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Testing 3D Ultrasound with Image-Guided Robotics for Prostate Brachytherapy. Nathaniel Hayward Department of Medical Biophysics The University of Western Ontario. Supervisor: Aaron Fenster. Prostate Cancer. The most commmon non-skin cancer among Canadian men

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Presentation Transcript
slide1

Testing 3D Ultrasound with Image-Guided Robotics for Prostate Brachytherapy

Nathaniel Hayward

Department of Medical Biophysics

The University of Western Ontario

Supervisor: Aaron Fenster

slide2

Prostate Cancer

  • The most commmon non-skin cancer among Canadian men
    • 25, 500 men will be diagnosed this year
    • 4, 400 of these cases will be fatal
  • Treatments of Prostate Cancer
    • Irradiation of Prostate Externally:
      • Troubled Urination, Irritation
    • Complete Prostatectomy:
      • Incontinence, Impotence, Altered Bowel Habits
    • Prostate Brachytherapy:
      • Troubled Urination (Short-Term),Impotence
slide3

Standard Brachytherapy Procedures

Needle Pre-Loaded with Iodine25 Seeds

Bladder

slide4

Prostate Brachytherapy

  • Used to treat early localised prostate cancer tumours
  • Utilises implantation of radioactive seeds
    • Seeds deliver a local high-dose radiation that decreases
  • Less damaging than other irradiation techniques as the seeds are implanted directly into the prostate
slide6

3-D Ultrasound Method

  • Sound Waves sent and received at different angles
  • Returning echoes are processed by a computer which reconstructs a 3-D image
  • Works much like a CT scan that utilises multiple x-rays (true image)
slide8

Image Quality vs. Real-Time

  • There is a trade-off between quality and how fast the image is processed.
  • Why is this important?
slide9

The Problem

  • Needles are guided parallel to TRUS transducer
    • 5mm increments limit lateral positioning
  • Prostate changes position during procedure
    • Need constant adjustment, Labour intensive for physician
  • Enlarge Prostates – sections occluded by patients pubic arch
    • Parallel insertion completely miss these areas and lead to insufficient dose coverage
slide10

Prostate Phantom Testing

  • Allows for testing of brachytherapy procedures
  • Prostate mold is cast from a stereo-lithograph of a real patient
  • Mold injected with molten agar and left to cool (Clear)
  • Background agar is created to fill the rest of the box (Opaque)
slide11

The Solution

  • Image-guided robotics receiving real-time updates
    • Removes problem of pubic arch interference
  • Previous Attempts have distinct advantages
    • Respective procedures are still invasive
  • Current project utilises physician
    • Robot loads, and positions needle

Needle

Needle

slide12

Robot Accuracy

  • Evaluation of Mean Target Accuracy involves:
    • Guide the needle to a 3D target
    • Record the location of the needle within the image
slide14

Robot Accuracy

  • Needle accuracy of actual target vs. “true” measurement and measurement using 3D-guided Robotics
slide15

Future Work

  • Testing on human subjects
    • Give a better feel for different sized prostates and accuracies
  • Reduce the size of the robot
    • Portability, Improve physician accuracy
  • Improve design to work with larger angles
    • Increases success of brachytherapy especially in patients with enlarged prostates
acknowledgements
Acknowledgements
  • Aaron Fenster - Supervisor
  • Adam Krasinski- Supervisor
  • Jeffrey Bax
  • David Smith
  • Laura Bartha
  • Jacques Montreuil
  • Shi Sherebrin
  • Lori Gardi
  • ChandimaEdirisinghe
slide17

References

  • Bax J, Fenster A, Montreuil J, Gardi L, Smith D. Apparatus And Method For Guiding Insertion of a Medical Tool. US Patent Application No: 11/427,121: Filed June 28, 2007 (Pending).
  • Fenster A, Downey DB, Cardinal HN. Three-dimensional ultrasound imaging. Physics in Medicine & Biology. 2001 ;46R67-R99.
  • D.W. Rickey, P.A. Picot, D.A. Christopher, and A. Fenster, “A Wall-less Vessel Phantom for Doppler Ultrasound Studies,” Ultrasound in Med. & Biol 21(9), pp.1163-1176, 1995.