Simulated required accuracy of image registration tools for targeting high-grade cancer components with prostate biopsies

Ven, Wendy J. M. van de; Kaa, Christina A. Hulsbergen‐van de; Hambrock, Thomas; Barentsz, Jelle O.; Huisman, Henkjan

doi:10.1007/s00330-012-2701-1

Cited by 39 publications

(23 citation statements)

References 29 publications

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“…Most PCas are heterogeneous with respect to Gleason score, and targeting a high-grade focus of PCa requires a technical registration accuracy of 1.9 mm [21]. This accuracy is not achieved with cognitive targeting and is just within the reported limits achieved with elastic MRI/ultrasoundfusion guidance [22].…”

Section: Discussionmentioning

confidence: 96%

Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis in Biopsy-naive Men with Suspected Prostate Cancer Based on Elevated Prostate-specific Antigen Values: Results from a Randomized Prospective Blinded Controlled Trial

et al. 2016

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Section: Discussionmentioning

confidence: 96%

Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis in Biopsy-naive Men with Suspected Prostate Cancer Based on Elevated Prostate-specific Antigen Values: Results from a Randomized Prospective Blinded Controlled Trial

et al. 2016

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“…A recent study by Van de Ven et al 7 provides insight into a potential avenue for improvement of the positive core rate. The authors estimated the maximum allowable target registration error (TRE) of MRI-3D TRUS registration for correct Gleason grading of 95% of peripheral zone PCa with fusion biopsy of sphere-shaped tumors 7 . The results of that study lead to the observation that the positive core rate is related to the biopsy system error in delivering the needle to the intended tumor target.…”

Section: Description Of Purposementioning

confidence: 97%

“…the method utilized by Van de ven et al 7 ), we constructed a sphere of equal volume in the 3D TRUS space for each of the 81 tumors in our sample. For each tumor in our sample, as well is its corresponding sphere, we conducted an exhaustive search to estimate the maximum RMS error giving at least 95% probability of a successful tumor sample in one biopsy core using the method described in the preceding paragraph.…”

Section: Probability Of a Successful Sample With Assumption Of Spherimentioning

confidence: 99%

Toward 3D-guided prostate biopsy target optimization: an estimation of tumor sampling probabilities

et al. 2014

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Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the ~23% false negative rate of clinical 2D TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsy still yields false negatives. Therefore, we propose optimization of biopsy targeting to meet the clinician's desired tumor sampling probability, optimizing needle targets within each tumor and accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. We obtained multiparametric MRI and 3D TRUS images from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D surfaces that were registered to 3D TRUS. We estimated the probability, P, of obtaining a tumor sample with a single biopsy. Given an RMS needle delivery error of 3.5 mm for a contemporary fusion biopsy system, ≥ 95% for 21 out of 81 tumors when the point of optimal sampling probability was targeted. Therefore, more than one biopsy core must be taken from 74% of the tumors to achieve ≥ 95% for a biopsy system with an error of 3.5 mm. Our experiments indicated that the effect of error along the needle axis on the percentage of core involvement (and thus the measured tumor burden) was mitigated by the 18 mm core length.Keywords: Prostate cancer diagnosis, 3D guided biopsy planning, 3D ultrasound, 3D tumor shape, needle guidance error. DESCRIPTION OF PURPOSEProstate cancer (PCa) is the most common non-cutaneous cancer in North American men 1, 2 . The current clinical standard for PCa diagnosis is 2D transrectal ultrasound (TRUS)-guided biopsy. As PCa is seldom detectable on ultrasound, a systematic template commonly containing 6 or 12 cores is used to guide the biopsy needle. However, this approach has been shown to have an approximately 23% false negative rate and therefore many patients have to return to the clinic for repeat biopsies 3 . Additionally, this biopsy method may underestimate the true Gleason score of a patient's cancer. A 15 year clinical study involving 1670 men demonstrated that biopsy Gleason score was undergraded in 32% of the subjects, as compared to grading on radical prostatectomy specimens 4 .It has been shown that multiparametric MRI is effective for PCa detection and localisation 5 . To avoid the cost of in-bore MRI-guided biopsy, 3D TRUS-guided biopsy systems were developed to improve upon the spatial information of 2D TRUS and allow for MRI targeting via image registration. A 3D TRUS biopsy system with MRI-3D TRUS fusion ("fusion biopsy") produced significantly higher (p < 0.01) positive biopsy core rates, mean Gleason scores and tumor volume sampled, compared to 2D-TRUS guided 12-core systematic biopsy 6 . This approach demonstrated positive core rates of 30.4% and 42.3% for moderate and high suspicion lesions, respectively, improving upon the positive core rates of 2D TRUS-guided biopsy (7.1% and 25.6% for moderate and high suspicious lesions respectively) 6 . This m...

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“…First, van de Ven et al 6 estimated the maximum allowable target registration error of MRI-3D TRUS registration for correct Gleason grading of 95% of peripheral zone PCa with fusion biopsy of sphere-shaped tumors. Second, our previous study 7 took the perspective that for a fusion biopsy system with a given needle delivery error, some (larger) tumors can be sampled with a clinically desired probability (e.g.…”

Section: Description Of Purposementioning

confidence: 99%

Optimizing MRI-targeted fusion prostate biopsy: the effect of systematic error and anisotropy on tumor sampling

et al. 2015

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Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the 21-47% false negative rate of clinical 2D TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsy still has a substantial false negative rate. Therefore, we propose optimization of biopsy targeting to meet the clinician's desired tumor sampling probability, optimizing needle targets within each tumor and accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. As a step toward this optimization, we obtained multiparametric MRI (mpMRI) and 3D TRUS images from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D surfaces that were registered to 3D TRUS. We estimated the probability, , of obtaining a tumor sample with a single biopsy, and investigated the effects of systematic errors and anisotropy on . Our experiments indicated that a biopsy system's lateral and elevational errors have a much greater effect on sampling probabilities, relative to its axial error. We have also determined that for a system with RMS error of 3.5 mm, tumors of volume 1.9 cm 3 and smaller may require more than one biopsy core to ensure 95% probability of a sample with 50% core involvement, and tumors 1.0 cm 3 and smaller may require more than two cores.Keywords: Prostate cancer diagnosis, 3D guided biopsy planning, 3D ultrasound, 3D tumor shape, needle guidance error, anisotropic guidance error, systematic guidance error. DESCRIPTION OF PURPOSEThe current clinical standard for prostate cancer (PCa) diagnosis is 2D transrectal ultrasound (TRUS)-guided biopsy. As PCa is seldom detectable on ultrasound, a systematic template commonly containing 6 or 12 cores is used to guide the biopsy needle. However, this approach has been shown to have up to a 21-47% false negative rate and therefore many patients return to the clinic for repeat biopsies 1,2 . Additionally, this biopsy method may underestimate the true Gleason score of a patient's cancer 3 .It has been shown that mpMRI is effective for PCa detection and localisation 4 . To avoid the cost of in-bore MRIguided biopsy and enable widespread implementation in an office setting, 3D TRUS-guided biopsy systems were developed to improve upon the spatial information of 2D TRUS and allow for MRI targeting via image registration. A 3D TRUS biopsy system with MRI-3D TRUS fusion ("fusion biopsy") has been shown to produce significantly higher (p < 0.01) positive biopsy core rates, mean Gleason scores and tumor volumes sampled, compared to 2D-TRUS guided 12-core systematic biopsy 5 . Although fusion biopsy increased positive core rates, there is clinically significant room for further improvement. This approach may be further improved by investigating the overall uncertainty in delivering a biopsy needle to a point target within a 3D contour.There have been two recent studies that provide insight into potential avenues for impro...

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Simulated required accuracy of image registration tools for targeting high-grade cancer components with prostate biopsies

Cited by 39 publications

References 29 publications

Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis in Biopsy-naive Men with Suspected Prostate Cancer Based on Elevated Prostate-specific Antigen Values: Results from a Randomized Prospective Blinded Controlled Trial

Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis in Biopsy-naive Men with Suspected Prostate Cancer Based on Elevated Prostate-specific Antigen Values: Results from a Randomized Prospective Blinded Controlled Trial

Toward 3D-guided prostate biopsy target optimization: an estimation of tumor sampling probabilities

Optimizing MRI-targeted fusion prostate biopsy: the effect of systematic error and anisotropy on tumor sampling

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