Robotic-assisted transrectal MRI-guided biopsy. Technical feasibility and role in the current diagnosis of prostate cancer: an initial single-center experience.

OBJECTIVES To evaluate the potential clinical and technical utility to manage in practice the use of a robotic MRI in-bore-targeted prostate biopsies in the current work-up of prostate cancer diagnosis. METHODS Thirty patients with a single cancer suspicious lesion interpreted on MRI using PI-RADSv2.1 category ≥ 3 underwent in-bore robotic transrectal MRI remote-controlled-guided biopsy. It was analyzed the technical success, clinical details, biopsy findings in correlation with the MRI examination, complications and cancer detection rate (CDR). RESULTS The overall CDR for any cancer was 73% (22/30). It was 86% (19/22) for significant tumors (Gleason score of more than 6 or maximum cancer core length greater than 3 mm for Gleason 6) and 77% (17/22) for tumors with Gleason > 6. CDR for biopsy-naive patients was 89% (16/18) and 50% (6/12) for patients with prior negative transrectal ultrasound-guided biopsies. The CDR for PI-RADS > 3 was 92% (22/24). All the lesions (n = 30) were reachable with the robotic MRI device. A self-limited rectal hemorrhagic complication was reported. CONCLUSION This initial data show that a robotic MRI-guided biopsy could be useful, efficient and feasible procedure in the new paradigm to diagnose significant prostate cancer in selected patients.