Automatic Shape-Based Level Set Segmentation for Needle Tracking in 3-D TRUS-Guided Prostate Brachytherapy

Prostate brachytherapy is an effective treatment for early prostate cancer. The success depends critically on the correct needle implant positions. We have devised an automatic shape-based level set segmentation tool for needle tracking in 3-D transrectal ultrasound (TRUS) images, which uses the shape information and level set technique to localize the needle position and estimate the endpoint of needle in real-time. The 3-D TRUS images used in the evaluation of our tools were obtained using a 2-D TRUS transducer from Ultrasonix (Richmond, BC, Canada) and a computer-controlled stepper motor system from Thorlabs (Newton, NJ, USA). The accuracy and feedback mechanism had been validated using prostate phantoms and compared with 3-D positions of these needles derived from experts' readings. The experts' segmentation of needles from 3-D computed tomography images was the ground truth in this study. The difference between automatic and expert segmentations are within 0.1 mm for 17 of 19 implanted needles. The mean errors of automatic segmentations by comparing with the ground truth are within 0.25 mm. Our automated method allows real-time TRUS-based needle placement difference within one pixel compared with manual expert segementation.