Multimodal image-guided prostate fusion biopsy based on automatic deformable registration.

PURPOSE: Transrectal ultrasound (TRUS)-guided random prostate biopsy is, in spite of its low sensitivity, the gold standard for the diagnosis of prostate cancer. The recent advent of PET imaging using a novel dedicated radiotracer, [Formula: see text]-labeled prostate-specific membrane antigen (PSMA), combined with MRI provides improved pre-interventional identification of suspicious areas. This work proposes a multimodal fusion image-guided biopsy framework that combines PET-MRI images with TRUS, using automatic segmentation and registration, and offering real-time guidance. METHODS: The prostate TRUS images are automatically segmented with a Hough transform-based random forest approach. The registration is based on the Coherent Point Drift algorithm to align surfaces elastically and to propagate the deformation field calculated from thin-plate splines to the whole gland. RESULTS: The method, which has minimal requirements and temporal overhead in the existing clinical workflow, is evaluated in terms of surface distance and landmark registration error with respect to the clinical ground truth. Evaluations on agar-gelatin phantoms and clinical data of 13 patients confirm the validity of this approach. CONCLUSION: The system is able to successfully map suspicious regions from PET/MRI to the interventional TRUS image.

3D velocity field and flow profile reconstruction from arbitrarily sampled Doppler ultrasound data.

With the need for adequate analysis of blood flow dynamics, different maging modalities have been developed to measure varying blood velocities over time. Due to its numerous advantages, Doppler ultrasound sonography remains one of the most widely used techniques in clinical routine, but requires additional preprocessing to recover 3D velocity information. Despite great progress in the last years, recent approaches do not jointly consider spatial and temporal variation in blood flow. In this work, we present a novel gating- and compounding-free method to simultaneously reconstruct a 3D velocity field and a temporal flow profile from arbitrarily sampled Doppler ultrasound measurements obtained from multiple directions. Based on a laminar flow assumption, a patch-wise B-spline formulation of blood velocity is coupled for the first time with a global waveform model acting as temporal regularization. We evaluated our method on three virtual phantom datasets, demonstrating robustness in terms of noise, angle between measurements and data sparsity, and applied it successfully to five real case datasets of carotid artery examination.

Predicate-Based Focus-and-Context Visualization for 3D Ultrasound.

Direct volume visualization techniques offer powerful insight into volumetric medical images and are part of the clinical routine for many applications. Up to now, however, their use is mostly limited to tomographic imaging modalities such as CT or MRI. With very few exceptions, such as fetal ultrasound, classic volume rendering using one-dimensional intensity-based transfer functions fails to yield satisfying results in case of ultrasound volumes. This is particularly due its gradient-like nature, a high amount of noise and speckle, and the fact that individual tissue types are rather characterized by a similar texture than by similar intensity values. Therefore, clinicians still prefer to look at 2D slices extracted from the ultrasound volume. In this work, we present an entirely novel approach to the classification and compositing stage of the volume rendering pipeline, specifically designed for use with ultrasonic images. We introduce point predicates as a generic formulation for integrating the evaluation of not only low-level information like local intensity or gradient, but also of high-level information, such as non-local image features or even anatomical models. Thus, we can successfully filter clinically relevant from non-relevant information. In order to effectively reduce the potentially high dimensionality of the predicate configuration space, we propose the predicate histogram as an intuitive user interface. This is augmented by a scribble technique to provide a comfortable metaphor for selecting predicates of interest. Assigning importance factors to the predicates allows for focus-and-context visualization that ensures to always show important (focus) regions of the data while maintaining as much context information as possible. Our method naturally integrates into standard ray casting algorithms and yields superior results in comparison to traditional methods in terms of visualizing a specific target anatomy in ultrasound volumes.