2010 Winter Project Week MRI Guided Robotic Prostate Intervention

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  Projects List

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  A screenshot of the current version of the ProstateNav module during a phantom experiment

Key Investigators

• Andras Lasso (Queen's University)
• Junichi Tokuda (BWH)

Objective

We will continue to develop 3D Slicer's ProstateNav module for MRI-compatible devices for transrectal and transperineal prostate interventions. Based on our experiments in Fall 2009, we will improve the usability and stability of the module and prepare for clinical trials of transperineal device planned in Spring 2010.

Approach, Plan

A few complex developments (details to be specified) is planned to be completed during the project week.

Progress

The current version of the module is already tested in a few phantom experiments. Further improvements are needed to make the module usable in clinical trials.

• Evaluated Bug/Feature list and organized plans
  • Slicer bugs/feature requests entered into Mantis
  • DICOM Files reviewed:
    • Multiframe dicom images appear not to have spacing, position, and orientation parsed correctly in ITK
    • Slicer GUI has bad performance on large DICOM directories with many series
    • New features for sorting DICOM files to subdirectories will help and have general utility.
• Several minor fixes and enhancements in the ProstateNav module
• Adding support for a third biopsy device (transperineal template) has been partially completed.

References

• Lasso, A., J. Tokuda, S. Vikal, C. M. Tempany, N. Hata, and G. Fichtinger, "A generic computer assisted intervention plug-in module for 3D Slicer with multiple device support", Medical Image Computing and Computer-Assisted Intervention (MICCAI), London, UK, 2009
• Tokuda, J., G. Fischer, C. Csoma, S. DiMaio, D. Gobbi, G. Fichtinger, C. Tempany, and N. Hata, "Software strategy for robotic transperineal prostate therapy in closed-bore MRI", Medical image computing and computer-assisted intervention (MICCAI), vol. 11, no. Pt 2: Department of Radiology, Brigham, Women's Hospital, Harvard Medical School, 75 Francis St , Boston, MA 02115, USA tokuda@bwh harvard edu, pp. 701-709, 2008.

Preparations

TCON Dec 7, 2009, 16:00-16:50

• Recent feedbacks
  • Transrectal device
    • Phantom study with new software to determine if it is feasible for clinical studies
    • Numerical results are the same as old software
    • Advantage of 3D Slicer over the previous software: felxibility of 3D display where the needle, target, etc are.
    • Issues: image quality for fiducial detection. The sequence has been optimized for Philips scanner at NIH, but not for Siemens at JHH. Currently the accuracy of registration is 1.5mm at NIH, while it is 2.5mm at JHH.
    • 3D Slicer's performance issue: fiducial, slice view (zooming), DICOM compatibility (Slicer crashes when it loads DICOM data from the scanner... but the data might have some errors in location field.)
  • Transperineal device
    • Repeatability was quite good; there was systematic errors
    • Registration accuracy should be improved; currently the registration is based on a single-slice image; it could possible to improve the accuracy by increasing the number of slices used for the registration.
    • DICOM transfer was not practical. Currently we use DICOM listener at the lab. During the experiment, we logged in the laboratory network from the scanner room remotely, transfer images from the scanner to the listener using DICOM transfer, copy DICOM images from the laboratory network to the local machine, which ran 3D Slicer, and then finally loaded them.
• Potential goals for the Winter Project Week
  • Improved Z-frame tracking (multi-slice registration)
  • Prepare for the clinical application (biopsy)
  • Improved GUI -- Andras has created more specific lists. We will track them using tracking system at Queen's.
  • Packaging using extension manager. This is particularly important once we bring 3D Slicer ORs and start clinical studies.
  • Secondary monitor based on the multiple camera support, recently implemented in 3D Slicer.
  • Features for needle biopsy/brachytherapy based on template
  • Tina suggested to integrate prostate integration with ProstateNav Module: this should be independent, because the segmentation module can be used alone.

Goals of Winter Project Week

• Review list of ProstateNav and Slicer problems/enhancements, enter bug reports, discuss plan for fixing them
  • Slice viewer can become unresponsive if calib markers are moved around a lot
  • Fiducial marker, slice display manipulation is slow
  • DICOM issues (slow loading of large sets of images; Philips multi-frame MR image loading)
  • Display original image slices
• Get information about how to package the module using extension manager. This is particularly important once we bring 3D Slicer ORs and start clinical studies.
• Get information about possibilities for GUI testing