Qian Li1, Yu Duan2, Masoud Baikpour3, Theodore T Pierce3, Colin J McCarthy4, Ashraf Thabet3, Suk-Tak Chan5, Anthony E Samir6. 1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA. Electronic address: li.qian@mgh.harvard.edu. 2. Department of Medical Ultrasonics, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Rd, Yuexiu District, Guangzhou, Guangdong, 510080, China. Electronic address: kilody@foxmail.com. 3. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA. 4. Interventional Radiology, the University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1471, Houston, TX, 77030, USA. 5. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 Thirteenth Street, Charlestown, MA, 02129, USA. 6. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA. Electronic address: ASAMIR@mgh.harvard.edu.
Abstract
PURPOSE: To investigate whether the 2-seed placement per Magnetic Resonance Imaging (MRI) suspicious lesion yields a higher seed placement accuracy than a 1-seed strategy on a phantom. METHODS: Eight olives embedded in gelatin, each simulating a prostate, underwent MRI. Three virtual spherical lesions (3, 5, and 8 mm diameters) were marked in each olive on the MRI images and co-registered to the MRI/Transrectal Ultrasonography (TRUS) fusion biopsy system. Two radiologists placed 0.5 mm fiducials, targeting the center of each virtual lesion under fusion image guidance. Half of the 8 olives in each phantom were assigned either to the 1-seed or 2-seeds per lesion strategy. Post-procedure Computed Tomography (CT) images identified each seed and were fused with MR to localize each virtual lesion and collected the seed placement error - distance between the virtual target and the corresponding seed (using the closer seed for the 2-seed strategy). Seed placement success is defined as fiducial placement within a lesion boundary. RESULTS: Each operator repeated the procedure on three different phantoms, and data from 209 seeds placed for 137 lesions were analyzed, with an overall error of 3.03 ± 1.52 mm. The operator skill, operator phantom procedural experience, lesion size, and number of seeds, were independently associated with the seed placement error. Seed placement success rate was higher for the 2-seed group compared to 1-seed, although the difference was not statistically significant. CONCLUSIONS: Placing 2 seeds per MRI lesion yielded a significantly lower error compared to 1-seed strategy, although seed placement success rate was not significantly different.
PURPOSE: To investigate whether the 2-seed placement per Magnetic Resonance Imaging (MRI) suspicious lesion yields a higher seed placement accuracy than a 1-seed strategy on a phantom. METHODS: Eight olives embedded in gelatin, each simulating a prostate, underwent MRI. Three virtual spherical lesions (3, 5, and 8 mm diameters) were marked in each olive on the MRI images and co-registered to the MRI/Transrectal Ultrasonography (TRUS) fusion biopsy system. Two radiologists placed 0.5 mm fiducials, targeting the center of each virtual lesion under fusion image guidance. Half of the 8 olives in each phantom were assigned either to the 1-seed or 2-seeds per lesion strategy. Post-procedure Computed Tomography (CT) images identified each seed and were fused with MR to localize each virtual lesion and collected the seed placement error - distance between the virtual target and the corresponding seed (using the closer seed for the 2-seed strategy). Seed placement success is defined as fiducial placement within a lesion boundary. RESULTS: Each operator repeated the procedure on three different phantoms, and data from 209 seeds placed for 137 lesions were analyzed, with an overall error of 3.03 ± 1.52 mm. The operator skill, operator phantom procedural experience, lesion size, and number of seeds, were independently associated with the seed placement error. Seed placement success rate was higher for the 2-seed group compared to 1-seed, although the difference was not statistically significant. CONCLUSIONS: Placing 2 seeds per MRI lesion yielded a significantly lower error compared to 1-seed strategy, although seed placement success rate was not significantly different.
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