A Mechatronic Needle Guidance System for Prostate-Specific Positron Emission Tomography and 3D Transrectal Ultrasound-Guided Trans-perineal Prostate Biopsy

Abstract

Prostate cancer (PCa) is the most frequent cancer in men in Canada which the underlines importance of the devel- opment of new methods for diagnosis. The current study pre- sents a mechatronic needle guidance system which is to be used in conjunction with a prostate specific PET (P-PET) system and 3D transrectal ultrasound (TRUS) for trans-perineal prostate biopsy. The system consists of a motorized 3D TRUS system for the generation of volumetric images, a tracking arm for target- ing and a needle guidance device for needle placement and re- positioning. The mechatronic needle guidance system includes a needle template which is capable of two-dimensional manual translation, and it helps in the alignment of the needle with the P-PET defined lesions in real time with the help of TRUS. To coordinate the biopsy, a functional and anatomic imaging from P-PET and 3D TRUS were co-registered with the help of a land- mark-based registration method. The system was assessed us- ing a phantom which was designed to simulate the prostate gland with artificial lesions and the outcomes indicated that the needle path planning and placement was accurate with a mean guidance error of 0.85 ± 0.22 mm. This innovation incorporates the 3D TRUS imaging technology and the P-PET functional in- formation and the mechatronic needle guidance system for ac- curate and efficient needle placement. This paper aims at over- coming the challenges that are associated with 2D TRUS-guided techniques; hence it reduces false negative rates, the rates of re- peat procedures, and improves the identification of the early stage and high-grade PCa. Further research will concentrate in- teroperability, on the enhancement of the needle system’s guid- ance system to achieve better accuracy and the assessment of the system in clinical trials as a diagnostic and therapeutic tool in prostate cancer.