopsy, multiparametric magnetic resonance imaging (mpMRI)-ultrasound fusion TP biopsy, and systematic sampling TP biopsy. The findings indicate that the ARFI system is feasible for guiding a targeted biopsy. For lower-grade cancer (grade groups [GG] 1-2), ARFI underperformed mpMRI and systematic sampling, detecting cancer in 54% of GG 2 subjects. However, ARFI performance improved with increasing cancer grade; for higher-grade cancer (GG 3-5), ARFI performed comparably to the other biopsy approaches, and detected cancer in all GG 4 and 5 subjects. The findings also suggest the benefit of using 2-D ARFI imaging to confirm target location during live B-mode imaging, which could improve existing ultrasonic fusion biopsy workflows. This study is registered with ClinicalTrials.gov as NCT04607135.

Keywords: acoustic radiation force; elasticity imaging; image-guided biopsy; prostate cancer; transperineal biopsy.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: K. R. Nightingale and M. L. Palmeri have intellectual property related to radiation force-based imaging technologies that has been licensed to Siemens, Samsung, and MicroElastic Ultrasound Systems.

References

    1. Goldberg H, Ahmad AE, Chandrasekar T, et al. Comparison of magnetic resonance imaging and transrectal ultrasound informed prostate biopsy for prostate cancer diagnosis in biopsy naïve men: A systematic review and meta-analysis. J Urol 2020;203(6):1085–93. - PubMed
    1. Xiang J, Yan H, Li J, et al. Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer: a systematic review and meta-analysis. World J Surg Oncol 2019;17:31. - PMC - PubMed
    1. Das CJ, Razik A, Sharma S, et al. Prostate biopsy: When and how to perform. Clin Radiol 2019;74(11):853–64. - PubMed
    1. Chatterjee A, Harmath C, Oto A. New prostate MRI techniques and sequences. Abdom Radiol 2020;45(12):4052–62. - PubMed
    1. Weinreb JC, Barentsz JO, Choyke PL, et al. PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2. Eur Urol 2016;69(1):16–40. - PMC - PubMed

Publication types

Associated data