CT scan based patient-specific transperineal ultrasound probe setups for image guided radiotherapy

S.M. Camps, F. Verhaegen, P.H.N. de With, D. Fontanarosa

Research output: Chapter in Book/Report/Conference proceedingConference contributionAcademicpeer-review


Purpose: Interpretation of ultrasound (US) images is crucial during their acquisition. Typically, a trained operator needs to verify if the correct anatomical structures are visualized with sufficient quality. This is one of the key reasons why US imaging is not widely used in radiotherapy workflows. In this study, we explored the feasibility of providing the operator with patient-specific US probe setups for 4D transperineal (TPUS) imaging of prostate cancer patients. These setups were automatically calculated based on a CT scan of the patient.

Methods: After bone mask extraction from a CT volume of a prostate cancer patient, internal perineum boundaries and the perineal area on the patients’ skin were automatically identified. Subsequently, the areas on which the US probe could not be positioned in clinical practice (e.g. around the anus) were removed resulting in a skin area accessible for TPUS imaging. Translation and rotation of a virtual probe on this skin area, while taking into account probe pressure effects, resulted in 7546 possible probe setups. Finally, we used anatomical structure delineations to assess if these setups allowed visualization of the prostate, the seminal vesicles, and the adjacent edges of bladder and rectum, as clinically required.

Results: In total 392 of the suitable setups potentially allowed visualization of all clinically required structures without bone blockage. The best setup (out of 392) potentially allows visualization of 100% of the prostate and seminal vesicles, 78% of the bladder and 69% of the rectum.

Conclusion: In this proof-of-concept study, we showed that it is feasible to provide the operator with patient-specific probe setups (based on a CT scan) that satisfy all clinical requirements. In future steps, we will investigate the clinical requirements for implementation in the radiotherapy workflow. In the end, the use of these setups can potentially remove the need for skilled operators.
Original languageEnglish
Title of host publicationAmerican Association of Physicist in Medicine Conference, 30 July - 3 August 2017, Denver, Colorado
Place of Publications.l.
PublisherAAPM - American Association of Physicists in Medicine
Publication statusPublished - 9 Mar 2017


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