Intra-operative 360° 3D transvaginal ultrasound guidance during high-dose-rate interstitial gynecologic brachytherapy needle placement

Jessica R. Rodgers; Jeffrey Bax; Vikram Velker; Kathleen Surry; David D'Souza; Eric Leung; Aaron Fenster

doi:10.1117/12.2292767

13 March 2018 Intra-operative 360° 3D transvaginal ultrasound guidance during high-dose-rate interstitial gynecologic brachytherapy needle placement

Jessica R. Rodgers, Jeffrey Bax, Vikram Velker, Kathleen Surry, David D'Souza, Eric Leung, Aaron Fenster

Author Affiliations +

Proceedings Volume 10576, Medical Imaging 2018: Image-Guided Procedures, Robotic Interventions, and Modeling; 105761O (2018) https://doi.org/10.1117/12.2292767
Event: SPIE Medical Imaging, 2018, Houston, Texas, United States

Abstract

In high-dose-rate (HDR) interstitial gynecologic brachytherapy, needles are positioned into the tumor and surrounding area through a template to deliver radiotherapy. Optimal dose and avoidance of nearby organs requires precise needle placement; however, there is currently no standard method for intra-operative needle visualization or guidance. We have developed and validated a 360° three-dimensional (3D) transvaginal ultrasound (TVUS) system and created a sonolucent vaginal cylinder that is compatible with the current template to accommodate a conventional side-fire ultrasound probe. This probe is rotated inside the hollow sonolucent cylinder to generate a 3D image. We propose the use of this device for intra-operative verification of brachytherapy needle locations. In a feasibility study, the first ever 360° 3D TVUS image of a gynecologic brachytherapy patient was acquired and the image allowed key features, including bladder, rectum, vaginal wall, and bowel, to be visualized with needles clearly identifiable. Three patients were then imaged following needle insertion (28 needles total) and positions of the needles in the 3D TVUS image were compared to the clinical x-ray computed tomography (CT) image, yielding a mean trajectory difference of 1.67 ± 0.75°. The first and last visible points on each needle were selected in each modality and compared; the point pair with the larger distance was selected as the maximum difference in needle position with a mean maximum difference of 2.33 ± 0.78 mm. This study demonstrates that 360° 3D TVUS may be a feasible approach for intra-operative needle localization during HDR interstitial brachytherapy of gynecologic malignancies.

Conference Presentation

Citation Download Citation

Jessica R. Rodgers, Jeffrey Bax, Vikram Velker, Kathleen Surry, David D'Souza, Eric Leung, and Aaron Fenster "Intra-operative 360° 3D transvaginal ultrasound guidance during high-dose-rate interstitial gynecologic brachytherapy needle placement", Proc. SPIE 10576, Medical Imaging 2018: Image-Guided Procedures, Robotic Interventions, and Modeling, 105761O (13 March 2018); https://doi.org/10.1117/12.2292767

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available