Preclinical Validation of a Semi-Autonomous Robot for Transperineal Prostate Biopsy

Prostate biopsy is a manual procedure carried out mostly under ultrasound (US) guidance to confirm the presence of cancer. The standard biopsy is random and includes at least 12 insertions; targeted biopsy makes use of dedicated hardware and software, but is still performed manually. We present here the pre-clinical validation of PROST, a robot primarily designed to automate targeted transperineal biopsy. The overall validation of the system was performed on cadavers, while some features, such as image segmentation, were tested on human tissue. PROST is designed to minimize human error by introducing some autonomy in the execution of key steps of the procedure, i.e., target selection, image fusion and needle positioning. The protocol was approved by the ethics committee; 10 cadavers were included in the study. We envision that PROST has the potential to increase the detection of clinically significant prostate cancer, to simplify the procedure, to reduce human errors and to shorten training time. The use of a robot for the biopsy of the prostate will create the possibility to include also a treatment, such as focal ablation, to be delivered through the same system.