Accuracy of Elastic Fusion of Prostate Magnetic Resonance and Transrectal Ultrasound Images under Routine Conditions: A Prospective Multi-Operator StudyReportar como inadecuado




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Purpose

To evaluate in unselected patients imaged under routine conditions the co-registration accuracy of elastic fusion between magnetic resonance MR and ultrasound US images obtained by the Koelis Urostation™.

Materials and Methods

We prospectively included 15 consecutive patients referred for placement of intraprostatic fiducials before radiotherapy and who gave written informed consent by signing the Institutional Review Board-approved forms. Three fiducials were placed in the prostate under US guidance in standardized positions right apex, left mid-gland, right base using the Koelis Urostation™. Patients then underwent prostate MR imaging. Four operators outlined the prostate on MR and US images and an elastic fusion was retrospectively performed. Fiducials were used to measure the overall target registration error TRE3D, the error along the antero-posterior TREAP, right-left TRERL and head-feet TREHF directions, and within the plane orthogonal to the virtual biopsy track TRE2D.

Results

Median TRE3D and TRE2D were 3.8–5.6 mm, and 2.5–3.6 mm, respectively. TRE3D was significantly influenced by the operator p = 0.013, fiducial location p = 0.001 and 3D axis orientation p<0.0001. The worst results were obtained by the least experienced operator. TRE3D was smaller in mid-gland and base than in apex average difference: -1.21 mm 95% confidence interval 95%CI: -2.03; -0.4 and -1.56 mm 95%CI: -2.44; -0.69 respectively. TREAP and TREHF were larger than TRERL average difference: +1.29 mm 95%CI: +0.87; +1.71 and +0.59 mm 95%CI: +0.1; +0.95 respectively.

Conclusions

Registration error values were reasonable for clinical practice. The co-registration accuracy was significantly influenced by the operator’s experience, and significantly poorer in the antero-posterior direction and at the apex.



Autor: Paul Moldovan, Corina Udrescu, Emmanuel Ravier, Rémi Souchon, Muriel Rabilloud, Flavie Bratan, Thomas Sanzalone, Fanny Cros, Sé

Fuente: http://plos.srce.hr/



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