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Prostate brachytherapy involves implanting radioactive seeds (I125 forinstance) permanently in the gland for the treatment of localized prostatecancers, e.g., cT1c-T2a N0 M0 with good prognostic factors. Treatment planningand seed implanting are most often based on the intensive use of transrectalultrasound (TRUS) imaging. This is not easy because prostate visualization isdifficult in this imaging modality particularly as regards the apex of thegland and from an intra- and interobserver variability standpoint. Radioactiveseeds are implanted inside open interventional MR machines in some centers.Since MRI was shown to be sensitive and specific for prostate imaging whilstopen MR is prohibitive for most centers and makes surgical procedures verycomplex, this work suggests bringing the MR virtually in the operating roomwith MRI/TRUS data fusion. This involves providing the physician withbi-modality images (TRUS plus MRI) intended to improve treatment planning fromthe data registration stage. The paper describes the method developed andimplemented in the PROCUR system. Results are reported for a phantom and firstseries of patients. Phantom experiments helped characterize the accuracy of theprocess. Patient experiments have shown that using MRI data linked with TRUSdata improves TRUS image segmentation especially regarding the apex and base ofthe prostate. This may significantly modify prostate volume definition and havean impact on treatment planning.

MRI/TRUS data fusion for prostate brachytherapy. Preliminary results