Positioning Biopsy Needles in the Prostate Gland Using 3D Computer Modelling

University dissertation from Uppsala : Acta Universitatis Upsaliensis

Abstract: In the world of medicine, image diagnostics have, until recently, been based merely on two dimensional information sources. The understanding of three dimensional structures has been limited to creating mental images in the mind of the physician, to wax models and to autopsy. In the last few years, computers have made it possible to model and reconstruct real three dimensional objects and thus give the physician a new tool not only to describe localisation and distribution patterns of diseases, above all cancer, but also as an aid in the understanding of the human body. This thesis contributes in the development of such tools, based on a specific application.Prostate cancer is for men the most common form of cancer. Improvement in diagnostics for this form of cancer would facilitate planning of treatment and hence save, and preserve the quality of, life. One way to diagnose and quantify prostate cancer is to assess its presence and malignancy grade in cylindrical tissue samples taken with a needle biopsy device. Today, two to six such samples are generally taken, with poorly standardised rules for the positioning of the needle, thus interindividual variation exists.In this thesis, 3D models to analyse the problem with the positioning of biopsy needles have been developed. By using information from physical prostates removed from patients by surgery, a 3D cancer probability distribution has been built. Using this information, a standardised biopsy needle protocol has been created that is efficient, stable and easy to use. In this process new methods for morphing images, registrating slices and optimising positions for use with computer modelling have been developed.Many physicians were involved in the study. Thus, an important part of the work has been to make every part of the work understandable for people without special computer programming knowledge. Also, efforts have been made to make it possible to easily examine every piece of information created in order to verify the correctness of the methods used.

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