Advantage of robotic needle placement on a prostate model in HDR brachytherapy

Strassmann, Gerd; Olbert, P.; Hegele, Axel; Richter, Detlev K.; Fokas, Emmanouil; Timmesfeld, Nina; Hofmann, Rainer; Engenhart‐Cabillic, Rita

doi:10.1007/s00066-011-2185-y

Cited by 25 publications

(22 citation statements)

References 26 publications

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“…In the described report, the urinary morbidity was increased and was relieved by medication. Alternative methods involving robotic seed placement have also been described (in primary implantation) [14]. …”

Section: Discussionmentioning

confidence: 99%

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

et al. 2013

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IntroductionWe describe five patients receiving a re-implantation (RI) after post-operative dosimetry of the primary 125-I permanent prostate brachytherapy (BT) for prostate cancer revealed an insufficient dose coverage.Materials and methodsFive out of 222 consecutive patients treated (from March, 2001 to August, 2012) with 125-I BT, received a RI after dosimetric verification by CT and MRI fusion four to eight weeks after implantation displayed an insufficient dose coverage. RIs were performed with 10 to 19 seeds, three to four months after primary intervention. Dosimetry after RI showed an improved and sufficient total dose coverage in all patients.ResultsAt last follow-up (18 to 99 months, median 57 months), none of the patients had relevant implant associated side-effects. Functional outcome was comparable to patients after one-time implantation. PSA levels post intervention showed a decreasing tendency in 4 patients. One patient had a local recurrence after 12 months.ConclusionIn our series, approximately 2% of the patients treated with permanent prostate BT required a RI due to insufficient dose coverage. None of the patients who underwent RI experienced complications. Our series, although only with 5 cases and limited follow-up, along with other published reports, demonstrates good tolerability.

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Section: Discussionmentioning

confidence: 99%

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

et al. 2013

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“…In [1] the needle placement precision of manual template guidance was calculated to be around 3 mm (2.7 ± 0.7 mm). Many applications require a higher precision (1 mm) making the manual task impossible to achieve.…”

Section: Definition Of An Innovative Robotic Structurementioning

confidence: 99%

“…A simple way to use the space inside the gantry very efficiently is to keep the rotation axis of the first active joint, 1 q , in the plane defined by the horizontal laser. In this situation, the radius of the spherical mechanism will be concentric with the gantry, ensuring the free motion of the mechanism without any risks of damaging the gantry.…”

Section: Advanced Engineering Forum Vols 8-9 579mentioning

confidence: 99%

“…Geometrically, this means that B G ≡ . In this case, when the tip of the needle is exactly in the center of the sphere no matter how one modifies the values of 1 q and 2 q , the position of the needle tip will remain the same. For needle placement applications, the needle is driven on a linear trajectory so this case has no effect on the robot maneuverability.…”

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confidence: 99%

“…Base on the medical data provided, the needle is oriented parallel with the linear trajectory to be achieved. This is done using only the active joints 1 q and 2 q . 5.…”

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confidence: 99%

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A CT-Scan Compatible Robotic Device for Needle Placement in Medical Applications

Vaida

Gherman

Pîslă

et al. 2013

AEF

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Abstract. Several medical applications require devices capable of placing different substances inside the human body. Due to the nature of the task it is desirable to perform these actions with visual feedback, whereas the most viable solution, especially for deep target points, is computer tomography (CT). The paper presents an innovative device, which can be fitted inside the CT gantry, and has decoupled motions to ensure maximum accuracy during the needle placement. It will be shown that for needle placement tasks 5 degrees of freedom (DOF) are sufficient to achieve the task. The geometric and kinematic model of the robot will be presented. The workspace and precision mapping are computed. Some simulation results will show the robot capabilities as well as its placement in the CT scan environment.

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Catheters and dose optimization using a modified CVT algorithm and multi‐criteria optimization in prostate HDR brachytherapy

et al. 2022

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Purpose: Currently, in high-dose rate (HDR) brachytherapy planning, the catheter's positions are often selected by the planner, which involves the planner's experience. The catheters are then inserted using a template that helps to guide the catheters. For certain applications, it is of interest to choose the optimal location and number of catheters needed for dose coverage and potential decrease of the treatment's toxicity. Hence, it is of great importance to develop patient-specific algorithms for catheters and dose optimization. Methods: A modified Centroidal Voronoi tessellation (CVT) algorithm is implemented and merged with a graphics processing unit (GPU)-based multi-criteria optimization algorithm (gMCO). The CVT algorithm optimizes the catheters' positions,and the gMCO algorithm optimizes the dwell times and dwell positions. The CVT algorithm can be used simultaneously for insertion with or without a template. Some improvements to the CVT algorithm are presented such as a new way of considering the area that needs to be covered. One hundred eight previously treated prostates HDR cases using real-time ultrasound are used to evaluate the different optimization procedures. The plan robustness is evaluated using two types of errors:deviations (random) in the insertion and deviation (systematic) in the reconstruction of the catheters. Results: Using gMCO on clinically inserted catheter increases the acceptance rate by 37% for Radiation Therapy Oncology Group (RTOG) criteria. Our results show that all the patients respect RTOG criteria with 11 catheters using CVT+gMCO with a template of 5 mm. The number of catheters needed for all patients to respect RTOG criteria with the freehand technique is 10 catheters using CVT+gMCO. When deviations are introduced, using a template, the acceptance rate goes to 85% with 3 mm deviations using 11 catheters. This decrease is less significant when the number of catheters is higher, decreasing by less than 5% with a 3 mm deviation using 13 catheters or more. In conclusion, it is feasible to decrease the number of catheters needed to treat most patients. Conclusions: Some cases still need a high number of catheters to reach the plan's criteria. Using gMCO allows an increase in the plan quality, while using CVT reduces the number of catheters. A higher number of catheters equates to plans that are more robust to deviations.

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Advantage of robotic needle placement on a prostate model in HDR brachytherapy

Cited by 25 publications

References 26 publications

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

A CT-Scan Compatible Robotic Device for Needle Placement in Medical Applications

Catheters and dose optimization using a modified CVT algorithm and multi‐criteria optimization in prostate HDR brachytherapy

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