Prostate biopsy is considered as a definitive way for diagnosing prostate malignancies. Urologists are currently moving towards MR-guided prostate biopsies over conventional transrectal ultrasound-guided biopsies for prostate cancer detection. Recently, robotic systems have started to emerge as an assistance tool for urologists to perform MR-guided prostate biopsies. However, these robotic assistance systems are designed for a specific clinical environment and cannot be adapted to modifications or changes applied to the clinical setting and/or workflow. This work presents the preliminary design of a cable-driven manipulator developed to be used in both MR scanners and MR-ultrasound fusion systems. The proposed manipulator design and functionality are evaluated on a simulated virtual environment. The simulation is created on an in-house developed interventional planning software to evaluate the ergonomics and usability. The results show that urologists can benefit from the proposed design of the manipulator and planning software to accurately perform biopsies of targeted areas in the prostate.
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End‐user evaluation of software‐generated intervention planning environment for transrectal magnetic resonance‐guided prostate biopsies
This study presents user evaluation studies to assess the effect of information rendered by an interventional planning software on the operator's ability to plan transrectal magnetic resonance (MR)‐guided prostate biopsies using actuated robotic manipulators.
An intervention planning software was developed based on the clinical workflow followed for MR‐guided transrectal prostate biopsies. The software was designed to interface with a generic virtual manipulator and simulate an intervention environment using 2D and 3D scenes. User studies were conducted with urologists using the developed software to plan virtual biopsies.
User studies demonstrated that urologists with prior experience in using 3D software completed the planning less time. 3D scenes were required to control all degrees‐of‐freedom of the manipulator, while 2D scenes were sufficient for planar motion of the manipulator.
The study provides insights on using 2D versus 3D environment from a urologist's perspective for different operational modes of MR‐guided prostate biopsy systems.
- Award ID(s):
- 1646566
- NSF-PAR ID:
- 10454364
- Publisher / Repository:
- Wiley Blackwell (John Wiley & Sons)
- Date Published:
- Journal Name:
- The International Journal of Medical Robotics and Computer Assisted Surgery
- Volume:
- 17
- Issue:
- 1
- ISSN:
- 1478-5951
- Page Range / eLocation ID:
- p. 1-12
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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null (Ed.)This work presents an interventional planning software to be used in conjunction with a robotic manipulator to perform transrectal MR guided prostate biopsies. The interventional software was designed taking in consideration a generic manipulator used under the two modes of operation: side-firing and end-firing of the biopsy needle. Studies were conducted with urologists using the software to plan virtual biopsies. The results show features of software relevant for operating efficiently under the two modes of operation.more » « less
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Abstract Background User interfaces play a vital role in the planning and execution of an interventional procedure. The objective of this study is to investigate the effect of using different user interfaces for planning transrectal robot‐assisted MR‐guided prostate biopsy (MRgPBx) in an augmented reality (AR) environment.
Method End‐user studies were conducted by simulating an MRgPBx system with end‐ and side‐firing modes. The information from the system to the operator was rendered on HoloLens as an output interface. Joystick, mouse/keyboard, and holographic menus were used as input interfaces to the system.
Results The studies indicated that using a joystick improved the interactive capacity and enabled operator to plan MRgPBx in less time. It efficiently captures the operator's commands to manipulate the augmented environment representing the state of MRgPBx system.
Conclusions The study demonstrates an alternative to conventional input interfaces to interact and manipulate an AR environment within the context of MRgPBx planning.
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Abstract Prostate cancer treatment planning is largely dependent upon examination of core-needle biopsies. The microscopic architecture of the prostate glands forms the basis for prognostic grading by pathologists. Interpretation of these convoluted three-dimensional (3D) glandular structures via visual inspection of a limited number of two-dimensional (2D) histology sections is often unreliable, which contributes to the under- and overtreatment of patients. To improve risk assessment and treatment decisions, we have developed a workflow for nondestructive 3D pathology and computational analysis of whole prostate biopsies labeled with a rapid and inexpensive fluorescent analogue of standard hematoxylin and eosin (H&E) staining. This analysis is based on interpretable glandular features and is facilitated by the development of image translation–assisted segmentation in 3D (ITAS3D). ITAS3D is a generalizable deep learning–based strategy that enables tissue microstructures to be volumetrically segmented in an annotation-free and objective (biomarker-based) manner without requiring immunolabeling. As a preliminary demonstration of the translational value of a computational 3D versus a computational 2D pathology approach, we imaged 300 ex vivo biopsies extracted from 50 archived radical prostatectomy specimens, of which, 118 biopsies contained cancer. The 3D glandular features in cancer biopsies were superior to corresponding 2D features for risk stratification of patients with low- to intermediate-risk prostate cancer based on their clinical biochemical recurrence outcomes. The results of this study support the use of computational 3D pathology for guiding the clinical management of prostate cancer.
Significance: An end-to-end pipeline for deep learning–assisted computational 3D histology analysis of whole prostate biopsies shows that nondestructive 3D pathology has the potential to enable superior prognostic stratification of patients with prostate cancer.
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Abstract Background Percutaneous coronary interventions (PCIs) within left main coronary arteries are high-risk procedures that require optimization of interactions between stent(s) and diseased vessels. Optical Coherence Tomography (OCT) is a widely accepted tool that enhances physicians’ ability to assess proper stent appositions during clinical procedures. The primary aim of this study was to develop complementary post-procedure imaging methodologies to better assess and interpret outcomes of left main PCI procedures, utilizing both reanimated and perfusion-fixed human hearts.
Methods PCIs were performed while obtaining OCT scans within the left main anatomies of six human hearts. Subsequently, each heart was scanned with a micro-CT scanner with optimized parameters to achieve resolutions up to 20 µm. Scans were reconstructed and imported into a DICOM segmentation software to generate computational models of implanted stents and associated coronary vessels. 2D images from OCT that were obtained during PCIs were compared to the 3D models generated from micro-CT reconstructions. In addition, the 3D models were utilized to create virtual reality scenes and enlarged 3D prints for development of “mixed reality” tools relative to bifurcation stenting within human left main coronary arteries.
Results We developed reproducible methodologies for post-implant analyses of coronary artery stenting procedures. In addition, we generated high-resolution 3D computational models, with ~ 20-micron resolutions, of PCIs performed within reanimated and perfusion-fixed heart specimens.
Conclusions Generated computational models of left main PCIs performed in isolated human hearts can be used to obtain detailed measurements that provide further clinical insights on procedural outcomes. The 3D models from these procedures are useful for generating virtual reality scenes and 3D prints for physician training and education.
