  Computer-assisted prostate biopsies became a very active research area during
the last years. Prostate tracking makes it possi- ble to overcome several
drawbacks of the current standard transrectal ultrasound (TRUS) biopsy
procedure, namely the insufficient targeting accuracy which may lead to a
biopsy distribution of poor quality, the very approximate knowledge about the
actual location of the sampled tissues which makes it difficult to implement
focal therapy strategies based on biopsy results, and finally the difficulty to
precisely reach non-ultrasound (US) targets stemming from different modalities,
statistical atlases or previous biopsy series. The prostate tracking systems
presented so far are limited to rigid transformation tracking. However, the
gland can get considerably deformed during the intervention because of US probe
pres- sure and patient movements. We propose to use 3D US combined with
image-based elastic registration to estimate these deformations. A fast elastic
registration algorithm that copes with the frequently occurring US shadows is
presented. A patient cohort study was performed, which yielded a statistically
significant in-vivo accuracy of 0.83+-0.54mm.
