Mechanically assisted 3D ultrasound guided prostate biopsy system

Abstract

There are currently limitations associated with the prostate biopsy procedure, which is the most commonly used method for a definitive diagnosis of prostate cancer. With the use of two-dimensional (2D) transrectal ultrasound (TRUS) for needle-guidance in this procedure, the physician has restricted anatomical reference points for guiding the needle to target sites. Further, any motion of the physician's hand during the procedure may cause the prostate to move or deform to a prohibitive extent. These variations make it difficult to establish a consistent reference frame for guiding a needle. We have developed a 3D navigation system for prostate biopsy, which addresses these shortcomings. This system is composed of a 3D US imaging subsystem and a passive mechanical arm to minimize prostate motion. To validate our prototype, a series of experiments were performed on prostate phantoms. The 3D scan of the string phantom produced minimal geometric distortions, and the geometric error of the 3D imaging subsystem was 0.37 mm. The accuracy of 3D prostate segmentation was determined by comparing the known volume in a certified phantom to a reconstructed volume generated by our system and was shown to estimate the volume with less then 5% error. Biopsy needle guidance accuracy tests in agar prostate phantoms showed that the mean error was 2.1 mm and the 3D location of the biopsy core was recorded with a mean error of 1.8 mm. In this paper, we describe the mechanical design and validation of the prototype system using an in vitro prostate phantom. Preliminary results from an ongoing clinical trial show that prostate motion is small with an in-plane displacement of less than 1 mm during the biopsy procedure.

Comparison of prostate MRI-3D transrectal ultrasound fusion biopsy for first-time and repeat biopsy patients with previous atypical small acinar proliferation

“…21 The system attaches a standard 9 MHz, end-fire 2D TRUS probe (Philips, Seattle, WA, U.S.) to a mechanical linkage that provides a natural range-of-motion. The mechanical design is similar to the Artemis ® system (Eigen, Grass Valley, CA, U.S.), with 3D TRUS images acquired in 3-7 seconds through rotation of the TRUS probe about its long axis.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] Targeted biopsy of MP-MRI lesions can be performed directly using MRI [8][9][10] or under ultrasound guidance using cognitive targeting or MRI-TRUS fusion software. 6,13 Needle insertion can be transrectal or transperineal under ultrasound guidance. MRI-targeted, TRUS-guided biopsy is likely best performed through fusion of MRI to 3D TRUS (MRI-TRUS fusion) rather than attempting to cognitively infer the MRI lesion location on standard non-fusion TRUS.…”

“…MRI-targeted, TRUS-guided biopsy is likely best performed through fusion of MRI to 3D TRUS (MRI-TRUS fusion) rather than attempting to cognitively infer the MRI lesion location on standard non-fusion TRUS. 5,[14][15][16] While MRI-guided and MRI-TRUS fusion approaches have merit, MRI-TRUS fusion biopsy (Fn-Bx) allows for real-time needle visualization and can be performed in a clinical setting using a standard 2D TRUS probe incorporated into a 3D system, 13 rather than in an MRI suite with specialized MRI-compatible hardware. 8 Fn-Bx has demonstrated higher per-core CaP detection rates, higher Gleason grades, and higher percentage of tumour involvement within targeted cores as compared to systematic biopsy.…”

Detection of curved robots using 3D ultrasound

“…Multiple sensing modalities are available for tracking surgical instruments, such as optical tracking (OPT), electromagnetic tracking (EMT), image-based tracking [6], ultrasonic sensor tracking (UST) [19], mechanical tracking [20], [21], as well as some hybrid systems integrating two or more modalities [22], [23]. A recent summary of tracking technologies appears in [24].…”

Efficient 3D Endfiring TRUS Prostate Segmentation with Globally Optimized Rotational Symmetry

“…Currently, 3D endfiring transrectal ultrasound (TRUS) is the most commonly used imaging modality for image-guided biopsy of PCa due to its real-time imaging capability, low cost and simplicity [15]. Segmenting the acquired 3D endfiring TRUS prostate images efficiently and accurately, especially in an automated or semi-automated way, is highly desired in a 3D endfiring TRUS guided prostate biopsy system [3], due to the arduous and time consuming effort associated with manual 3D prostate segmentation. In addition, through the segmentation results of 3D prostate TRUS and MR images, the 3D surface-based TRUS-MRI registration technique provides an effective way to target biopsy needles toward regions of the prostate containing MR identified suspicious lesions, as an alternative to the more expensive and inefficient, MRI-based prostate biopsy [5,12].…”