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  4. TRUS Destekli Prostat Biyopsisi için Sanal MR/Ultrason Rehberliği

TRUS Destekli Prostat Biyopsisi için Sanal MR/Ultrason RehberliğiSiemens offers the ArtemisTM solution by Eigen1

Prostate cancer visual

"I take care of my health, so I undergo regular PSA testing. Due to rising PSA levels, I had to have biopsy samples taken – under ultrasound guidance. No cancer was detected. But my PSA continued to rise. Twenty-four more samples were taken in a repeat procedure. This confirmed that I had cancer. My physician indicated that the cancer was not high risk and initially recommended active monitoring. However, my PSA is continuing to rise and he is getting worried. He wants me to have another prostate biopsy.”


Patient Concerns


Many patients diagnosed with prostate cancer and patients with negative biopsy results but continously rising PSA levels have concerns about the quality of diagnosis and the best treatment methods. They want improved methods for detecting and diagnosing high-risk cancer and more convenient biopsy.


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Expert Views

Oncological Imaging and the Role of Multiparametric Magnetic Resonance Imaging (mMRI) in the Detection of Prostate Cancer, Guided Biopsies, and Therapy

Professor Heinz-Peter Schlemmer

"Multiparametric MRI is essential for clinical decision making in prostate cancer comprising planning and guidance of biopsy, of radical and focal therapies as well as of active surveillance."2 

Professor Heinz-Peter Schlemmer
German Cancer Research Center, Heidelberg, Germany  

 

  

Professor Anwar R. Padhani

"Multiparametric MRI is now being incorporated into many guidelines for the detection of prostate cancer particularly in men with persistently raised PSA levels and negative systematic transrectal prostate biopsies, who are considered to harbor cancer that has not yet been diagnosed. Beyond detection of suspected lesions, better targeted biopsies from cancer suspicious regions at highest risk of harbouring the most aggressive lesion is needed.”2 

Professor Anwar R. Padhani
Mount Vernon Cancer Center and Institute of Cancer Research,
Royal Marsden Hospital, London , United Kingdom

  

ESUR Algorithmus Diagram

Clinical Guidelines for MR Imaging in Prostate Cancer3,4

According to prostate cancer guidelines published by the European Association of Urology in 2014, correlation with radical prostatectomy specimens has shown that multiparametric MRI has excellent sensitivity for detecting aggressive cancers with a Gleason score greater than 7. In addition to detecting these aggressive cancers, mMRI is particularly good at accurately detecting anterior tumors, which are not usually detected by systematic biopsies. A (targeted) repeat prostate biopsy under mMRI guidance is recommended to detect tumors that may have been missed by systematic biopsies.5

Level of evidence: 2b. Grade of recommendation: B.

 
Siemens Solution

Siemens offers a fully integrated solution for all aspects of prostate cancer diagnosis – to ensure not only a precise and early diagnosis but also the best possible care. The ArtemisTM solution by Eigen provides proven and effective virtual MR guidance for TRUS-assisted prostate biopsy.

Artemis by Eigen

With ArtemisTM by Eigen, Siemens Accessories Solutions offers a comprehensive and proven system for integrating reliable multiparametric MRI information into TRUS-guided prostate biopsies.

ArtemisTM by Eigen

The key elements for a successful clinical integration of multiparametric MR information into TRUS-assisted prostate biopsies are:

  • Ease of use
  • Standardized integration of multiparametric MRI information
  • Suitability for transrectal and perineal procedures

The ArtemisTM comprises three system components that support the streamlined and efficient workflow needed to integrate multiparametric MRI into TRUS-guided prostate biopsies. With a reported total intervention time of approximately 20 minutes6 it has a clear advantage in terms of intervention compared to targeted prostate biopsies performed under direct MRI guidance.7

ArtemisTM – Three System Components for Diagnostic Confidence

Pro FuseTM

Definition of region of interest for interventions based on multiparametric MRI with a comprehensive planning tool

  • Available where needed e.g. in the radiology reading room, at a separate workplace, during an intervention
  • Easy communication of intervention planning data to the ArtemisTM biopsy system

ProFuse BXTM

Integration of MR data into TRUS assisted biopsy

  • Quick and easy
  • Takes endorectal coils, bladder filling, and patient position into account

ArtemisTM

Semi-automated TRUS-guided prostate biopsy

  • 3D navigation and real-time control
  • Accelerates biopsy procedures
  • Detailed reporting and management of pathology and clinical history
1

The information shown herein refers to products of 3rd party manufacturer’s (ArtemisTM, Eigen) and thus are in their regulatory responsibility. Please contact the 3rd party manufacturer for further information.

2
The outcomes achieved by customers described herein were achieved under the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption), there can be no guarantee that others will achieve the same results.
3
Barentz, Jelle O., et al.; ESUR prostate MR guidelines 2012. European Radiology, DOI 10.1007/s00330-011-2377-y
4
The information presented is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Healthcare practitioners reading this information are reminded that they must use their own learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Healthcare to be used for any purpose in that regard.
5
Mottet, N. et al.; Guidelines on Prostate Cancer, European Association of Urology, 2014
6
Sonn, G.A. et al.; Targeted Biopsy in the Detection of Prostate Cancer using an Office-Based MR-US Fusion Device; J Urol., 2013 January ;189(1): 86–91. DOI:10.1016/j.juro.2012.08.095
7
Overduin, C. et al. MRI-Guided Biopsy for Prostate Cancer Detection: A Systematic Review of Current Clinical Results; Curr Urol. Rep (2013) 14:209–213. DOI 10.1007/s11934-013-0323-z