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. 2008 Sep;13(5):255-64.
doi: 10.3109/10929080802364645.

Real-time MRI-TRUS fusion for guidance of targeted prostate biopsies

Sheng Xu  1 , Jochen Kruecker, Baris Turkbey, Neil Glossop, Anurag K Singh, Peter Choyke, Peter Pinto, Bradford J Wood
Affiliations

Real-time MRI-TRUS fusion for guidance of targeted prostate biopsies

Sheng Xu et al. Comput Aided Surg. 2008 Sep.

Abstract

Targeted prostate biopsy is challenging because no currently established imaging modality is both accurate for prostate cancer diagnosis and cost-effective for real-time procedure guidance. A system that fuses real-time transrectal ultrasound images with previously acquired endorectal coil MRI images for prostate biopsy guidance is presented here. The system uses electromagnetic tracking and intraoperative image registration to superimpose the MRI data on the ultrasound image. Prostate motion is tracked and compensated for without the need for fiducial markers. The accuracy of the system in phantom studies was shown to be 2.4 +/- 1.2 mm. The fusion system has been used in more than 20 patients to guide biopsies with almost no modification of the conventional protocol. Retrospective clinical evaluation suggests that clinically acceptable spatial accuracy can be achieved.

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Figures

Figure 1
Figure 1
Navigation system for targeted prostate biopsy. (a) System components: localizer (L), tracked ultrasound probe (US) and prostate phantom (P). (b) System setup in patient study. [Color version available online.]
Figure 2
Figure 2
Selected image frames for 2.5D to 3D registration. [Color version available online.]
Figure 3
Figure 3
Example of image-based motion compensation. (a) Real-time ultrasound. (b) Registration result of (a) in the reconstructed reference ultrasound volume. (c) Initial starting point of the registration.
Figure 4
Figure 4
CT image example showing needle tip in tumor. (a) XY section. (b) ZY section. (c) XZ section. [Color version available online.]
Figure 5
Figure 5
2D plots of the objective function near the global minimum with respect to two translation parameters. (a) is the result of registering one image frame, while (b) is the result of registering four image frames. The grid unit is 1mm. [Color version available online.]
Figure 6
Figure 6
Motion compensation using 2.5D/3D registration. The red contours show the prostate segmentation in the MRI image. The 3D MRI volume is pre-registered to a 3D ultrasound volume that is not shown. Top row: RTUS overlaid on MRI. Bottom row: MRI images. (a) and (a′) are the initial registration without patient motion; (b) and (b′) are the deteriorated registration after patient motion; and (c) and (c′) are the registration after motion compensation. [Color version available online.]
Figure 7
Figure 7
Screenshots of fused MRI/TRUS image guidance. (a) T2-weighted MRI fused with reference ultrasound volume (color map), along with the real-time ultrasound and target information. (b) Corresponding real-time ultrasound (top) and MRI MPR views (bottom) at the time of needle deployment. [Color version available online.]
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References

    1. American Cancer Society. Statistics for 2007. http://www.cancer.org/docroot/STT/stt_0_2007.asp.
    1. Fichtinger G, Krieger A, Susil RC, Tanacs A, Whitcomb LL, Atalar E. Transrectal prostate biopsy inside closed MRI scanner with remote actuation, under real-time image guidance. In: Dohi T, Kikinis R, editors. Proceedings of the 5th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2002); September 2002; Toyko, Japan. Berlin: Springer; pp. 91–98. Part I. Lecture Notes in Computer Science 2488.
    1. Rabbani F, Stroumbakis N, Kava BR, Cookson MS, Fair WR. Incidence and clinical significance of false-negative sextant prostate biopsies. J Urol. 1998;159:1247–1250. - PubMed
    1. Guichard G, Larré S, Gallina A, Lazar A, Faucon H, Chemama S, Allory Y, Patard J, Vordos D, Hoznek A. Extended 21-sample needle biopsy protocol for diagnosis of prostate cancer in 1000 consecutive patients. Eur Urol. 2007;52(2):430–435. - PubMed
    1. Kaplan I, Oldenburg NE, Meskell P, Blake M, Church P, Holupka EJ. Real time MRI-ultrasound image guided stereotactic prostate biopsy. Magn Reson Imaging. 2002;20(3):295–299. - PubMed

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