Robot-assisted MRI/US transperineal target prostate biopsy with Biobot Mona Lisa 2.0: first experience in Europe

Enrico Checcucci; Gabriele Bignante; Gabriele Volpi; Saverio Liguori; Paolo Alessio; Michele Sica; Michele Ortenzi; Daniele Amparore; Alessandra Saliva; Alberto Piana; Stefano De Luca; Alessandro Cerutti; Francesco Porpiglia

doi:10.1038/s41391-026-01094-8

Robot-assisted MRI/US transperineal target prostate biopsy with Biobot Mona Lisa 2.0: first experience in Europe

Prostate Cancer Prostatic Dis. 2026 Feb 25. doi: 10.1038/s41391-026-01094-8. Online ahead of print.

Affiliations

¹ Division of Urology, Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy. checcu.e@hotmail.it.
² Division of Urology, Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.
³ Division of Anesthesiology, Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.
⁴ Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy.

PMID: 41741676
DOI: 10.1038/s41391-026-01094-8

Abstract

Introduction: The Mona Lisa 2.0 robotic platform integrates MRI/ultrasound fusion, AI-based prostate segmentation, and automated needle trajectory planning to optimize transperineal targeted biopsy (TB) precision.

Case presentation: We report the first European experience in 10 consecutive patients undergoing robot-assisted TB, with optional systematic cores. Clinically significant prostate cancer was detected in all rTB procedures. Standard cores added limited diagnostic yield and mainly sampled perilesional "penumbra" areas. Mean biopsy duration was 12.9 min, no peri- or post-procedural complications occurred, and high-quality tissue samples were consistently obtained.

Conclusions: These preliminary data confirm feasibility, safety, and reproducibility of Mona Lisa 2.0 robotic platform, as a new kid on the block in urologic robotic armamentarium.