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At the American Urological Association’s 2026 meeting, University of Miami Miller School of Medicine researchers presented a proposed augmented reality‑guided approach that integrates artificial intelligence with MRI fusion to improve prostate biopsy accuracy, visualization and workflow.
Archan Khandekar, M.D., shared video documentation of DSUI’s operating room experience using artificial intelligence (AI) to drive augmented reality (AR) for MRI–ultrasound fusion prostate biopsy at the 2026 American Urological Association (AUA) Annual Meeting.
Rather than a clinical data readout, the presentation laid out a proposed new way to perform biopsy under AR guidance.
“We were among the first centers, globally, to demonstrate prostate biopsy on a surgeon-centered AR platform,” said Dr. Khandekar, an assistant professor of urologic oncology at Desai Sethi Urology Institute (DSUI), part of the University of Miami Miller School of Medicine.
MRI-targeted and systematic approaches define the new standard of care in the early detection of prostate cancer, with the 2025 National Comprehensive Cancer Network (NCCN) guidelines recommending combined sampling for higher detection of clinically significant cancer.
There are, however, real-world drawbacks to the recommended approach that augmented reality aims to solve.
“Conventional fusion biopsy forces the surgeon to look away and mentally map 2D images into a 3D space,” Dr. Khandekar said. “AR-guided biopsy projects the target directly in view, improving accuracy, speed and teaching through shared visualization.”
While precise, traditional MRI–ultrasound fusion is registration-dependent, AR aims to simplify that by removing the disconnect between the screen and the anatomy.
“After loading the T2 MRI and lesion points, the system connects the headset and the ultrasound machine. Segmentation data are projected as 3D overlays in real space, aligned to the patient through optical tracking,” Dr. Khandekar said. “The surgeon sees the lesion floating exactly where it lies within the gland, with the biopsy needle path visualized before insertion.”
As the probe moves, real-time registration updates the holographic overlay, giving continuous spatial feedback and true see-through navigation. Upstream, AI bridges imaging and execution. Multiparametric MRI (mpMRI) datasets are analyzed by habitat risk-scoring algorithms that automatically segment suspicious lesions into distinct imaging “habitats” and assign quantitative risk scores from the underlying imaging features.
The result is a seamless transition from imaging intelligence to real-time visualization. The HoloLens headset serves as a high-fidelity navigation platform, allowing the entire team to see the holographic overlay and turning biopsy into a collaborative process.
The platform’s shortcomings have narrowed as the technology has advanced. Dr. Khandekar noted that earlier tracker versions showed positional jitter at steep angles, introducing small but measurable targeting errors. The current, sixth-generation tracker dramatically improves positional stability, holding sub-millimeter tracking accuracy even at steep insertion angles.
Dr. Khandekar was careful to frame the work as a proposed new approach rather than a completed study. The platform is nearly ready for clinical use (“ready for prime time soon,” as he put it) but has not yet been compared head-to-head with standard-of-care fusion biopsy. An institutional review board (IRB) protocol to enable that prospective comparison is in development.
“It’s important that DSUI is sharing its experience at major meetings because the technology is not available at most institutions, and evidence is needed before large-scale, mainstream adoption can happen,” Dr. Khandekar said.
Dr. Khandekar noted other challenges to large-scale use, including FDA clearance and data ownership, as well as technology-dependent registration. Accuracy drift, during which the MRI overlay can fall out of alignment as the prostate shifts and deforms under probe pressure and patient movement, and fatigue from prolonged headset wear also must be addressed.
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Tags: AI, artificial intelligence, AUA2026, cancer research, Desai Sethi Urology Institute, Dr. Archan Khandekar, prostate biopsy, prostate cancer, technology, urology
This article was printed from The Miller School of Medicine Medical News
at the following URL: https://news.med.miami.edu/ai-ar-prostate-biopsy-aua-2026-miller-school/
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