Validation of guiding needle placement using registered ultrasound imaging for gynecologic brachytherapy in a simulated pelvic Phantom

Sci Rep. 2025 Jul 1;15(1):22065. doi: 10.1038/s41598-025-06421-y.

Abstract

Our previous research demonstrated that, under ideal conditions, high-precision image registration between real-time ultrasound (US) images and preoperative CT/MR images could be achieved using real-time US guidance for needle insertion. In this study, we enhanced a constructed phantom to better simulate the structure of human abdominal tissue, aiming to verify the accuracy of surgical needle placement guided by real-time US images registered with preoperative CT/MR images. Specifically, the pelvic phantom was improved using animal abdominal tissue to mimic the properties of human abdominal tissue. In the improved phantom experiments, the target registration error (TRE) for the real-time needle trajectory of four implanted needles in the registered US-CT images was 0.81 ± 0.11 mm (mean ± SD), with an average trajectory angle error of 0.83 ± 0.063 degrees (mean ± SD). For the registered US-MR images, the average registration error was 0.76 ± 0.014 mm (mean ± SD), and the average trajectory angle error was 0.825 ± 0.018 degrees (mean ± SD). These results demonstrate that, even in simulated human tissue, rigid registration between real-time US images and preoperative CT/MR images maintained high accuracy, supporting the feasibility of real-time US-guided needle insertion.

Keywords: Cervical carcinoma; Gynecologic brachytherapy; Image-guidance; Registered ultrasound image; Rigid registration.

Publication types

  • Validation Study

MeSH terms

  • Animals
  • Brachytherapy* / instrumentation
  • Brachytherapy* / methods
  • Female
  • Genital Neoplasms, Female* / diagnostic imaging
  • Genital Neoplasms, Female* / radiotherapy
  • Humans
  • Magnetic Resonance Imaging
  • Needles
  • Pelvis* / diagnostic imaging
  • Phantoms, Imaging*
  • Radiotherapy, Image-Guided* / methods
  • Tomography, X-Ray Computed
  • Ultrasonography / methods
  • Ultrasonography, Interventional* / methods