Dataset Information

Quantifying the effect of biopsy lateral decubitus patient positioning compared to supine prostate magnetic resonance image scanning on prostate translocation and distortion.

ABSTRACT:

Introduction

More than a quarter of tumors are missed by magnetic resonance imaging/ultrasound (MRI/US) fusion-guided biopsy, the majority due to software-based misregistration. Transrectal approaches to biopsy are typically performed in the lateral decubitus position; conversely, diagnostic MRI is performed with the patient lying supine. Any position-related difference in prostate location or gland deformation could potentially exacerbate misregistration at subsequent biopsy.

Methods

Fifteen healthy male volunteers (mean age 35.9 years, range 27-53) were included in this prospective, institutional review board-approved study. Each volunteer had an MRI performed in the supine position, followed by the second in the lateral decubitus position (mimicking a typical biopsy position). MRI images were co-registered and analyzed in order to assess prostate translocation and distortion.

Results

Whole prostate translocation of ≥5 mm was observed in 20% of patients and of ≥3 mm in 60% of patients. When dividing the prostate into prostatic sectors, the prostatic base demonstrated the largest positional difference. When plotting the translocation directions with relative volume difference, there was a moderate negative correlation trend in the latero-lateral direction. Only minimal distortion was observed, with similar distortion among all prostatic sectors.

Conclusions

Positional change affects the prostate translocation, however, the effect on prostate distortion appears to be negligible. Prostate translocation in latero-lateral direction can be minimized with larger bladder volumes. Prostate translocation needs to be considered alongside software misregistration error; however, positional change should not affect software registration of MRI/US fusion-guided prostate biopsy.

SUBMITTER: Snoj Z

PROVIDER: S-EPMC7492036 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Quantifying the effect of biopsy lateral decubitus patient positioning compared to supine prostate magnetic resonance image scanning on prostate translocation and distortion.

Snoj Žiga Ž Rundo Leonardo L Gill Andrew B AB Barrett Tristan T

Canadian Urological Association journal = Journal de l'Association des urologues du Canada 20200901 9

<h4>Introduction</h4>More than a quarter of tumors are missed by magnetic resonance imaging/ultrasound (MRI/US) fusion-guided biopsy, the majority due to software-based misregistration. Transrectal approaches to biopsy are typically performed in the lateral decubitus position; conversely, diagnostic MRI is performed with the patient lying supine. Any position-related difference in prostate location or gland deformation could potentially exacerbate misregistration at subsequent biopsy.<h4>Methods ...[more]

PMID: 32223873

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Project description:BackgroundAnterior retroperitoneal lumbar spinal exposure has traditionally been performed in the supine position (SUP) to access the L4-L5 and L5-S1 disc spaces where lateral approaches may be unsafe. However, advancements in lateral single position surgery have resulted in advocacy for anterior L4-5 disc access in the lateral decubitus position (LAT). While L5-S1 access in the lateral position is well-described, no series of L4-5 anterior access in the lateral position has been published. The study aims to evaluate the safety of anterior lumbar exposure at the L4-5 disc level in the LAT compared to the SUP.MethodsA multi-center retrospective study of patients who underwent anterior retroperitoneal lumbar exposure involving the L4-5 disc level were classified according to patient positioning: (I) LAT or (II) SUP.ResultsOne hundred and forty patients were included, of which 65 LAT and 75 SUP patients. Two hundred and thirty-eight anterior levels were exposed, including 113 levels performed in lateral and 125 levels in supine. Mean anterior levels fused was similar (1.74 vs. 1.67 levels, P=0.37). Significantly more LAT patients underwent additional lateral lumbar interbody fusion (LLIF) (21.50% vs. 0.00%, P<0.001). A larger proportion of LAT patients underwent surgery for spinal deformity (21.50% vs. 6.70%, P=0.01) and planned staged procedures (21.50% vs. 6.70%, P=0.01). Intraoperative complication rates were similar (3.10% vs. 4.00%, P=0.77), including similar vascular injury rates (1.50% vs. 0.00%, P=0.28) and no visceral injury. Postoperative complications (15.40% vs. 38.70%, P=0.002) were significantly lower in the LAT group, however major complications (6.20% vs. 13.30%, P=0.16) were similar between groups. Fewer LAT patients experienced postoperative ileus (0.00% vs. 6.70%, P=0.03). The rate of reoperation within 30 days (3.10% vs. 6.70%, P=0.33) and 90 days (3.10% vs. 10.70%, P=0.09) were similar between groups.ConclusionsAnterior lumbar spinal exposure of the L4-5 disc in the LAT is safe compared to supine exposure, despite higher case complexity in the lateral position.

Dataset Information

Quantifying the effect of biopsy lateral decubitus patient positioning compared to supine prostate magnetic resonance image scanning on prostate translocation and distortion.

Introduction

Methods

Results

Conclusions

Publications

Quantifying the effect of biopsy lateral decubitus patient positioning compared to supine prostate magnetic resonance image scanning on prostate translocation and distortion.

Similar Datasets

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