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Proceedings Paper

Seed-based ultrasound and fluoroscopy registration using iterative optimal assignment for intraoperative prostate brachytherapy dosimetry
Author(s): Ismail B. Tutar; Sreeram Narayanan; Hila Lenz; Rizwan Nurani; Peter Orio; Paul S. Cho; Kent Wallner; Yongmin Kim
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Paper Abstract

Prostate brachytherapy involves permanent implantation of radioactive sources into the prostate gland. Since fluoroscopy and transrectal ultrasound (TRUS) imaging modalities currently complement each other by providing good visualization of seeds and soft tissue, respectively, the registration of these two imaging modalities could lead to the intraoperative dosimetry analysis of brachytherapy procedures, thus improving patient outcome and reducing costs. Although it is desirable to register TRUS and fluoroscopy images by using the implanted seeds as fiducial markers, an operator, based on our experience, can locate only a small fraction of implanted seeds in axial TRUS images. Therefore, to perform TRUS-fluoroscopy registration in a clinical setting, there is a need for (1) a new method that can reliably perform registration at low seed detection rates and (2) a new imaging technique to enhance the seed visibility. We previously developed iterative optimal assignment (IOA), which can perform registration at seed detection rates below 20%, to address the former. In this paper, we present a new TRUS acquisition method where we acquire images of the prostate by rotating the longitudinal transducer of a biplanar probe in the clockwise/counter-clockwise direction. We acquired post-implant fluoroscopy and TRUS images from 35 patients who underwent a seed implant procedure. The results show that the combined use of IOA and rotational images makes TRUS-fluoroscopy registration possible and practical, thus our goal of intraoperative dosimetry can be realized.

Paper Details

Date Published: 21 March 2007
PDF: 9 pages
Proc. SPIE 6509, Medical Imaging 2007: Visualization and Image-Guided Procedures, 650914 (21 March 2007); doi: 10.1117/12.712296
Show Author Affiliations
Ismail B. Tutar, Univ. of Washington (United States)
Sreeram Narayanan, Univ. of Washington (United States)
Hila Lenz, Puget Sound Health Care System (United States)
Rizwan Nurani, Univ. of Washington (United States)
Peter Orio, Univ. of Washington (United States)
Paul S. Cho, Univ. of Washington (United States)
Kent Wallner, Univ. of Washington (United States)
Puget Sound Health Care System (United States)
Yongmin Kim, Univ. of Washington (United States)


Published in SPIE Proceedings Vol. 6509:
Medical Imaging 2007: Visualization and Image-Guided Procedures
Kevin R. Cleary; Michael I. Miga, Editor(s)

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