@article {Krieger2007a, title = {Design and preliminary accuracy studies of an MRI-guided transrectal prostate intervention system}, journal = {Medical image computing and computer-assisted intervention (MICCAI)}, volume = {10}, number = {Pt 2}, year = {2007}, pages = {59{\textendash}67}, publisher = {Department of Mechanical Engineering, Johns Hopkins University, Baltimore, USA}, abstract = {

This paper reports a novel system for magnetic resonance imaging (MRI) guided transrectal prostate interventions, such as needle biopsy, fiducial marker placement, and therapy delivery The system utilizes a hybrid tracking method, comprised of passive fiducial tracking for initial registration, subsequent incremental motion measurement along the degrees of freedom using fiber-optical encoders, mechanical scales Targeting accuracy of the system is evaluated in prostate phantom experiments Achieved targeting accuracy, procedure times were found to compare favorably with existing systems using passive, active tracking methods Moreover, the portable design of the system using only standard MRI image sequences, minimal custom scanner interfacing allows the system to be easily used on different MRI scanners

}, keywords = {Algorithms, Artificial Intelligence, Automated, Biopsy, Computer-Assisted, Equipment Design, Equipment Failure Analysis, Humans, Image Enhancement, Image Interpretation, Imaging, instrumentation/methods, Interventional, Magnetic Resonance Imaging, Male, methods, Needle, pathology/surgery, Pattern Recognition, Pilot Projects, Prostatectomy, Prostatic Neoplasms, Rectum, Reproducibility of Results, Robotics, Sensitivity, Specificity, Three-Dimensional, User-Computer Interface}, author = {Axel Krieger and Csaba Csoma and Iulian Iordachita and Peter Guion and Anurag K. Singh and Gabor Fichtinger and Whitcomb, Louis L.} } @article {Fichtinger2006, title = {Robotically assisted prostate brachytherapy with transrectal ultrasound guidance{\textendash}Phantom experiments}, journal = {Brachytherapy}, volume = {5}, number = {1}, year = {2006}, pages = {14{\textendash}26}, publisher = {Engineering Research Center, The Johns Hopkins University, Baltimore, MD 21218-2682, USA gabor@cs jhu edu}, 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, 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, parallel needle trajectories were demonstrated Based on TRUS, the average transverse placement error was 2 mm (worst case 2 5 mm, 80\% less than 2 mm), and the average sagittal error was 2 5 mm (worst case 5 0 mm, 70\% less than 2 5 mm) CONCLUSIONS: The concept, 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 = {Anatomic, Brachytherapy, Endosonography, Equipment Design, Humans, instrumentation, Male, methods, Models, Prostatic Neoplasms, radiotherapy/ultrasonography, Rectum, Robotics}, doi = {10 1016/j brachy 2005 10 003}, url = {http://dx doi org/10 1016/j brachy 2005 10 003}, author = {Gabor Fichtinger and E. Clif Burdette and Attila Tanacs and Alexandru Patriciu and Dumitru Mazilu and Whitcomb, Louis L. and Dan Stoianovici} } @article {Susil2006, title = {Transrectal prostate biopsy and fiducial marker placement in a standard 1 5T magnetic resonance imaging scanner}, journal = {The Journal of Urology}, volume = {175}, number = {1}, year = {2006}, month = {Jan}, pages = {113{\textendash}120}, publisher = {Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA}, abstract = {

PURPOSE: We investigated the accuracy, feasibility of a system that provides transrectal needle access to the prostate concurrent with 1 5 Tesla MRI which previously has not been possible MATERIALS AND METHODS: In 5 patients with previously diagnosed prostate cancer, MRI guided intraprostatic placement of gold fiducial markers (4 procedures),/or prostate biopsy (3 procedures) was performed using local anesthesia RESULTS: Mean procedure duration was 76 minutes, all patients tolerated the intervention well Procedure related adverse events included self-limited hematuria, hematochezia following 3 of 8 procedures (all resolved in less than 1 week) Mean needle placement accuracy was 1 9 mm for the fiducial marker placement studies, 1 8 mm for the biopsy procedures Mean fiducial marker placement accuracy was 4 8 mm, the mean fiducial marker placement accuracy transverse to the needle direction was 2 6 mm All patients who underwent the procedure were able to complete their course of radiotherapy without delay or complication CONCLUSIONS: While studies of clinical usefulness are warranted, transrectal 1 5 T MRI guided prostate biopsy, fiducial marker placement is feasible using this system, providing new opportunities for image guided diagnostic, therapeutic prostate interventions

}, keywords = {Biopsy, Equipment Design, Feasibility Studies, Humans, instrumentation, instrumentation/methods, Magnetic Resonance Imaging, Male, Needle, pathology, Prostate, Prostatic Neoplasms}, doi = {10 1016/S0022-5347(05)00065-0}, url = {http://dx doi org/10 1016/S0022-5347(05)00065-0}, author = {Robert Susil and Cynthia Menard and Axel Krieger and Jonathan Coleman and Kevin Camphausen and Peter Choyke and Gabor Fichtinger and Whitcomb, Louis L. and Norman Coleman and Ergin Atalar} }