Brachytherapy
Volume 5, Issue 1 , Pages 14-26, January 2006

Robotically assisted prostate brachytherapy with transrectal ultrasound guidance—Phantom experiments••

  • Gabor Fichtinger

      Affiliations

    • Engineering Research Center, The Johns Hopkins University, Baltimore, MD
    • Corresponding Author InformationCorresponding author. Engineering Research Center, The Johns Hopkins University, New Engineering Bldg, Room B26, 3400 North Charles Street, Baltimore, MD 21218-2682. Tel.: +1-410-516-4057; Mobile: +1-410-562-6955; fax: +1-410-516-5553.
    • ,
  • Everette C. Burdette

      Affiliations

    • Acoustic MedSystems, Inc., Urbana-Champaign, IL
    • ,
  • Attila Tanacs

      Affiliations

    • Engineering Research Center, The Johns Hopkins University, Baltimore, MD
    • ,
  • Alexandru Patriciu

      Affiliations

    • Engineering Research Center, The Johns Hopkins University, Baltimore, MD
    • Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, MD
    • ,
  • Dumitru Mazilu

      Affiliations

    • Brady Urological Institute, The Johns Hopkins University, Baltimore, MD
    • ,
  • Louis L. Whitcomb

      Affiliations

    • Engineering Research Center, The Johns Hopkins University, Baltimore, MD
    • Department of Mechanical Engineering, The Johns Hopkins University, Baltimore, MD
    • ,
  • Dan Stoianovici

      Affiliations

    • Engineering Research Center, The Johns Hopkins University, Baltimore, MD
    • Brady Urological Institute, The Johns Hopkins University, Baltimore, MD

Received 29 July 2005; received in revised form 28 October 2005; accepted 31 October 2005.

Abstract 

Purpose

To report the preliminary experimental results obtained with a robot-assisted transrectal ultrasound (TRUS)–guided prostate brachytherapy system.

Methods and materials

The system consists of a TRUS unit, a spatially coregistered needle insertion robot, and an FDA-approved treatment planning and image-registered implant system. The robot receives each entry/target coordinate pair of the implant plan, inserts a preloaded needle, and then the seeds are deposited. The needles/sources are tracked in TRUS, thus allowing the plan to be updated as the procedure progresses.

Results

The first insertion attempt was recorded for each needle, without adjustment. All clinically relevant locations were reached in a prostate phantom. Nonparallel and parallel needle trajectories were demonstrated. Based on TRUS, the average transverse placement error was 2mm (worst case 2.5mm, 80% less than 2mm), and the average sagittal error was 2.5mm (worst case 5.0mm, 70% less than 2.5mm).

Conclusions

The concept and technical viability of robot-assisted brachytherapy were demonstrated in phantoms. The kinematically decoupled robotic assistant device is inherently safe. Overall performance was promising, but further optimization is necessary to prove the possibility of improved dosimetry.

Keywords: Prostate, Brachytherapy, Ultrasound, Image guidance, Robotics

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• In this paper we make extensive reference to the Interplant brachytherapy system manufactured by Computerized Medical Systems (St. Louis, MO). At the time of this research, E. Clif Burdette, PhD, was an employee of the company and before that an employee of Burdette Medical Systems, Inc. No current financial interest exists.

• The robotic devices employed in this research include patented inventions of Stoianovici, Whitcomb, and other JHU personnel, with all rights assigned to The Johns Hopkins University. The patent portfolio has been licensed to Image Guide, Inc., Wilmington, DE, in which Dr. Stoianovici has financial interest.

PII: S1538-4721(06)00002-X

doi:10.1016/j.brachy.2005.10.003

Brachytherapy
Volume 5, Issue 1 , Pages 14-26, January 2006

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