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Incorporating PET/CT Images Into 3D Ultrasound-Guided Biopsy of the Prostate

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B Fei

B Fei*, D Schuster, V Master, P Nieh, Emory University, Altanta, GA

TU-A-BRA-2 Tuesday 8:00:00 AM - 9:55:00 AM Room: Ballroom A

Purpose: Prostate cancer is the second leading cause of cancer mortality in American men. Systematic transrectal ultrasound (TRUS)-guided prostate biopsy is considered as the standard method for prostate cancer detection. The current biopsy technique has a significant sampling error and can miss up to 30% of cancers. As a result, a patient may be informed of a negative biopsy result but may in fact be harboring an occult early-stage cancer because the current ultrasound imaging technology has difficulty to differentiate carcinoma from benign prostate tissue and because the current TRUS-guided biopsy is blind and random. We are developing methods to combine PET/CT with three-dimensional (3D) ultrasound images for targeted biopsy of the prostate with the aim of improving cancer detection rate.

Methods: The 3D ultrasound-guided biopsy system consists of a 3D mechanical localization system and software workstation for image segmentation, registration, and biopsy planning. For PET imaging, we use a new molecular imaging tracer called anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid ([F18]FACBC) that has shown promising results for detecting and localizing prostate cancer in our human clinical trials. In order to plan biopsy, we developed a 3D, automatic segmentation method for the prostate ultrasound images. In order to incorporate PET/CT images into ultrasound-guided biopsy, we developed image registration methods to fuse TRUS and PET/CT images.

Results: The segmentation method was tested in ten patients with a DICE overlap ratio of 92.4% ± 1.1 %. The registration method has been tested in phantoms. The biopsy system was tested in prostate phantoms. Three-dimensional ultrasound images were acquired from four human patients. We are integrating the system for PET/CT directed, 3D ultrasound-guided, targeted biopsy in human patients.

Conclusions: A PET/CT image-directed, 3D ultrasound-guided biopsy system has been developed for the prostate.

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