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Intraoperative dosimetry during prostate brachytherapy is a long standing clinical problem. We propose a novel framework to address this problem by reliable detection of a subset of seeds from 3D transrectal ultrasound and registration to fluoroscopy. Seed detection in ultrasound is achieved through template matching in the RF ultrasound domain followed by thresholding and spatial filtering based on the fixed distance between stranded seeds. This subset of seeds is registered to the complete reconstruction of the implant in C-arm fluoroscopy. We report results, validated with a leave-one-needle-out approach, both in a phantom (average post-registration seed distance of 2.5 mm) and in three clinical patient datasets (average error: 3.9 mm over 113 seeds).

Towards Intra-operative Prostate Brachytherapy Dosimetry Based on Partial Seed Localization in Ultrasound and Registration to C-arm Fluoroscopy