Effects of Ultrasound Section-Thickness on Brachytherapy Needle Tip Localization Error

Abstract. Purpose: Ultrasound section-thickness is the out-of-plane beamwidth causing major roles in creating image artifacts normally appearing around the anechoic areas. These artifacts can introduce errors in localizing the needle tips during any ultrasound-guided procedure. To study how section-thickness and imaging parameters can affect observing and localizing needle tips, we have conducted a typical calibration setup experiment. Method: Multiple needles were inserted orthogonal to the axial image plane, at various distances from the transducer. The experiment was conducted on a brachytherapy stepper for a curvilinear transrectal-ultrasound probe. Result: Experiments demonstrated that the imaging parameters have direct impacts on observing needle tips at different axial locations. They suggest specific settings to minimize the imaging artifacts. Conclusion: The ultrasound section-thickness and side lobes could result in misjudgment of needle insertion depth in an ultrasound-guided procedure. A beam profile could assist in considering the likelihood of position errors, when the effects of side lobes are minimized

The effects of leaflet material properties on the simulated function of regurgitant mitral valves

Advances in three-dimensional imaging provide the ability to construct and analyze finite element (FE) models to evaluate the biomechanical behavior and function of atrioventricular valves. However, while obtaining patient-specific valve geometry is now possible, non-invasive measurement of patient-specific leaflet material properties remains nearly impossible. Both valve geometry and tissue properties play a significant role in governing valve dynamics, leading to the central question of whether clinically relevant insights can be attained from FE analysis of atrioventricular valves without precise knowledge of tissue properties. As such we investigated 1) the influence of tissue extensibility and 2) the effects of constitutive model parameters and leaflet thickness on simulated valve function and mechanics. We compared metrics of valve function (e.g., leaflet coaptation and regurgitant orifice area) and mechanics (e.g., stress and strain) across one normal and three regurgitant mitral valve (MV) models with common mechanisms of regurgitation (annular dilation, leaflet prolapse, leaflet tethering) of both moderate and severe degree. We developed a novel fully-automated approach to accurately quantify regurgitant orifice areas of complex valve geometries. We found that the relative ordering of the mechanical and functional metrics was maintained across a group of valves using material properties up to 15% softer than the representative adult mitral constitutive model. Our findings suggest that FE simulations can be used to qualitatively compare how differences and alterations in valve structure affect relative atrioventricular valve function even in populations where material properties are not precisely known

Automated intraoperative calibration for prostate cancer brachytherapy

Purpose: Prostate cancer brachytherapy relies on an accurate spatial registration between the implant needles and the TRUS image, called "calibration". The authors propose a new device and a fast, automatic method to calibrate the brachytherapy system in the operating room, with instant error feedback. Methods: A device was CAD-designed and precision-engineered, which mechanically couples a calibration phantom with an exact replica of the standard brachytherapy template. From real-time TRUS images acquired from the calibration device and processed by the calibration system, the coordinate transformation between the brachytherapy template and the TRUS images was computed automatically. The system instantly generated a report of the target reconstruction accuracy based on the current calibration outcome. Results: Four types of validation tests were conducted. First, 50 independent, real-time calibration trials yielded an average of 0.57 6 0.13 mm line reconstruction error (LRE) relative to ground truth. Second, the averaged LRE was 0.37 6 0.25 mm relative to ground truth in tests with six different commercial TRUS scanners operating at similar imaging settings. Furthermore, testing with five different commercial stepper systems yielded an average of 0.29 6 0.16 mm LRE relative to ground truth. Finally, the system achieved an average of 0.56 6 0.27 mm target registration error (TRE) relative to ground truth in needle insertion tests through the template in a water tank. Conclusions: The proposed automatic, intraoperative calibration system for prostate cancer brachytherapy has achieved high accuracy, precision, and robustness

DCMQI: An open source library for standardized communication of quantitative image analysis results using DICOM

Quantitative analysis of clinical image data is an active area of research that holds promise for precision medicine, early assessment of treatment response, and objective characterization of the disease. Interoperability, data sharing, and the ability to mine the resulting data are of increasing importance, given the explosive growth in the number of quantitative analysis methods being proposed. The Digital Imaging and Communications in Medicine (DICOM) standard is widely adopted for image and metadata in radiology. dcmqi (DICOM for Quantitative Imaging) is a free, open source library that implements conversion of the data stored in commonly used research formats into the standard DICOM representation. dcmqi source code is distributed under BSD-style license. It is freely available as a precompiled binary package for every major operating system, as a Docker image, and as an extension to 3D Slicer. Installation and usage instructions are provided in the GitHub repository at https://github.com/qiicr/dcmqi

Targeting Error Simulator for Image-Guided Prostate Needle Placement

Abstract-Motivation: Needle-based biopsy and local therapy of prostate cancer depend multimodal imaging for both target planning and needle guidance. The clinical process involves selection of target locations in a pre-operative image volume and registering these to an intra-operative volume. Registration inaccuracies inevitably lead to targeting error, a major clinical concern. The analysis of targeting error requires a large number of images with known ground truth, which has been infeasible even for the largest research centers. Methods: We propose to generate realistic prostate imaging data in a controllable way, with known ground truth, by simulation of prostate size, shape, motion and deformation typically encountered in prostatic needle placement. This data is then used to evaluate a given registration algorithm, by testing its ability to reproduce ground truth contours, motions and deformations. The method builds on statistical shape atlas to generate large number of realistic prostate shapes and finite element modeling to generate high-fidelity deformations, while segmentation error is simulated by warping the ground truth data in specific prostate regions. Expected target registration error (TRE) is computed as a vector field. Results: The simulator was configured to evaluate the TRE when using a surface-based rigid registration algorithm in a typical prostate biopsy targeting scenario. Simulator parameters, such as segmentation error and deformation, were determined by measurements in clinical images. Turnaround time for the full simulation of one test case was below 3 minutes. The simulator is customizable for testing, comparing, optimizing segmentation and registration methods and is independent of the imaging modalities used

Automatic fiducial localization in ultrasound images for a thermal ablation validation platform

ABSTRACT PURPOSE: Development of ultrasound-based tumor ablation monitoring systems requires extensive validation. Validation is based on the comparison of ablated regions, computed from ultrasound images, to the ground truth region observed on histopathology images. Registration of ultrasound and histopathology images can be efficiently implemented by localizing fiducial lines embedded in the test phantom. Manual fiducial localization is time consuming and may be inaccurate. Current automatic localization algorithms were designed for use on images containing easily detectable fiducials in clear water, while the images produced by the ablation monitoring platform contain fiducials and ablated tissue embedded in tissue-mimicking gel. Our goal was to develop an automatic fiducial localization algorithm for the ablation monitoring platform. METHOD: A previously existing algorithm for detecting fishing line in water for ultrasound probe calibration, created by Chen et al., was tested on ultrasound images of an ablation phantom. Fiducial and line point detection parameters were determined by running the algorithm multiple times with different parameter sets and searching for the set that results in the best detection success rate. The fiducial intensity scoring method was modified to use intensities from an unaltered image; this greatly reduced the number of incorrectly identified fiducials. Line finding was modified to suit the ablation phantom geometry. RESULTS: The new algorithm was tested by comparing the automatic localization results to manually identified fiducial positions. Using the optimized parameters, it was found to have a 94.1 % success rate on the tested images. Fiducial localization error was defined as the difference between the manually segmented positions and the positions found by the algorithm. Fiducial localization error was -0.04±0.18mm along the x-axis, and -0.09±0.14mm along the y-axis. CONCLUSION: We have developed an automatic algorithm that detects line fiducials at a high success rate in complex phantoms containing a tissue sample embedded in tissue-mimicking gel

Tracked ultrasound calibration studies with a phantom made of LEGO® bricks

Consortium research supervisor: Gabor Fichtinger PURPOSE: Real-time tracked ultrasound imaging is a non-invasive and safe approach to facilitate needle-based interventions such as biopsy, drug delivery and surgical ablation. These procedures require a degree of accuracy maintained by an accurate and consistent spatial and temporal calibration that relates the image pixels of the ultrasound to the coordinate system of the tracked probe. In this study, spatial calibration of tracked ultrasound was compared by using a calibration phantom made of LEGO® bricks [1] and two 3-D printed N-wire phantoms METHODS: The accuracy and variance of calibrations were compared under a variety of operating conditions. Twenty trials were performed using an electromagnetic tracking device with a linear probe and three trials were performed using varied probes, varied tracking devices and the three aforementioned N-wire phantoms shown in figure 1. The accuracy and variance of spatial calibrations found through the standard deviation and error of the 3-D image reprojection were used to compare the calibrations produced from the phantoms. CONCLUSION: Given that the phantom made of LEGO® bricks is significantly less expensive, more readily available, and more easily modified than precision-machined N-wire phantoms, it prompts to be a viable calibration tool especially for quick laboratory research and proof of concept implementations of tracked ultrasound navigation