Nathanael Kuo1, Ehsan Dehghan2, Anton Deguet3, Omar Y Mian4, Yi Le4, E Clif Burdette5, Gabor Fichtinger6, Jerry L Prince1, Danny Y Song4, Junghoon Lee7. 1. Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21218. 2. Philips Research North America, Briarcliff Manor, New York 10510. 3. Department of Computer Science, Johns Hopkins University, Baltimore, Maryland 21218. 4. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231. 5. Acoustic MedSystems Inc., Savoy, Illinois 61974. 6. School of Computing, Queen's University, Kingston, Ontario K7L3N6, Canada. 7. Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21218 and Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231.
Abstract
PURPOSE: Brachytherapy is a standard option of care for prostate cancer patients but may be improved by dynamic dose calculation based on localized seed positions. The American Brachytherapy Society states that the major current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. An image-guidance system was therefore developed to localize seeds for dynamic dose calculation. METHODS: The proposed system is based on transrectal ultrasound (TRUS) and mobile C-arm fluoroscopy, while using a simple fiducial with seed-like markers to compute pose from the nonencoded C-arm. Three or more fluoroscopic images and an ultrasound volume are acquired and processed by a pipeline of algorithms: (1) seed segmentation, (2) fiducial detection with pose estimation, (3) seed matching with reconstruction, and (4) fluoroscopy-to-TRUS registration. RESULTS: The system was evaluated on ten phantom cases, resulting in an overall mean error of 1.3 mm. The system was also tested on 37 patients and each algorithm was evaluated. Seed segmentation resulted in a 1% false negative rate and 2% false positive rate. Fiducial detection with pose estimation resulted in a 98% detection rate. Seed matching with reconstruction had a mean error of 0.4 mm. Fluoroscopy-to-TRUS registration had a mean error of 1.3 mm. Moreover, a comparison of dose calculations between the authors' intraoperative method and an independent postoperative method shows a small difference of 7% and 2% forD90 and V100, respectively. Finally, the system demonstrated the ability to detect cold spots and required a total processing time of approximately 1 min. CONCLUSIONS: The proposed image-guidance system is the first practical approach to dynamic dose calculation, outperforming earlier solutions in terms of robustness, ease of use, and functional completeness.
PURPOSE: Brachytherapy is a standard option of care for prostate cancerpatients but may be improved by dynamic dose calculation based on localized seed positions. The American Brachytherapy Society states that the major current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. An image-guidance system was therefore developed to localize seeds for dynamic dose calculation. METHODS: The proposed system is based on transrectal ultrasound (TRUS) and mobile C-arm fluoroscopy, while using a simple fiducial with seed-like markers to compute pose from the nonencoded C-arm. Three or more fluoroscopic images and an ultrasound volume are acquired and processed by a pipeline of algorithms: (1) seed segmentation, (2) fiducial detection with pose estimation, (3) seed matching with reconstruction, and (4) fluoroscopy-to-TRUS registration. RESULTS: The system was evaluated on ten phantom cases, resulting in an overall mean error of 1.3 mm. The system was also tested on 37 patients and each algorithm was evaluated. Seed segmentation resulted in a 1% false negative rate and 2% false positive rate. Fiducial detection with pose estimation resulted in a 98% detection rate. Seed matching with reconstruction had a mean error of 0.4 mm. Fluoroscopy-to-TRUS registration had a mean error of 1.3 mm. Moreover, a comparison of dose calculations between the authors' intraoperative method and an independent postoperative method shows a small difference of 7% and 2% forD90 and V100, respectively. Finally, the system demonstrated the ability to detect cold spots and required a total processing time of approximately 1 min. CONCLUSIONS: The proposed image-guidance system is the first practical approach to dynamic dose calculation, outperforming earlier solutions in terms of robustness, ease of use, and functional completeness.
Authors: Junghoon Lee; Christian Labat; Ameet K Jain; Danny Y Song; Everette Clif Burdette; Gabor Fichtinger; Jerry L Prince Journal: IEEE Trans Med Imaging Date: 2010-07-19 Impact factor: 10.048
Authors: Brian J Davis; Eric M Horwitz; W Robert Lee; Juanita M Crook; Richard G Stock; Gregory S Merrick; Wayne M Butler; Peter D Grimm; Nelson N Stone; Louis Potters; Anthony L Zietman; Michael J Zelefsky Journal: Brachytherapy Date: 2012 Jan-Feb Impact factor: 2.362
Authors: Nathanael Kuo; Anton Deguet; Danny Y Song; Everette C Burdette; Jerry L Prince; Junghoon Lee Journal: Med Eng Phys Date: 2011-07-29 Impact factor: 2.242
Authors: Ehsan Dehghan; Junghoon Lee; Pascal Fallavollita; Nathanael Kuo; Anton Deguet; Yi Le; E Clif Burdette; Danny Y Song; Jerry L Prince; Gabor Fichtinger Journal: Med Image Anal Date: 2012-06-16 Impact factor: 8.545
Authors: Junghoon Lee; Omar Y Mian; Yi Le; Hee Joon Bae; E Clif Burdette; Theodore L DeWeese; Jerry L Prince; Daniel Y Song Journal: Radiother Oncol Date: 2017-06-21 Impact factor: 6.280
Authors: Tanmay Singh; Junghoon Lee; Marianna Zahurak; Hee Joon Bae; Tamey Habtu; Robert Hobbs; Yi Le; Everette C Burdette; Daniel Y Song Journal: Pract Radiat Oncol Date: 2021-03-13