To facilitate training and planning for medical procedures such as prostate brachytherapy, we are developing an interactive simulation of needle insertion and radioactive seed implantation in soft tissues. We describe a new 2D dynamic FEM model based on a reduced set of scalar parameters such as needle friction, sharpness, and velocity, where the mesh is updated to maintain element boundaries along the needle shaft and the effects of needle tip and frictional forces are simulated. The computational complexity of our model grows linearly with the number of elements in the mesh and achieves 24 frames per second for 1250 triangular elements on a 750 MHz PC. We use the simulator to characterize the sensitivity of seed placement error to physician-controlled and biological parameters. Results indicate that seed placement error is highly sensitive to physician-controlled parameters such as needle position, sharpness, and friction, and less sensitive to patient-specific parameters such as tissue stiffness and compressibility.

Medical procedures such as seed implantation, biopsies, and treatment injections require inserting a needle tip to a specific target location inside the human body. This is difficult because (1) needle insertion causes soft tissues to displace and deform, and (2) it is often difficult or impossible to obtain precise imaging data during insertion. We are developing a sensorless planning system for needle insertion that incorporates numerical optimization with a soft tissue simulation based on a dynamic FEM formulation that models the effects of needle tip and frictional forces using a 2D mesh. In this paper we describe a sensorless planning algorithm for radioactive seed implantation that computes needle insertion offsets that compensate for tissue deformations. We apply the method to seed implantation during permanent seed prostate brachytherapy to minimize seed placement error in simulation without relying on real-time imaging.