Surgical Planning Laboratory - Brigham & Women's Hospital - Boston, Massachusetts USA - a teaching affiliate of Harvard Medical School

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In-bore Setup and Software for 3T MRI-guided Transperineal Prostate Biopsy

Institution:
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD, USA.
3School of Computing, Queen’s University, Kingston, ON, Canada.
Publisher:
IOP Publishing Ltd.
Publication Date:
Sep-2012
Journal:
Phys Med Biol.
Volume Number:
57
Issue Number:
18
Pages:
5823-5840
Citation:
Phys Med Biol. 2012 Sep 21;57(18):5823-40.
Links:
http://dx.doi.org/10.1088/0031-9155/57/18/5823
PubMed ID:
22951350
PMCID:
PMC3517895
Appears in Collections:
SNR, NA-MIC, NCIGT, Prostate Group, SLICER, SPL
Sponsors:
P01 CA067165/CA/NCI NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
P41 RR019703/RR/NCRR NIH HHS/United States
R01 CA111288/CA/NCI NIH HHS/United States
R01 CA124377/CA/NCI NIH HHS/United States
R01 CA138586/CA/NCI NIH HHS/United States
U01 CA151261/CA/NCI NIH HHS/United States
U54 EB005149/EB/NIBIB NIH HHS/United States
Generated Citation:
Tokuda J., Tuncali K., Iordachita I., Song S-E., Fedorov A., Oguro S., Lasso A., Fennessy F.M., Tempany C.M., Hata N. In-bore Setup and Software for 3T MRI-guided Transperineal Prostate Biopsy. Phys Med Biol. 2012 Sep 21;57(18):5823-40. PMID: 22951350. PMCID: PMC3517895.
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MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3T MRI scanner. The setup consists of a specially designed tabletop and a needle guiding template with a Z-frame that gives a physician access to the perineum of the patient at the imaging position and allows the physician to perform MRI guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right–left (RP) and anterior–posterior (AP) axes were 1.1 ± 0.8 and 1.4 ± 1.1 mm, respectively, while the rotational errors around the RL, AP and superior–inferior axes were (0.8 ± 1.0), (1.7 ± 1.6) and (0.0±0.0), respectively. The 2D root-mean-square (RMS) needle-placement error was 3 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle-placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop setup and software, which supports manual needle placement without moving the patient out of the magnet.

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