Toward a real-time system for temporal enhanced ultrasound-guided prostate biopsy



We have previously proposed temporal enhanced ultrasound (TeUS) as a new paradigm for tissue characterization. TeUS is based on analyzing a sequence of ultrasound data with deep learning and has been demonstrated to be successful for detection of cancer in ultrasound-guided prostate biopsy. Our aim is to enable the dissemination of this technology to the community for large-scale clinical validation.


In this paper, we present a unified software framework demonstrating near-real-time analysis of ultrasound data stream using a deep learning solution. The system integrates ultrasound imaging hardware, visualization and a deep learning back-end to build an accessible, flexible and robust platform. A client–server approach is used in order to run computationally expensive algorithms in parallel. We demonstrate the efficacy of the framework using two applications as case studies. First, we show that prostate cancer detection using near-real-time analysis of RF and B-mode TeUS data and deep learning is feasible. Second, we present real-time segmentation of ultrasound prostate data using an integrated deep learning solution.


The system is evaluated for cancer detection accuracy on ultrasound data obtained from a large clinical study with 255 biopsy cores from 157 subjects. It is further assessed with an independent dataset with 21 biopsy targets from six subjects. In the first study, we achieve area under the curve, sensitivity, specificity and accuracy of 0.94, 0.77, 0.94 and 0.92, respectively, for the detection of prostate cancer. In the second study, we achieve an AUC of 0.85.


Our results suggest that TeUS-guided biopsy can be potentially effective for the detection of prostate cancer.

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This work was supported in part by the Natural Sciences and Engineering Research Council of Canada (NSERC) and in part by the Canadian Institutes of Health Research (CIHR).

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Correspondence to Shekoofeh Azizi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Azizi, S., Van Woudenberg, N., Sojoudi, S. et al. Toward a real-time system for temporal enhanced ultrasound-guided prostate biopsy. Int J CARS 13, 1201–1209 (2018).

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  • Temporal enhanced ultrasound
  • Prostate cancer
  • 3D slicer
  • Real-time biopsy guidance