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Urol Oncol. 2014 Aug;32(6):903-11. doi: 10.1016/j.urolonc.2013.08.006. Epub 2013 Nov 13.

Target detection: magnetic resonance imaging-ultrasound fusion-guided prostate biopsy.

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Department of Urology, Stanford University, Stanford, CA.
Department of Radiology, University of California, Los Angeles, CA.
Department of Urology, University of California, Los Angeles, CA. Electronic address:


Recent advances in multiparametric magnetic resonance imaging (MRI) have enabled image-guided detection of prostate cancer. Fusion of MRI with real-time ultrasound (US) allows the information from MRI to be used to direct biopsy needles under US guidance in an office-based procedure. Fusion can be performed either cognitively or electronically, using a fusion device. Fusion devices allow superimposition (coregistration) of stored MRI images on real-time US images; areas of suspicion found on MRI can then serve as targets during US-guided biopsy. Currently available fusion devices use a variety of technologies to perform coregistration: robotic tracking via a mechanical arm with built-in encoders (Artemis/Eigen, BioJet/Geoscan); electromagnetic tracking (UroNav/Philips-Invivo, Hi-RVS/Hitachi); or tracking with a 3D US probe (Urostation/Koelis). Targeted fusion biopsy has been shown to identify more clinically significant cancers and fewer insignificant cancers than conventional biopsy. Fusion biopsy appears to be a major advancement over conventional biopsy because it allows (1) direct targeting of suspicious areas not seen on US and (2) follow-up biopsy of specific cancerous sites in men undergoing active surveillance.


Biopsy; Magnetic resonance imaging; Prostatic neoplasms; Ultrasonography

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