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
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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.
© (2016) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
W. Thomas Hrinivich, W. Thomas Hrinivich, Douglas A. Hoover, Douglas A. Hoover, Kathleen Surry, Kathleen Surry, Chandima Edirisinghe, Chandima Edirisinghe, Jacques Montreuil, Jacques Montreuil, David D'Souza, David D'Souza, Aaron Fenster, Aaron Fenster, Eugene Wong, 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); doi: 10.1117/12.2216149; https://doi.org/10.1117/12.2216149
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