Three-dimensional printing technique assisted cognitive fusion in targeted prostate biopsy

Objective To explore the effect of 3-dimensional (3D) printing-assisted cognitive fusion on improvement of the positive rate in prostate biopsy. Methods From August to December 2014, 16 patients with suspected prostatic lesions detected by multiparametric magnetic resonance imaging (MRI) were included. Targeted prostate biopsy was performed with the use of prostate 3D reconstruction modeling, computer-simulated biopsy, 3D printing, and cognitive fusion biopsy. All patients had received 3.0 T multiparametric MRI before biopsy. The DICOM MRI files were imported to medical imaging processing software for 3D reconstruction modeling to generate a printable .stl file for 3D printing with use of transparent resin as raw material. We further performed a targeted 2- to 3-core biopsy at suspected lesions spotted on MRI. Results For the 16 patients in the present study, 3D modeling with cognitive fusion-based targeted biopsy was successfully performed. For a single patient, 1-2 lesions (average: 1.1 lesions) were discovered, followed by 2-6 cores (average: 2.4 cores) added as targeted biopsy. Systematic biopsies accounted for 192 cores in total, with a positive rate of 22.4%; targeted biopsies accounted for 39 cores in total, with a positive rate of 46.2%. Among these cases, 10 patients (62.5%) were diagnosed with prostate adenocarcinoma, in which seven were discovered by both systematic and targeted biopsy, one was diagnosed by systematic biopsy only, and two were diagnosed by targeted biopsy only. For systematic biopsy, Gleason score ranged from 6 to 8 (average: 7), while that for targeted biopsy ranged from 6 to 9 (average: 7.67). Among the seven patients that were diagnosed by both systematic and targeted biopsy, three (42.8%) were reported with a higher Gleason score in targeted therapy than in systematic biopsy. Conclusion 3D printing-assisted cognitive fusion technique markedly promoted positive rate in prostate biopsy, and reduced missed detection in high-risk prostate cancer.