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Prostate Biopsy: Can a Robot Make it Better?

Misop Han, M.D., the David Hall McConnell Professor of Urology, believes that prostate biopsies don't provide enough information. "A typical transrectal ultrasound (TRUS)-guided biopsy has significant limitations," he explains, "because the probe is handled by human hand." In new research funded by the Patrick C. Walsh Prostate Cancer Research Fund, he and his co-investigators, robotics expert Dan Stoianovici and epidemiologist Bruce Trock, plan to improve TRUS-guided prostate biopsy with a novel robotic TRUS manipulator (called a TRUS Robot), "which was developed in our laboratory."

With robotic guidance, Han believes, the TRUS-guided biopsy will not only be able to provide important information about the precise location of the biopsy cores, but about the stiffness of the prostate. As urologist Patrick Walsh explains, the prostate should feel soft in a digital rectal exam, "like the pad of your thumb. But if there is cancer, it feels harder," more like a knuckle. The biopsy needle can't feel; but Han hopes to fix this: "With the TRUS Robot, we are incorporating a new imaging modality, ultrasound elastography, which can detect the relative stiffness of the prostate. With elastography guidance, regions of elevated relative stiffness will also be included in the biopsy plan," to make the urologist aware of any "trouble spots" that may need further investigation.

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