1. RadVision integration with TRUS robot for Brachytherapy
Computer Integrated Surgery II
Team Members: Adam Clayton
Team Mentor: Peter Kazanzides 1

2. Background on Prostate Cancer
The American Cancer Society reports that 240,890 cases of prostate cancer were diagnosed and about 33,720 men will die from it.
While most cases of prostate cancer are slow growing and symptom-free.
Mortality rate second only to lung cancer.
Common treatments include prostatectomy, brachytherapy, external beam radiation 2

3. Prostate brachytherapy

4. Prostate brachytherapy
Used to treat 46% of all cases of prostate
Uses grid of holes to guide needle.
Radioactive seeds injected near tumor
Isotopes used as radioactive seeds have short half-life, include Palladium-103 and Iodine-125 4

5. Problems with conventional approach
Inaccuracy of needle insertion due to template
Inaccuracy of needle insertion due to imprecise targeting
Unable to change orientation of needles

6. Goal of Project
Integrate the RadVision treatment planning software with the (Trans-Rectal Ultrasound ) or TRUS brachytherapy robot.
The accuracy study in which I plan to participate will assess the accuracy of the TRUS robot in needle placement.

7. Motivation and Significance
Make needle placement more accurate
Greater effectiveness of radioactive seeds with fewer side effects.
Evaluate the performance of the TRUS system compared to other systems

8. TRUS Hardware Setup

9. TRUS Hardware Robot Two 2-axis Galil servo mechanisms
Allows for 2D positioning as well as orientation

10. TRUS Hardware Button Controller
Developed to allow surgeon to control robot without computer
Has 4 buttons that allow for translation and orientation changes
Switch for switching between “Turbo” and normal mode

11. Software Interaction Current
Button Controller
USB/Serial
Robot Control
DLL
Galil Controller Driver
Robot
Ethernet

12. Software Interaction After
RadVision
Button Controller
OpenIGTLink
OpenIGTLink
USB/Serial
Microcontroller Interface
Robot Control
DLL
Galil Controller Driver
Robot
Ethernet

13. RadVision Simulation/Treatment planning software
Interfaces with OpenIGTlink

14. Accuracy Study Protocol by Danny Song Poke graph paper with needle
Analyze with HD camera
Repeat 100 times
Place seeds in phantom gel

15. List of deliverables Minimum Deliverable Expected Deliverable
User slicer or some other interface instead of Radvision with camera with phantom gel
Accuracy Study using TRUS Robot. (APM task group 132 protocol)
Expected Deliverable
Using RadVision and real ultrasound with phantom gel. (or with slicer if dependences are not available in time)
Using button box to send commands to RadVision
Maximum Deliverable
IRAB approved ready for clinical trial 15

16. List of dependencies & plan for resolving
RadVision software – Currently waiting on company
TRUS Robot – Already have robot
Ultrasound equipment - Provided at hospital
Phantom gel - Peter 16

17. Management Plan Meeting every other week with Professor Kazanzides
20-30 hr/wk 17

18. Key Dates

19. Reading List
Gabor Fichtinger, Jonathan P. Fiene, Christopher W. Kennedy, Gernot Kronreif, Iulian Iordachita, Danny Y. Song, Everette C. Burdette, Peter Kazanzides, Robotic assistance for ultrasound-guided prostate brachytherapy, Medical Image Analysis, Volume 12, Issue 5, October 2008, Pages , ISSN , /j.media (
Keywords: Medical robotics; Image guided surgery; Prostate cancer; Brachytherapy 19