Image-based registration methods for quantification and compensation of prostate motion during trans-rectal ultrasound (TRUS)-guided biopsy

Prostate biopsy is the clinical standard for cancer diagnosis and is typically performed under two-dimensional (2D) transrectal ultrasound (TRUS) for needle guidance. Unfortunately, most early stage prostate cancers are not visible on ultrasound and the procedure suffers from high false negative rates due to the lack of visible targets. Fusion of pre-biopsy MRI to 3D TRUS for targeted biopsy could improve cancer detection rates and volume of tumor sampled. In MRI-TRUS fusion biopsy systems, patient or prostate motion during the procedure causes misalignments in the MR targets mapped to the live 2D TRUS images, limiting the targeting accuracy of the biopsy system. In order to sample smallest clinically significant tumours of 0.5 cm3with 95% confidence, the root mean square (RMS) error of the biopsy system needs to be The target misalignments due to intermittent prostate motion during the procedure can be compensated by registering the live 2D TRUS images acquired during the biopsy procedure to the pre-acquired baseline 3D TRUS image. The registration must be performed both accurately and quickly in order to be useful during the clinical procedure. We developed an intensity-based 2D-3D rigid registration algorithm and validated it by calculating the target registration error (TRE) using manually identified fiducials within the prostate. We discuss two different approaches that can be used to improve the robustness of this registration to meet the clinical requirements. Firstly, we evaluated the impact of intra-procedural 3D TRUS imaging on motion compensation accuracy since the limited anatomical context available in live 2D TRUS images could limit the robustness of the 2D-3D registration. The results indicated that TRE improved when intra-procedural 3D TRUS images were used in registration, with larger improvements in the base and apex regions as compared with the mid-gland region. Secondly, we developed and evaluated a registration algorithm whose optimization is based on learned prostate motion characteristics. Compared to our initial approach, the updated optimization improved the robustness during 2D-3D registration by reducing the number of registrations with a TRE \u3e 5 mm from 9.2% to 1.2% with an overall RMS TRE of 2.3 mm. The methods developed in this work were intended to improve the needle targeting accuracy of 3D TRUS-guided biopsy systems. The successful integration of the techniques into current 3D TRUS-guided systems could improve the overall cancer detection rate during the biopsy and help to achieve earlier diagnosis and fewer repeat biopsy procedures in prostate cancer diagnosis

Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology

Until recently, Computer-Aided Medical Interventions (CAMI) and Medical Robotics have focused on rigid and non deformable anatomical structures. Nowadays, special attention is paid to soft tissues, raising complex issues due to their mobility and deformation. Mini-invasive digestive surgery was probably one of the first fields where soft tissues were handled through the development of simulators, tracking of anatomical structures and specific assistance robots. However, other clinical domains, for instance urology, are concerned. Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU, radiofrequency, or cryoablation), increasingly early detection of cancer, and use of interventional and diagnostic imaging modalities, recently opened new challenges to the urologist and scientists involved in CAMI. This resulted in the last five years in a very significant increase of research and developments of computer-aided urology systems. In this paper, we propose a description of the main problems related to computer-aided diagnostic and therapy of soft tissues and give a survey of the different types of assistance offered to the urologist: robotization, image fusion, surgical navigation. Both research projects and operational industrial systems are discussed

A hybrid camera- and ultrasound-based approach for needle localization and tracking using a 3D motorized curvilinear ultrasound probe

Three-dimensional (3D) motorized curvilinear ultrasound probes provide an effective, low-cost tool to guide needle interventions, but localizing and tracking the needle in 3D ultrasound volumes is often challenging. In this study, a new method is introduced to localize and track the needle using 3D motorized curvilinear ultrasound probes. In particular, a low-cost camera mounted on the probe is employed to estimate the needle axis. The camera-estimated axis is used to identify a volume of interest (VOI) in the ultrasound volume that enables high needle visibility. This VOI is analyzed using local phase analysis and the random sample consensus algorithm to refine the camera-estimated needle axis. The needle tip is determined by searching the localized needle axis using a probabilistic approach. Dynamic needle tracking in a sequence of 3D ultrasound volumes is enabled by iteratively applying a Kalman filter to estimate the VOI that includes the needle in the successive ultrasound volume and limiting the localization analysis to this VOI. A series of ex vivo animal experiments are conducted to evaluate the accuracy of needle localization and tracking. The results show that the proposed method can localize the needle in individual ultrasound volumes with maximum error rates of 0.7 mm for the needle axis, 1.7° for the needle angle, and 1.2 mm for the needle tip. Moreover, the proposed method can track the needle in a sequence of ultrasound volumes with maximum error rates of 1.0 mm for the needle axis, 2.0° for the needle angle, and 1.7 mm for the needle tip. These results suggest the feasibility of applying the proposed method to localize and track the needle using 3D motorized curvilinear ultrasound probes

SMART IMAGE-GUIDED NEEDLE INSERTION FOR TISSUE BIOPSY

M.S