Optimizing the MRI-US Fusion Prostate Biopsy Workflow

Historically, ultrasound (US)-guided biopsies were the standard of care for diagnosing prostate cancer. However, these “blind” biopsies have significant limitations, including the detection of clinically insignificant disease and, more concerningly, failing to detect nearly half of high-grade cases.1

Recognizing these shortcomings, the American Urological Association now recommends MRI fusion guided biopsies for all patients needing a prostate biopsy, including those who are biopsy-naive.2 This advanced procedure demonstrates a 93% sensitivity in detecting high-grade cancers with a Gleason score above 4 + 3 — compared to just 48% sensitivity with standard US-guided biopsies.3

While MRI-US fusion offers substantial benefits, it also presents challenges, such as patient movement during the procedure and the high costs associated with the technology. The Navigo 4D Fusion Navigation System addresses these issues, providing a more effective solution for urologists seeking to improve prostate cancer diagnosis and treatment workflows.

Optimizing Fusion Biopsy with Navigo

Navigo works in concert with any Transrectal Ultrasound (TRUS) system, as well as TP MRI/US, blending advanced diagnostics with the real-time electromagnetic tracking of the ultrasound and patient movement. This capability allows physicians to quickly navigate and precisely target regions of interest, without interruptions or delays, thanks to Navigo’s real-time adaptation to patient movement and ultrasound settings changes.

The system utilizes an external electromagnetic tracking system and a software-based registration algorithm, that compensates for patient body and prostate motion during the biopsy.4 This makes Navigo the only real-time navigation system that not only accounts for patient movement but also allows physicians freedom-of-movement during the biopsy.5

Moreover, Navigo’s compatibility with most commercially available ultrasounds further optimizes biopsy workflows. It integrates smoothly into various work modalities (TRUS and TP) without requiring changes to preferred system configurations or workflows, allowing for automated processes without disruptions or the need to stop and make manual adjustments during the biopsies.

Bringing Fusion Biopsies In-Office

Navigo’s convenience and efficiency, combined with a unique per-procedure cost model allows urology practices to bring fusion biopsies in-office as an alternative to performing the procedure in a hospital or surgery center setting.

For practices, that can mean increased billables, higher reimbursements per procedure, easier patient scheduling and improved patient monitoring and treatment oversight. Learn more about the benefits of in-office fusion biopsy by downloading this white paper.

Additional Optimization of Biopsy Workflows with SmartBx

Advancements in targeted biopsy are transforming prostate cancer screening and biopsy, but risks to diagnostic accuracy may still exist during the handling of tissue specimens. Research shows that up to 40% of biopsied tissue is lost or damaged between needle and slide.6

UC-Care’s SmartBx biopsy management system extends the benefits of Navigo’s fusion technology by keeping biopsy specimens intact during transport to the lab. Through SmartBx, tissue specimens are protected while preserving core location and orientation from needle to slide, increasing prostate cancer detection rates by 25%.7,8,9

Combining the powerful technology behind Navigo 4D Fusion Navigation System with SmartBx biopsy management provides an unprecedented level of accuracy, efficiency and effectiveness when it comes to diagnosing prostate cancer. Discover if Navigo and SmartBx can benefit your urology practice by scheduling a demo.

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Sources

1. Eklund M, Jäderling F, Discacciati A, et al. MRI-Targeted or Standard Biopsy in Prostate Cancer Screening. N Engl J Med. 2021;385(10):908-920.

2. Bjurlin MA, Carroll PR, Eggener S, et al. Update of the Standard Operating Procedure on the Use of Multiparametric Magnetic Resonance Imaging for the Diagnosis, Staging and Management of Prostate Cancer. J Urol. 2020;203(4):706-712.

3. Ahmed HU, El-Shater Bosaily A, Brown LC, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017;389(10071):815-822.

4. Magnier A, Nedelcu C, Chelly S et al. Prostate cancer detection by targeted prostate biopsy using the 3D Navigo system: a prospective study. Abdominal Radiology. 2021;46:4381-4287.

5. UC Care Brochure. The Freedom of Precision.

6. 2015 AUA meeting presentation

7. 2019 Aa et al. BMC Urology Three-dimensional greyscale transrectal ultrasound-guidance and biopsy core pre-embedding for detection of prostate cancer: Dutch clinical cohort study

8. 2020 Masarwa et al. The value of the SmartBxTM system in improving the detection of prostate cancer in patients undergoing Transrectal Ultrasound-Guided Biopsy

9. 2021 Lavi Implications of a Novel Biopsy Downloading System on Prostate Cancer Detection Rate, Surveillance and Focal Therapy − A Prospective Study