Repeat Prostate Biopsy Accuracy: Simulator-based Comparison of Two- and Three-dimensional Transrectal US Modalities

Cool, Derek W.; Connolly, Michael; Sherebrin, Shi; Eagleson, Roy; Izawa, Jonathan I.; Amann, Justin; Romagnoli, Cesare; Romano, Walter; Fenster, Aaron

doi:10.1148/radiol.2542090674

Cited by 17 publications

(13 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This experiment used previously published work from our group, which assessed the accuracy of 5 experts using a 3-dimensional ultrasound system. 17 We found differences between experts and novices using the simulator with regards to the time taken (34.7 seconds vs. 78.3 seconds, respectively); however the differences in accuracy of each biopsy between experts and residents (3.76 mm vs. 4.16 mm, respectively) did not reach statistical significance. The differences in accuracy were trending towards reaching statistical significance (p = 0.16), and we suspect that the difference could be confirmed with larger sample sizes.…”

Section: Resultsmentioning

confidence: 55%

“…This experiment used and expanded upon previously published work from our group, which compared simulated prostate biopsy accuracies using 2D ultrasound to 3D ultrasound systems, and involved only experts and radiology residents. 17 Prior to each simulated biopsy, a single, static 2D TRUS image of the virtual target was provided to the operator for review. It is important to note that the length of time for target review was not limited and was at the discretion of the biopsy operator for each virtual target.…”

Section: Simulator Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Development and validation of a virtual reality transrectal ultrasound guided prostatic biopsy simulator

Chalasani

Cool²,

Sherebrin³

et al. 2013

CUAJ

Self Cite

View full text Add to dashboard Cite

Objective: We present the design, reliability, face, content and construct validity testing of a virtual reality simulator for transrectal ultrasound (TRUS), which allows doctors-in-training to perform multiple different biopsy schemes. Methods: This biopsy system design uses a regular "end-firing" TRUS probe. Movements of the probe are tracked with a micromagnetic sensor to dynamically slice through a phantom patient's 3D prostate volume to provide real-time continuous TRUS views. 3D TRUS scans during prostate biopsy clinics were recorded. Intrinsic reliability was assessed by comparing the left side of the prostate to the right side of the prostate for each biopsy. A content and face validity questionnaire was administered to 26 doctors to assess the simulator. Construct validity was assessed by comparing notes from experts and novices with regards to the time taken and the accuracy of each biopsy. Results: Imaging data from 50 patients were integrated into the simulator. The completed VR TRUS simulator uses real patient images, and is able to provide simulation for 50 cases, with a haptic interface that uses a standard TRUS probe and biopsy needle. Intrinsic reliability was successfully demonstrated by comparing results from the left and right sides of the prostate. Face and content validity respondents noted the realism of the simulator, and its appropriateness as a teaching model. The simulator was able to distinguish between experts and novices during construct validity testing. Conclusions: A virtual reality TRUS simulator has successfully been created. It has promising face, content and construct validity results. IntroductionThe current gold standard and the most widely used method to diagnose prostate cancer is transrectal ultrasound (TRUS)-guided prostatic biopsy, which is commonly performed in Westernized high income countries. For instance, in Australia in 2008 a total of 26 146 TRUS guided biopsies of the prostate were performed. 1Transrectal ultrasound-guided prostatic biopsy does have well-documented complications. A recently published Japanese nationwide survey of more than 200 000 prostatic biopsies revealed that complications occurred frequently, with hematuria in 12%, hematochezia in 5.9%, hematospermia in 1.2%, fever in 1.1%, sepsis in 0.07%, voiding symptoms in 1.9%, urinary retention in 1.1% and prostatitis in 0.9%. Hospitalization to treat complications occurred in 0.69% of the entire cohort.2 Mortality rates at 120 days of 1.3% have been also been reported from a cohort of 22 175 patients by Gallina and colleagues.

show abstract

Section: Resultsmentioning

confidence: 55%

Section: Simulator Evaluationmentioning

confidence: 99%

Development and validation of a virtual reality transrectal ultrasound guided prostatic biopsy simulator

Chalasani

Cool²,

Sherebrin³

et al. 2013

CUAJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…As traditional 2-D TRUS images cannot provide the precise 3-D position of the biopsy needle, the physician must mentally estimate the 3-D location of the biopsy needle based on limited 2-D information, which often results in suboptimal biopsy targeting [7].…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Nonrigid MR-TRUS Registration Using Dual Optimization

Sun

Yuan

Qiu

et al. 2015

IEEE Trans. Med. Imaging

Self Cite

View full text Add to dashboard Cite

In this study, we proposed an efficient nonrigid magnetic resonance (MR) to transrectal ultrasound (TRUS) deformable registration method in order to improve the accuracy of targeting suspicious regions during a three dimensional (3-D) TRUS guided prostate biopsy. The proposed deformable registration approach employs the multi-channel modality independent neighborhood descriptor (MIND) as the local similarity feature across the two modalities of MR and TRUS, and a novel and efficient duality-based convex optimization-based algorithmic scheme was introduced to extract the deformations and align the two MIND descriptors. The registration accuracy was evaluated using 20 patient images by calculating the TRE using manually identified corresponding intrinsic fiducials in the whole gland and peripheral zone. Additional performance metrics [Dice similarity coefficient (DSC), mean absolute surface distance (MAD), and maximum absolute surface distance (MAXD)] were also calculated by comparing the MR and TRUS manually segmented prostate surfaces in the registered images. Experimental results showed that the proposed method yielded an overall median TRE of 1.76 mm. The results obtained in terms of DSC showed an average of 80.8±7.8% for the apex of the prostate, 92.0±3.4% for the mid-gland, 81.7±6.4% for the base and 85.7±4.7% for the whole gland. The surface distance calculations showed an overall average of 1.84±0.52 mm for MAD and 6.90±2.07 mm for MAXD.

show abstract

“…However, TRUS-guided biopsy suffers from significant limitations related to difficulties in targeting predefined locations within the prostate, resulting in a false negative rate as high as 29.1%. 3 The limited anatomic information provided by 2D TRUS makes navigation to predefined 3D locations challenging 4 and does not permit a 3D record of biopsy locations, which can be useful in a repeat session wherein previously determined suspicious targets may need to be rebiopsied. In order to overcome these drawbacks, magnetic resonance imaging ͑MRI͒ and TRUS-guided systems have been developed to provide biopsy location information in 3D.…”

Section: Introductionmentioning

confidence: 99%

Quantification of prostate deformation due to needle insertion during TRUS-guided biopsy: comparison of hand-held and mechanically stabilized systems

et al. 2011

Self Cite

View full text Add to dashboard Cite

Purpose: Prostate biopsy is the clinical standard for the definitive diagnosis of prostate cancer. To overcome the limitations of 2D TRUS-guided biopsy systems when targeting preplanned locations, systems have been developed with 3D guidance to improve the accuracy of cancer detection. Prostate deformation due to needle insertion and biopsy gun firing is a potential source of error that can cause target misalignments during biopsies. Methods: The authors used nonrigid registration of 2D TRUS images to quantify the deformation that occurs during the needle insertion and the biopsy gun firing procedure and compare this effect in biopsies performed using a hand-held TRUS probe to those performed using a mechanically assisted 3D TRUS-guided biopsy system. The authors calculated a spatially varying 95% confidence interval on the prostate tissue motion and analyzed this motion both as a function of distance to the biopsy needle and as a function of distance to the lower piercing point of the prostate. The former is relevant because biopsy targets lie along the needle axis, and the latter is of particular importance due to the reported high concentration of prostate cancer in the peripheral zone, a substantial portion of which lies on the posterior side of the prostate where biopsy needles enter the prostate after penetrating the rectal wall during transrectal biopsy. Results: The results show that for both systems, the tissue deformation is such that throughout the length of the needle axis, including regions proximal to the lower piercing point, spherical tumors with a radius of 2.1 mm or more can be sampled with 95% confidence under the assumption of zero error elsewhere in the biopsy system. More deformation was observed in the direction orthogonal to the needle axis compared to the direction parallel to the needle axis; this is of particular importance given the long, narrow shape of the biopsy core. The authors measured lateral tissue motion proximal to the needle axis of not more than 1.5 mm, with 95% confidence. The authors observed a statistically significant and clinically insignificant maximum difference of 0.38 mm in the deformation, resulting from the hand-held and mechanically assisted systems along the needle axis, and the mechanical system resulted in a lower relative increase in deformation proximal to the needle axis during needle insertion, as well as lower variability of deformation during biopsy gun firing. Conclusions: Given the clinical need to biopsy tumors of volume greater than or equal to 0.5 cm 3 , Med. Phys. 38 "3…,

show abstract

Repeat Prostate Biopsy Accuracy: Simulator-based Comparison of Two- and Three-dimensional Transrectal US Modalities

Cited by 17 publications

References 23 publications

Development and validation of a virtual reality transrectal ultrasound guided prostatic biopsy simulator

Development and validation of a virtual reality transrectal ultrasound guided prostatic biopsy simulator

Three-Dimensional Nonrigid MR-TRUS Registration Using Dual Optimization

Quantification of prostate deformation due to needle insertion during TRUS-guided biopsy: comparison of hand-held and mechanically stabilized systems

Contact Info

Product

Resources

About