Feasibility of a 2 generation MR-compatible manipulator for transrectal prostate biopsy guidance

Objectives To assess the feasibility of a 2 generation MRcompatible, remote-controlled manipulator (RCM) as an aid to perform MR-guided transrectal prostate biopsy in males with suspicion of prostate cancer (PCa). Methods This prospective phase I study was approved by the local ethical committee and written informed consent was obtained from each patient. Twenty patients with ≥1 cancer suspicious region (CSR) with a PI-RADS score of ≥3 detected on the diagnostic multi-parametric MRI and no prior prostate treatment underwent MR-guided biopsy with the aid of the RCM. Complications were classified according to the modified Clavien system for reporting surgical complications. For evaluation of the workflow, procedureand manipulation times were recorded. Results All CSR’s (n=20) were reachable with the MRcompatible RCM and the cancer detection rate was 70 %. The median procedure time was 36:44 minutes (range, 23 – 61 minutes) and the median manipulation time for needle guide movement was 5:48 minutes (range, 1:15 – 18:35 minutes). Two Clavien grade 1 complications were reported. Conclusions It is feasible and safe to perform transrectal MRguided prostate biopsy using a MR-compatible RCM as an aid. It is a fast and efficient way to biopsy suspicious prostate lesions with a minimum number of biopsies per patient. Key Points • It is feasible to perform transrectal prostate biopsy using a MR-compatible RCM. • Using a RCM for MR-guided biopsy is safe, fast, and efficient. • All cancer suspicious regions were reachable with the RCM.