Transperineal Biopsy Workflow Transperineal Biopsy Workflow

Transperineal 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.

Pre-Biopsy Planning with MRI Preparation

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

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

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
3D Cartography
Biopsy Review

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
Transperineal and Transrectal Biopsy Approaches

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 cancer1,2,3

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:


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.

2. Jacewicz et al. Cancer Detection Rates in Targeted Transperineal MRI-TRUS Elastic Fusion-guided Prostate Biopsies Performed Under Local Anesthesia. Anticancer Res, 2021.

3. Jacewicz et al. Multicenter transperineal MRI-TRUS fusion guided outpatient clinic prostate biopsies under local anesthesia. Urol Oncol, 2021


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