Cool Derek, Sherebrin Shi, Izawa Jonathan, Chin Joseph, Fenster Aaron
Imaging Research Laboratories, Robarts Research Institute, London, Ontario N6A 5K8, Canada.
Med Phys. 2008 Oct;35(10):4695-707. doi: 10.1118/1.2977542.
Biopsy of the prostate using ultrasound guidance is the clinical gold standard for diagnosis of prostate adenocarcinoma. The current prostate biopsy procedure is limited to using 2D transrectal ultrasound (TRUS) images to target biopsy sites and record biopsy core locations for postbiopsy confirmation. Localization of the 2D image in its actual 3D position is ambiguous and limits procedural accuracy and reproducibility. We have developed a 3D TRUS prostate biopsy system that provides 3D intrabiopsy information for needle guidance and biopsy location recording. The system conforms to the workflow and imaging technology of the current biopsy procedure, making it easier for clinical integration. In this paper, we describe the system design and validate the system accuracy by performing mock biopsies on US/CT multimodal patient-specific prostate phantoms. Our biopsy system generated 3D patient-specific models of the prostate with volume errors less than 3.5% and mean boundary errors of less than 1 mm. Using the 3D biopsy system, needles were guided to within 2.3 +/- 1.0 mm of 3D targets and with a high probability of biopsying clinically significant tumors. The positions of the actual biopsy sites were accurately localized to within 1.5 +/- 0.8 mm.
在超声引导下进行前列腺活检是诊断前列腺腺癌的临床金标准。当前的前列腺活检程序仅限于使用二维经直肠超声（TRUS）图像来确定活检部位并记录活检组织芯的位置，以便在活检后进行确认。二维图像在其实际三维位置中的定位不明确，限制了操作的准确性和可重复性。我们开发了一种三维TRUS前列腺活检系统，该系统可提供三维活检信息，用于引导穿刺针和记录活检位置。该系统符合当前活检程序的工作流程和成像技术，便于临床整合。在本文中，我们描述了系统设计，并通过在针对患者的US/CT多模态前列腺模型上进行模拟活检来验证系统的准确性。我们的活检系统生成了针对患者的前列腺三维模型，体积误差小于3.5%，平均边界误差小于1毫米。使用三维活检系统，穿刺针被引导至距离三维靶点2.3±1.0毫米以内，并且活检具有临床意义肿瘤的概率很高。实际活检部位的位置被精确地定位在1.5±0.8毫米以内。
