Abstract
This paper presents the design of NaviPBx, an ultrasound-navigated prostate cancer biopsy system. NaviPBx is designed to support an affordable and sustainable national healthcare program in Senegal. It uses spatiotemporal navigation and multiparametric transrectal ultrasound to guide biopsies. NaviPBx integrates concepts and methods that have been independently validated previously in clinical feasibility studies and deploys them together in a practical prostate cancer biopsy system. NaviPBx is based entirely on free open-source software and will be shared as a free open-source program with no restriction on its use. NaviPBx is set to be deployed and sustained nationwide through the Senegalese Military Health Service. This paper reports on the results of the design process of NaviPBx. Our approach concentrates on “frugal technology”, intended to be affordable for low–middle income (LMIC) countries. Our project promises the wide-scale application of prostate biopsy and will foster time-efficient development and programmatic implementation of ultrasound-guided diagnostic and therapeutic interventions in Senegal and beyond.
Highlights
Prostate cancer (PCa) is the most frequent cancer and the leading cancer-related cause of death in African men [1]
In the Dakar region many patients still cannot get a prostate biopsy, because the waiting lists are too long in the public clinics and the procedure is prohibitively expensive in the private clinics
In tissue types of similar mechanical properties, Temporal-enhanced Ultrasound (TeUS) captures the spatial variations in the scattering function, which is expected to help detect PCa where changes in the nuclei configuration dominate in the tissue
Summary
Prostate cancer (PCa) is the most frequent cancer and the leading cancer-related cause of death in African men [1]. Considering the size of clinically significant prostate cancer, 0.5 cc in volume [11], this prostate segmentation prototype module is expected to achieve a clinically sufficient performance when fully integrated in NaviPBx. Labeling the McNeal zones (central, transition, peripheral and anterior zones) in TRUS is a critical function for planning and sampling the systematic biopsy target locations, typically 12 cores [7]. It must be noted that the most important aspect is the correct labeling of the McNeal zones, while the metric accuracy required for the zonal contours is quite lenient, considering the smallest size of significant prostate cancer to be biopsied, 0.5 cc in volume [11] This prostate anatomy labeling prototype module promises clinically sufficient performance when fully integrated in NaviPBx. NaviPBx must maintain the anatomy labels accurately on the live 2D TRUS image, while the prostate is being displaced and deformed by rectal pressure from the TRUS transducer. The current protype yields a 1.6 mm mean registration accuracy over the whole prostate gland, with a 10 Hz update rate, promising a clinically sufficient performance when fully integrated into NaviPBx
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