Transperineal Prostate Biopsy Workflow

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KOELIS Trinity^® – Intuitive Clinical Workflow for Transperineal Fusion Biopsies

KOELIS Trinity^® is an efficient, exceptionally accurate 3D MRI/ultrasound fusion biopsy system that offers a simplified workflow and unique features designed around you and your clinical needs. The system supports both Transperineal and Transrectal procedures, providing distinct advantages at every stage in the prostate biopsy workflow.

1. Efficient Pre-Biopsy Planning with MRI Preparation

Using Koelis' ProMap Lite^™ Application:

The prostate is segmented
Suspicious lesions are defined
Segmented MRIs are transferred to the Koelis Trinity^® prostate biopsy platform

Precision 3D Biopsy Scan and Guidance

2. 3D Ultrasound Scan

Prostate is scanned using our unique ultrasound technology
Motorized sensor rotates the ultrasound array within the probe’s housing
3D prostate scan in recorded in less than 3 seconds

3. Biopsy Guidance

A 3D model of the prostate is generated
Segmented MRI is elastically fused to the ultrasound image
A reference volume of the prostate is displayed with MRI targets

4. 3D Cartography

Biopsy of the prostate is performed
An updated 3D ultrasound is acquired with each pass of the biopsy needle
Location of each biopsy core is transferred to the reference volume
KOELIS Trinity^® builds a precise 3D map of the biopsy procedure

5. Post-Biopsy Review, Re-Biopsy and Treatment

Post-biopsy, the 3D map can be reviewed on either the Trinity or MRDraw workstation.
This map guides subsequent biopsies
3D map aids in future treatments such as prostate ablation

Comparing Transperineal and Transrectal Biopsy Approaches

KOELIS Trinity^® provides flexibility to perform targeted transperineal or transrectal or MRI/ultrasound fusion guided biopsies. While the majority of biopsies are conducted transrectally, transperineal biopsy has grown in popularity and offers a number of benefits including:

Reduced risk of infection
Access to anterior targets
Orientation similar to focal therapies conducted via the perineum
Technique possible under local anesthetic
Less discomfort for the patient during the procedure
Improved detection of clinically significant prostate cancer^1,2,3

To reduce the risk of infection or undersampling of the anterior prostate, consider the value of KOELIS Trinity^® for transperineal MRI/ultrasound fusion guided biopsies.

KOELIS supports transperineal prostate biopsy using the KOELIS 3D US side-fire probe—with the added flexibility to choose from a stabilized or freehand technique. For more information about our prostate biopsy probes, needle guides and grids, visit:

Transperineal biopsy probes, guides and grids

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References:

1. Bajeot et al. Managing Discordant Findings Between Multiparametric Magnetic Resonance Imaging and Transrectal Magnetic Resonance Imaging–directed Prostate Biopsy—The Key Role of Magnetic Resonance Imaging–directed Transperineal Biopsy. European Urology Oncology, 2021. https://pubmed.ncbi.nlm.nih.gov/34154979/

2. Jacewicz et al. Cancer Detection Rates in Targeted Transperineal MRI-TRUS Elastic Fusion-guided Prostate Biopsies Performed Under Local Anesthesia. Anticancer Res, 2021. https://pubmed.ncbi.nlm.nih.gov/34475059/

3. Jacewicz et al. Multicenter transperineal MRI-TRUS fusion guided outpatient clinic prostate biopsies under local anesthesia. Urol Oncol, 2021 https://pubmed.ncbi.nlm.nih.gov/33257219/