Application Of 3D Print Guide Navigation Targeting Puncture Technique In Diagnosis Of Prostate Cancer

OBJECTIVE:To study the individualized percutaneous prostate puncture template based on multi-parameter MRI combined with 3D printing technology,and to apply it in clinical prostate biopsy diagnosis,and observe the effectiveness and feasibility of the technique.METHODS:A retrospective analysis of 83 cases of Yantai Affiliated Hospital of Binzhou Medical College and Binzhou Medical College Affiliated Hospital from April 2017 to January 2019 using 3D printing technology combined with multi-parameter MRI for 3D reconstruction of prostate and its lesions Design and manufacture of prostate puncture navigation template,clinical data of suspicious prostate cancer patients with targeted puncture and system puncture for prostate cancer patients using puncture guides.The patient was 54-88 years old and the median age was 67 years.The PSA before puncturing was 1.25-32.84 ?g/L,the median PSA was 15.32 ?g/L,the prostate volume was 14.83-106.21 ml,and the median prostate volume was 41.52 ml.3.0T MRI and CT examinations were performed on eligible patients.The results of MRI examination were PI-RADS scored,and the scores were 3-5 into suspicious lesions.The MRI and CT data of the acquired bone tissue,prostate tissue,lesions and soft tissue were imported into the medical image processing software.The reconstruction of the three-dimensional model is based on the reconstructed 3D model,and the individualized puncture guides are designed,including the diameter and length of the puncture needle,the angle and depth of the catheter.Finally,the generated stl format file is imported into the 3D printer,and the designed puncture guide is printed by the 3D printer.All patients underwent targeted puncture according to the 3D printed puncture guide,followed by ultrasound-guided conventional 12-needle system puncture,and compared the detection rate of prostate cancer by the two puncture methods.RESULTS:The simulated puncture results were consistent with the actual puncture design.83 patients underwent prostate puncture under the guide navigation and the puncture was successful.One patient found 1-3 suspected lesions.53 cases(63.86%)of prostate cancer were detected by targeted puncture,and 58 cases(69.88%)of prostate cancer were detected by systemic puncture.The difference was not statistically significant(P>0.01).A total of 956 needles were obtained from the system,the positive rate of puncture was 10.36%,the total number of targeted punctures was 216,the number of needles was 2-6,and the positive rate of puncture was 28.31%.The difference was statistically significant(P<0.001).The system puncture Gleason score 6-8 points,the average score is 7.12 points,the targeted puncture Gleason score 6-9 points,an average of 7.53 points.Targeted puncture and systemic puncture showed 53 cases of prostate cancer,and 23 cases(46.94%)of patients with targeted puncture Gleason scoring system had high puncture.Conclusion:The application of individualized prostate-targeted puncture navigation guide plate can achieve the detection rate of prostate cancer with system puncture with the minimum number of puncture needles,improve the positive rate of high-risk prostate cancer puncture,and reduce the rate of missed diagnosis.Therefore,the puncture is safe and effective.