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OBJECTIVE: This study evaluated the accuracy in localisation and distributionof real-time three-dimensional (4-D) ultrasound-guided biopsies on a prostatephantom. METHODS: A prostate phantom was created. A three-dimensional real-timeultrasound system with a 5.9MHz probe was used, making it possible to seeseveral reconstructed orthogonal viewing planes in real time. Fourteenoperators performed biopsies first under 2-D then 4-D transurethral ultrasound(TRUS) guidance (336 biopsies). The biopsy path was modelled using segmentationin a 3-D ultrasonographic volume. Special software was used to visualise thebiopsy paths in a reference prostate and assess the sampled area. A comparativestudy was performed to examine the accuracy of the entry points and target ofthe needle. Distribution was assessed by measuring the volume sampled and aredundancy ratio of the sampled prostate. RESULTS: A significant increase inaccuracy in hitting the target zone was identified using 4-D ultrasonography ascompared to 2-D. There was no increase in the sampled volume or improvement inthe biopsy distribution with 4-D ultrasonography as compared to 2-D.CONCLUSION: The 4-D TRUS guidance appears to show, on a synthetic model, animprovement in location accuracy and in the ability to reproduce a protocol.The biopsy distribution does not seem improved.

european urology

Prostate biopsies guided by three-dimensional real-time (4-D)  transrectal ultrasonography on a phantom: comparative study versus  two-dimensional transrectal ultrasound-guided biopsies