Abstract
This paper presents a mechanically-assisted 3D transrectal ultrasound (TRUS) biopsy system with MRI–3D TRUS fusion. The 3D TRUS system employs a 4 degree-of-freedom linkage for real-time TRUS probe tracking. MRI–TRUS fusion is achieved using a surface-based non-linear registration incorporating thin-plate splines to provide real-time overlays of suspicious MRI lesions on 3D TRUS for intrabiopsy targeted needle guidance. Clinical use of the system is demonstrated on a prospective cohort study of 25 patients with clinical findings concerning for prostate adenocarcinoma (PCa). The MRI–3D TRUS registration accuracy is quantified and compared with alternative algorithms for optimal performance. Results of the clinical study demonstrated a significantly higher rate of positive biopsy cores and a higher Gleason score cancer grading for targeted biopsies using the MRI–3D TRUS fusion as compared to the standard 12-core sextant biopsy distribution. Lesion targeted biopsy cores that were positive for PCa contained a significantly higher percentage of tumor within each biopsy sample compared to the sextant cores and in some patients resulted in identifying higher risk disease.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
American Cancer Society: Cancer facts and figures 2010. Tech. rep., American Cancer Society (2010)
Anastasiadis, A.G., Lichy, M.P., Nagele, U., Kuczyk, M.A., Merseburger, A.S., Hennenlotter, J., Corvin, S., Sievert, K.D., Claussen, C.D., Stenzl, A., Schlemmer, H.P.: Mri-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing psa levels after previous negative trus biopsies. Eur. Urol. 50(4), 738–748 (2006), discussion 748–9
Andriole, G.L., Bullock, T.L., Belani, J.S., Traxel, E., Yan, Y., Bostwick, D.G., Humphrey, P.A.: Is there a better way to biopsy the prostate? prospects for a novel transrectal systematic biopsy approach. Urology 70(suppl. 6), 22–26 (2007)
Bax, J., Cool, D., Gardi, L., Knight, K., Smith, D., Montreuil, J., Sherebrin, S., Romagnoli, C., Fenster, A.: Mechanically assisted 3d ultrasound guided prostate biopsy system. Med. Phys. 35(12), 5397–5410 (2008)
Beyersdorff, D., Winkel, A., Hamm, B., Lenk, S., Loening, S.A., Taupitz, M.: Mr imaging-guided prostate biopsy with a closed mr unit at 1.5 t: initial results. Radiology 234(2), 576–581 (2005)
Bookstein, F.: Principal warps: Thin-plate splines and the decomposition of deformations. IEEE Trans. Pattern Anal. Mach. Intell. 11(6), 567–585 (1989)
Chrisochoides, N., Fedorov, A., Kot, A., Archip, N., Black, P., Clatz, O., Golby, A., Kikinis, R., Warfield, S.K.: Toward real-time image guided neurosurgery using distributed and grid computing. In: ACM/IEEE Conference on Supercomputing (SC 2006), p. 37 (2006)
Cool, D., Sherebrin, S., Izawa, J., Chin, J., Fenster, A.: Design and evaluation of a 3d transrectal ultrasound prostate biopsy system. Med. Phys. 35(10), 4695–4707 (2008)
Eichler, K., Hempel, S., Wilby, J., Myers, L., Bachmann, L.M., Kleijnen, J.: Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review. J. Urol. 175(5), 1605–1612 (2006)
Gleason, D.: Histologic grading and clinical staging of prostatic carcinoma, pp. 171–198. Lea and Febiger, Philadelphia (1977)
Hata, N., Jinzaki, M., Kacher, D., Cormak, R., Gering, D., Nabavi, A., Silverman, S.G., D’Amico, A.V., Kikinis, R., Jolesz, F.A., Tempany, C.M.: Mr imaging-guided prostate biopsy with surgical navigation software: device validation and feasibility. Radiology 220(1), 263–268 (2001)
Kadoury, S., Yan, P., Xu, S., Glossop, N., Choyke, P., Turkbey, B., Pinto, P., Wood, B.J., Kruecker, J.: Realtime TRUS/MRI fusion targeted-biopsy for prostate cancer: A clinical demonstration of increased positive biopsy rates. In: Madabhushi, A., Dowling, J., Yan, P., Fenster, A., Abolmaesumi, P., Hata, N. (eds.) MICCAI 2010. LNCS, vol. 6367, pp. 52–62. Springer, Heidelberg (2010)
Karnik, V.V., Fenster, A., Bax, J., Cool, D.W., Gardi, L., Gyacskov, I., Romagnoli, C., Ward, A.D.: Assessment of image registration accuracy in three-dimensional transrectal ultrasound guided prostate biopsy. Med. Phys. 37(2), 802–813 (2010)
Karnik, V.V., Fenster, A., Bax, J., Romagnoli, C., Ward, A.D.: Evaluation of intersession 3d-trus to 3d-trus image registration for repeat prostate biopsies. Medical physics 38(4), 1832–1843 (2011)
Krieger, A., Susil, R.C., Menard, C., Coleman, J.A., Fichtinger, G., Atalar, E., Whitcomb, L.L.: Design of a novel mri compatible manipulator for image guided prostate interventions. IEEE Trans. Biomed. Eng. 52(2), 306–313 (2005)
Ladak, H.M., Mao, F., Wang, Y., Downey, D.B., Steinman, D.A., Fenster, A.: Prostate boundary segmentation from 2d ultrasound images. Med. Phys. 27(8), 1777–1788 (2000)
Lattouf, J.B., Grubb, R.L., Lee, S.J., Bjurlin, M.A., Albert, P., Singh, A.K., Ocak, I., Choyke, P., Coleman, J.A.: Magnetic resonance imaging-directed transrectal ultrasonography-guided biopsies in patients at risk of prostate cancer. BJU Int. 99(5), 1041–1046 (2007)
Long, J.A., Daanen, V., Moreau-Gaudry, A., Troccaz, J., Rambeaud, J.J., Descotes, J.L.: Prostate biopsies guided by three-dimensional real-time (4-d) transrectal ultrasonography on a phantom: comparative study versus two-dimensional transrectal ultrasound-guided biopsies. Eur. Urol. 52(4), 1097–1104 (2007)
Norberg, M., Egevad, L., Holmberg, L., Sparen, P., Norlen, B.J., Busch, C.: The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer. Urology 50(4), 562–566 (1997)
Ourselin, S., Roche, A., Prima, S., Ayache, N.: Block matching: A general framework to improve robustness of rigid registration of medical images. In: Delp, S.L., DiGoia, A.M., Jaramaz, B. (eds.) MICCAI 2000. LNCS, vol. 1935, pp. 557–566. Springer, Heidelberg (2000)
Shen, F., Shinohara, K., Kumar, D., Khemka, A., Simoneau, A.R., Werahera, P.N., Li, L., Guo, Y., Narayanan, R., Wei, L., Barqawi, A., Crawford, E.D., Davatzikos, C., Suri, J.S.: Three-dimensional sonography with needle tracking: role in diagnosis and treatment of prostate cancer. J. Ultrasound Med. 27(6), 895–905 (2008)
Singh, A.K., Kruecker, J., Xu, S., Glossop, N., Guion, P., Ullman, K., Choyke, P.L., Wood, B.J.: Initial clinical experience with real-time transrectal ultrasonography-magnetic resonance imaging fusion-guided prostate biopsy. BJU Int. 101(7), 841–845 (2008)
Zakian, K.L., Sircar, K., Hricak, H., Chen, H.N., Shukla-Dave, A., Eberhardt, S., Muruganandham, M., Ebora, L., Kattan, M.W., Reuter, V.E., Scardino, P.T., Koutcher, J.A.: Correlation of proton mr spectroscopic imaging with gleason score based on step-section pathologic analysis after radical prostatectomy. Radiology 234(3), 804–814 (2005)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Cool, D.W. et al. (2011). Fusion of MRI to 3D TRUS for Mechanically-Assisted Targeted Prostate Biopsy: System Design and Initial Clinical Experience. In: Madabhushi, A., Dowling, J., Huisman, H., Barratt, D. (eds) Prostate Cancer Imaging. Image Analysis and Image-Guided Interventions. Prostate Cancer Imaging 2011. Lecture Notes in Computer Science, vol 6963. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23944-1_13
Download citation
DOI: https://doi.org/10.1007/978-3-642-23944-1_13
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-23943-4
Online ISBN: 978-3-642-23944-1
eBook Packages: Computer ScienceComputer Science (R0)