A technique is proposed for the development of an intraoperative, 3-dimensional registration of C-arm fluoroscopic images with spatially-registered ultrasound visualization and implant guidance of radioactive implants and on-line implant assessment during the procedure for treatment of prostate cancer. With present techniques using transrectal ultrasound guidance for brachytherapy, intra-operative localization of implanted seeds with respect to soft tissue anatomy is still an unsolved problem. Ultrasound (US) images provide satisfactory differentiation of relevant soft issue, but implanted brachytherapy seeds cannot be clearly identified in the US images. Currently sixty percent of the practitioners use intra-operative C-arm fluoroscopy as a qualitative check of the implants. While seeds can be accurately localized in X-ray, projected transluminal images do not reveal soft tissue anatomy. Hence, there is a standing clinical need to couple relevant information from C-arm with the US-guided delivery system, in a safe, robust, and cost-efficient manner. The goal of the proposed work is to implement intra-operative dosimetric quality assurance in transrectal US-guided prostate brachytherapy with the use of C-arm X-ray fluoroscopy. The specific objective of this program is to incorporate spatial location of implanted seeds determined from C-arm X-ray fluoroscopy images with soft tissue anatomy determined from ultrasound images. This will enable the actual dose distribution to be compared to the dose pre-plan and assessed while the implant process is underway. Thus, immediate therapeutic intervention would be possible to correct for any """"""""cold"""""""" regions or minimize """"""""hot"""""""" regions near critical structures and exactly """"""""match"""""""" the optimal source placement within the treatment volume. The outcome of this research could be of immediate benefit in the treatment of prostate cancer. It would provide the ability to visualize in real time the placement of implants, providing implants which reflect optimal dosimetry. A large group of patients with early-stage disease are candidates.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-SSS-1 (11))
Program Officer
Farahani, Keyvan
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Burdette Medical Systems, Inc.
United States
Zip Code
Jain, A; Deguet, A; Iordachita, I et al. (2012) Intra-operative 3D guidance and edema detection in prostate brachytherapy using a non-isocentric C-arm. Med Image Anal 16:731-43
Kuo, Nathanael; Lee, Junghoon; Deguet, Anton et al. (2010) Automatic segmentation of seeds and fluoroscope tracking (FTRAC) fiducial in prostate brachytherapy x-ray images. Proc SPIE Int Soc Opt Eng 7625:
Ayad, Maria S; Lee, Junghoon; Deguet, Anton et al. (2010) C-arm Pose Estimation Using a Set of Coplanar Ellipses in Correspondence. Proc IEEE Int Symp Biomed Imaging 2010:1401-1404
Ayad, Maria S; Lee, Junghoon; Prince, Jerry L et al. (2009) Prostate brachytherapy seed localization using a mobile c-arm without tracking. Proc SPIE Int Soc Opt Eng 7261:k
Jain, Ameet; Fichtinger, Gabor (2006) C-arm tracking and reconstruction without an external tracker. Med Image Comput Comput Assist Interv 9:494-502
Jain, Ameet Kumar; Mustafa, Tabish; Zhou, Yu et al. (2005) FTRAC--a robust fluoroscope tracking fiducial. Med Phys 32:3185-98
Jain, Ameet; Kon, Ryan; Zhou, Yu et al. (2005) C-arm calibration--is it really necessary? Med Image Comput Comput Assist Interv 8:639-46
Jain, Ameet Kumar; Zhou, Yu; Mustufa, Tabish et al. (2005) Matching and reconstruction of brachytherapy seeds using the Hungarian algorithm (MARSHAL). Med Phys 32:3475-92