Three-dimensional sonography with needle tracking: Role in diagnosis and treatment of prostate cancer

Objective. Image-guided prostate biopsy has become routine in medical diagnosis. Although it improves biopsy outcome, it mostly operates in 2 dimensions, therefore lacking presentation of information in the complete 3-dimensional (3D) space. Because prostatic carcinomas are nonuniformly distributed within the prostate gland, it is crucial to accurately guide the needles toward clinically important locations within the 3D volume for both diagnosis and treatment. Methods. We reviewed the uses of 3D image-guided needle procedures in prostate cancer diagnosis and cancer therapy as well as their advantages, work flow, and future directions. Results. Guided procedures for the prostate rely on accurate 3D target identification and needle navigation. This 3D approach has potential for better disease diagnosis and therapy. Additionally, when fusing together different imaging modalities and cancer probability maps obtained from a population of interest, physicians can potentially place biopsy needles and other interventional devices more accurately and efficiently by better targeting regions that are likely to host cancerous tissue. Conclusions. With the information from anatomic, metabolic, functional, biochemical, and biomechanical statuses of different regions of the entire gland, prostate cancers will be better diagnosed and treated with improved work flow.