Abstract
Intra-operative guidance in Transrectal Ultrasound (TRUS) guided prostate brachytherapy requires localization of inserted radioactive seeds relative to the prostate. Seeds were reconstructed using a typical C-arm, and exported to a commercial brachytherapy system for dosimetry analysis. Technical obstacles for 3D reconstruction on a non-isocentric C-arm included pose-dependent C-arm calibration; distortion correction; pose estimation of C-arm images; seed reconstruction; and C-arm to TRUS registration. In precision-machined hard phantoms with 40-100 seeds, we correctly reconstructed 99.8% seeds with a mean 3D accuracy of 0.68 mm. In soft tissue phantoms with 45-87 seeds and clinically realistic 15o C-arm motion, we correctly reconstructed 100% seeds with an accuracy of 1.3 mm. The reconstructed 3D seed positions were then registered to the prostate segmented from TRUS. In a Phase-1 clinical trial, so far on 4 patients with 66-84 seeds, we achieved intra-operative monitoring of seed distribution and dosimetry. We optimized the 100% prescribed iso-dose contour by inserting an average of 3.75 additional seeds, making intra-operative dosimetry possible on a typical C-arm, at negligible additional cost to the existing clinical installation.
Supported by DoD PC050170, DoD PC050042 and NIH 2R44CA099374.
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Jain, A. et al. (2007). Intra-operative 3D Guidance in Prostate Brachytherapy Using a Non-isocentric C-arm. In: Ayache, N., Ourselin, S., Maeder, A. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2007. MICCAI 2007. Lecture Notes in Computer Science, vol 4792. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-75759-7_2
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DOI: https://doi.org/10.1007/978-3-540-75759-7_2
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