MRI-Guided Robotic Prostate Biopsy: A Clinical Accuracy Validation

UNLABELLED Prostate cancer is a major health threat for men. For over five years, the U.S. National Cancer Institute has performed prostate biopsies with a magnetic resonance imaging (MRI)-guided robotic system. PURPOSE A retrospective evaluation methodology and analysis of the clinical accuracy of this system is reported. METHODS Using the pre and post-needle insertion image volumes, a registration algorithm that contains a two-step rigid registration followed by a deformable refinement was developed to capture prostate dislocation during the procedure. The method was validated by using three-dimensional contour overlays of the segmented prostates and the registrations were accurate up to 2 mm. RESULTS It was found that tissue deformation was less of a factor than organ displacement. Out of the 82 biopsies from 21 patients, the mean target displacement, needle placement error, and clinical biopsy error was 5.9 mm, 2.3 mm, and 4 mm, respectively. CONCLUSION The results suggest that motion compensation for organ displacement should be used to improve targeting accuracy.

[1]  M. Terris,et al.  Comparison of mid-lobe versus lateral systematic sextant biopsies in the detection of prostate cancer. , 1997, Urologia internationalis.

[2]  Andras Lasso,et al.  Accuracy validation for MRI-guided robotic prostate biopsy , 2010, Medical Imaging.

[3]  A. Jemal,et al.  Cancer Statistics, 2009 , 2009, CA: a cancer journal for clinicians.

[4]  Jelle O. Barentsz,et al.  Magnetic Resonance Imaging of Prostate Cancer , 2010 .

[5]  Aaron Fenster,et al.  Assessment of registration accuracy in three-dimensional transrectal ultrasound images of prostates , 2010, Medical Imaging.

[6]  J C Presti,et al.  Prostate cancer: assessment of risk using digital rectal examination, tumor grade, prostate-specific antigen, and systematic biopsy. , 2000, Radiologic clinics of North America.

[7]  C. N. Coleman,et al.  Transrectal prostate biopsy and fiducial marker placement in a standard 1.5T magnetic resonance imaging scanner. , 2006, The Journal of urology.

[8]  J Kurhanewicz,et al.  Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. , 2000, The Journal of urology.

[9]  K J Macura,et al.  The importance of organ geometry and boundary constraints for planning of medical interventions. , 2009, Medical engineering & physics.

[10]  Gabor Fichtinger,et al.  Design of a novel MRI compatible manipulator for image guided prostate interventions , 2005, IEEE Transactions on Biomedical Engineering.