Two-dimensional (2D) ultrasound imaging is commonly used for diagnosis in a variety of medical fields. However, there are several drawbacks of conventional 2D-ultrasound imaging. These include prostate or transducer movement that produces sets of different images that are difficult to interpret. Also during patient's reexamination correspondence between sets of images before reexamination and after is difficult to establish. This can be described as a problem of correlation between two sets of images: the first created before distortion or examination, the second one after. We propose a method to register 2D ultrasound volumes based on external markers introduced in the prostate. The metal balls are inserted in the prostate at three distinct locations in the prostate. These appear as bright dots in the ultrasound field, serve as reference points, are then outlined through a user-interactive program from two sets of images. Then, the computer program rotates and translates till they match respectively, and displays the mapped points with their corresponding location. Based on this idea we developed an image-guided system for PDT that require high-precision placement of implants. In the planning stage, the system performs an automatic acquisition of 2D transrectal ultrasound images that will ultimately be used to construct the treatment plan. At the time of the therapy, new sets of ultrasound images are acquired and a match is established between the virtual world and the patient's real world with the aid of manually introduced markers and image matching algorithms.
Photodynamic therapy (PDT) is an emerging minimally invasive treatment that can be employed in many human diseases including prostate cancer. This treatment of human prostate cancer depends on the localization of a drug (photosensitizer) into the prostate. The photosensitizer is activated by high- energy laser light and the active drug destroys cancerous tissue. The success of PDT depends on precise placement of light diffusers in the prostate. Since the prostate is irregular in shape, with different dimensions, a transurethral light delivery that is circular in distribution cannot be used in most cases of carcinoma of the prostate. Sources of light and their spatial distribution must be tailored to each individual patient. More uniform, therapeutic light distribution can be achieved by interstitial light irradiation. In this case, the light is delivered by diffusers placed within the substance of the prostate parallel to the urethra at a distance optimized to deliver adequate levels of light and to create the desired photodynamic effect. For this reason, we are developing a computer program that can calculate the distribution of energy depending on the number of light sources placed in the prostate, their position in the gland, the dimension of the prostate, and the attenuation coefficient. A patient's three-dimensional prostate model is built based on ultrasound images. Then the program is being designated to predict the best set of parameters and position of light diffusers in space, displays them in graphical form or in numerical form. The program is amenable for interfacing with robotic treatment systems.
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