Module 4

The targeted biopsy concept

What 'targeted' means: cognitive, software fusion and in-bore, plus systematic sampling.

Once the MRI shows a lesion, the obvious question is: how do we actually get the needle into it? This module makes "targeted biopsy" feel simple.

MRI slices live

The raw multi-parametric scan.

3D reconstruction live

Segmented gland, zones and lesion as a rotatable model.

Beside-patient spatial teaching future spatial workflow

Future spatial-computing workflows for placing the anatomy model in clinical space.

01 Targeted vs systematic 4 min

Two ideas, often done together.

Targeted: sample the specific lesion the MRI flagged.
Systematic: take a standard template of cores across the whole gland, regardless of the MRI, to catch anything hiding.

Key point Targeted hits the lesion; systematic samples the rest. They answer different questions.

You can define targeted and systematic biopsy in one sentence each.

A targeted biopsy samples what?

02 Three ways to hit the target 5 min

There are three ways to get the needle to an MRI lesion using ultrasound or the scanner.

Cognitive fusion: the operator looks at the MRI, then aims on live ultrasound from memory. Cheap, quick, operator-dependent.
Software fusion: the MRI is digitally overlaid onto the live ultrasound. More precise.
In-bore: the biopsy is done inside the MRI scanner itself. Most accurate, most resource-heavy.

Spectrum to remember Cognitive (in your head), software (on the screen), in-bore (in the magnet). Accuracy and cost rise across that line.

You can name the three targeting methods and their trade-offs.

Which method overlays the MRI onto the live ultrasound image?

03 Mapping the lesion to the gland 4 min

To be reproducible, we divide the gland into sectors and record where the lesion and the cores are. For transperineal work the Ginsburg scheme is a common standard.

This is exactly where spatial reasoning matters, and where a 3D model beats a flat diagram.

See it in 3D. Rotate a lesion case and see how its sector maps onto the whole gland. Open in 3D

You understand why we map cores to sectors rather than guessing locations.

Why divide the gland into sectors when biopsying?

04 Why combined is best 4 min

Targeted alone can miss significant cancer sitting outside the visible lesion. Systematic alone can miss the lesion's worst part. Doing both catches the most clinically significant disease, which is why combined biopsy is widely recommended.

Key point Targeted plus systematic detects more significant cancer than either alone.

You can justify why we usually do both. End of Module 4.

What does adding systematic cores to a targeted biopsy achieve?

That is Module 4. You understand how the MRI lesion becomes a needle in the right place.

Next: Transrectal (TRUS) biopsy →