Ultrasound elastography as a tool for imaging guidance during prostatectomy: Initial experience

Ioana Nicolaescu Fleming, Carmen Kut, Katarzyna Macura, Li Ming Su, Hassan Rivaz, Caitlin Schneider, Ulrike Maria Hamper, Tamara Lotan, Russell H Taylor, Gregory Hager, Emad Boctor

Research output: Contribution to journalArticle

Abstract

Background: During laparoscopic or robotic assisted laparoscopic prostatectomy, the surgeon lacks tactile feedback which can help him tailor the size of the excision. Ultrasound elastography (USE) is an emerging imaging technology which maps the stiffness of tissue. In the paper we are evaluating USE as a palpation equivalent tool for intraoperative image guided robotic assisted laparoscopic prostatectomy. Material/Methods: Two studies were performed: 1) A laparoscopic ultrasound probe was used in a comparative study of manual palpation versus USE in detecting tumor surrogates in synthetic and ex-vivo tissue phantoms; N=25 participants (students) were asked to provide the presence, size and depth of these simulated lesions, and 2) A standard ultrasound probe was used for the evaluation of USE on exvivo human prostate specimens (N=10 lesions in N=6 specimens) to differentiate hard versus soft lesions with pathology correlation. Results were validated by pathology findings, and also by in-vivo and ex-vivo MR imaging correlation. Results: In the comparative study, USE displayed higher accuracy and specificity in tumor detection (sensitivity= 84%, specificity=74%). Tumor diameters and depths were better estimated using USE versus with manual palpation. USE also proved consistent in identification of lesions in ex-vivo prostate specimens; hard and soft, malignant and benign, central and peripheral. Conclusions: USE is a strong candidate for assisting surgeons by providing palpation equivalent evaluation of the tumor location, boundaries and extra-capsular extension. The results encourage us to pursue further testing in the robotic laparoscopic environment.

Original languageEnglish (US)
JournalMedical Science Monitor
Volume18
Issue number11
StatePublished - 2012

Fingerprint

Elasticity Imaging Techniques
Prostatectomy
Palpation
Robotics
Prostate
Neoplasms
Pathology
Touch
Students
Technology
Sensitivity and Specificity

Keywords

  • Elastography
  • Laparoscopy
  • Prostatectomy
  • Robotics
  • Ultrasonography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ultrasound elastography as a tool for imaging guidance during prostatectomy : Initial experience. / Fleming, Ioana Nicolaescu; Kut, Carmen; Macura, Katarzyna; Su, Li Ming; Rivaz, Hassan; Schneider, Caitlin; Hamper, Ulrike Maria; Lotan, Tamara; Taylor, Russell H; Hager, Gregory; Boctor, Emad.

In: Medical Science Monitor, Vol. 18, No. 11, 2012.

Research output: Contribution to journalArticle

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T2 - Initial experience

AU - Fleming, Ioana Nicolaescu

AU - Kut, Carmen

AU - Macura, Katarzyna

AU - Su, Li Ming

AU - Rivaz, Hassan

AU - Schneider, Caitlin

AU - Hamper, Ulrike Maria

AU - Lotan, Tamara

AU - Taylor, Russell H

AU - Hager, Gregory

AU - Boctor, Emad

PY - 2012

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