2131 ELASTIC REGISTRATION OF 3D PROSTATE BIOPSY TRAJECTORY BY REAL-TIME 3D TRUS WITH MR/TRUS FUSION: PILOT PHATOM STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20112131 ELASTIC REGISTRATION OF 3D PROSTATE BIOPSY TRAJECTORY BY REAL-TIME 3D TRUS WITH MR/TRUS FUSION: PILOT PHATOM STUDY Osamu Ukimura, Mihir Desai, Monish Aron, Andrew Hung, Andre Berger, Samuel Valencerina, Suzanne Palmer, and Inderbir Gill Osamu UkimuraOsamu Ukimura Los Angeles, CA More articles by this author , Mihir DesaiMihir Desai Los Angeles, CA More articles by this author , Monish AronMonish Aron Los Angeles, CA More articles by this author , Andrew HungAndrew Hung Los Angeles, CA More articles by this author , Andre BergerAndre Berger Los Angeles, CA More articles by this author , Samuel ValencerinaSamuel Valencerina Los Angeles, CA More articles by this author , Suzanne PalmerSuzanne Palmer Los Angeles, CA More articles by this author , and Inderbir GillInderbir Gill Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2328AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Current, standard TRUS biopsies are insufficiently accurate to localize prostate cancer lesions with sub-millimeter accuracy. For the development of a clinically-relevant prostate focal therapy protocol, precise three-dimensional (3D) localization of the interventional needle (for biopsy or ablation) is critical. Real-time 3D TRUS with computer-guidance of biopsy needle placement could precisely document the actual location of every biopsy-sampled tissue. Such information would be critical for precise focal therapy targeting. In addition, multimodal MR is emerging as a reliable imaging modality for detection of clinically significant prostate cancer. In developing focal therapy, use of MR-image guidance could potentially increase the spatial accuracy of targeted biopsy or focal intervention. The aim of study is to determine the accuracy of a computer-aided 3D TRUS system with MR image fusion for guiding prostate biopsy using phantoms. METHODS We used 3 phantoms (CIRS-053), which contain 3 randomly located hypo-echoic lesions 0.5cc in volume, and 3 other phantoms (CIRS-066), which contain 3 randomly located iso-echoic but MR-visible lesions 0.5cc in volume. We performed 3 targeted biopsies in each lesion, and the biopsy tracts were discriminated by gadolinium-based contrast agent mixed with different colored India inks, to assess the accuracy with 1-mm step-section MRI and step-section analysis of the phantoms. The external software (Koelis, France) is capable of registering 3D trajectory of each biopsy in the 3D TRUS volume data of the prostate. RESULTS A total of 27 US-guided biopsies were targeted into 9 hypo-echoic lesions; each biopsy (27/27; 100%) successfully hit the target, resulting in a procedural error of 1.5±0.8mm. Adding the system registration error of 0.83, the mean total targeting error into US-visible lesions was 2.4mm. Of 27 MR fusion guided biopsies targeted into 9 iso-echoic MR-only-visible lesions, 24 (89%) successfully hit the target, of which 3 missed biopsies occurred during initial targeting due to the learning curve, resulting in a procedural targeting error of 2.1±1.3mm. Adding the system registration error, the mean needle registration error into MR-only-visible lesions was 2.9mm. CONCLUSIONS The computer-guided 3D TRUS guided biopsy localization system with MR/US fusion achieved encouraging accuracy (<3mm error) in the registration of each biopsy trajectory in the 3D prostatic space for use in future interventions. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e853 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Osamu Ukimura Los Angeles, CA More articles by this author Mihir Desai Los Angeles, CA More articles by this author Monish Aron Los Angeles, CA More articles by this author Andrew Hung Los Angeles, CA More articles by this author Andre Berger Los Angeles, CA More articles by this author Samuel Valencerina Los Angeles, CA More articles by this author Suzanne Palmer Los Angeles, CA More articles by this author Inderbir Gill Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...