A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning

18 March 2016 A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning

W. Thomas Hrinivich, Douglas A. Hoover, Kathleen Surry, Chandima Edirisinghe, Jacques Montreuil, David D'Souza, Aaron Fenster, Eugene Wong

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Proceedings Volume 9786, Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling; 97861H (2016) https://doi.org/10.1117/12.2216149
Event: SPIE Medical Imaging, 2016, San Diego, California, United States

Abstract

Background: High-dose-rate brachytherapy (HDR-BT) is a prostate cancer treatment option involving the insertion of hollow needles into the gland through the perineum to deliver a radioactive source. Conventional needle imaging involves indexing a trans-rectal ultrasound (TRUS) probe in the superior/inferior (S/I) direction, using the axial transducer to produce an image set for organ segmentation. These images have limited resolution in the needle insertion direction (S/I), so the sagittal transducer is used to identify needle tips, requiring a manual registration with the axial view. This registration introduces a source of uncertainty in the final segmentations and subsequent treatment plan. Our lab has developed a device enabling 3D-TRUS guided insertions with high S/I spatial resolution, eliminating the need to align axial and sagittal views.

Purpose: To compare HDR-BT needle tip localization accuracy between 2D and 3D-TRUS.

Methods: 5 prostate cancer patients underwent conventional 2D TRUS guided HDR-BT, during which 3D images were also acquired for post-operative registration and segmentation. Needle end-length measurements were taken, providing a gold standard for insertion depths.

Results: 73 needles were analyzed from all 5 patients. Needle tip position differences between imaging techniques was found to be largest in the S/I direction with mean±SD of -2.5±4.0 mm. End-length measurements indicated that 3D TRUS provided statistically significantly lower mean±SD insertion depth error of -0.2±3.4 mm versus 2.3±3.7 mm with 2D guidance (p < .001).

Conclusions: 3D TRUS may provide more accurate HDR-BT needle localization than conventional 2D TRUS guidance for the majority of HDR-BT needles.

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W. Thomas Hrinivich, Douglas A. Hoover, Kathleen Surry, Chandima Edirisinghe, Jacques Montreuil, David D'Souza, Aaron Fenster, and Eugene Wong "A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning", Proc. SPIE 9786, Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling, 97861H (18 March 2016); https://doi.org/10.1117/12.2216149

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KEYWORDS

Image segmentation

3D image processing

Prostate

Prostate cancer

3D acquisition

Ultrasonography

Transducers

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