Characterization of ultrasound elevation beamwidth artifacts for prostate brachytherapy needle insertion

Peikari, Mohammad; Chen, Thomas Kuriran; Lassó, András; Heffter, Tamas; Fichtinger, Gabor; Burdette, Everette C.

doi:10.1118/1.3669488

Cited by 20 publications

(20 citation statements)

References 24 publications

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“…Due to the limitation of ultrasound imaging, system and random error in stepper unit, and imaging artifacts, the catheter tip may be defined proximally or distally as much as 4 mm from its actual location. 27,28 As a result, all the dwell positions in the catheter will be offset by that distance, yielding significant dosimetry discrepancy. 25 When near the urethra, catheter track definition error can cause significant miscalculation of urethral dose, potentially yielding significant toxicity.…”

Section: Discussionmentioning

confidence: 99%

Real-time catheter tracking for high-dose-rate prostate brachytherapy using an electromagnetic 3D-guidance device: A preliminary performance study

et al. 2013

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The performance of an EM tracking system depends highly on the system configuration and surrounding environment. The accuracy of EM tracking for catheter reconstruction in a prostate HDR brachytherapy procedure can be improved by reducing interference from surrounding equipment, decreasing distance from transmitter to tracking area, and choosing appropriated sampling frequency. A calibration scheme is needed to further reduce the tracking error when the interference is high.

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Section: Discussionmentioning

confidence: 99%

Real-time catheter tracking for high-dose-rate prostate brachytherapy using an electromagnetic 3D-guidance device: A preliminary performance study

et al. 2013

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“…Further, lower US system gain settings (−15 dB compared to 15 dB) reduced intraobserver variations. Peikari et al found needle localization variations of 0.5–4 mm, depending on needle position with respect to the US fields and settings of gain and power [111]. The influence of geometric uncertainties on dosimetry was evaluated in a model-based simulation [112].…”

Section: Uncertainties At the Patient Levelmentioning

confidence: 99%

Review of clinical brachytherapy uncertainties: Analysis guidelines of GEC-ESTRO and the AAPM

Kirisits

Rivard

Baltas

et al. 2014

Radiotherapy and Oncology

258

210

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Background and purposeA substantial reduction of uncertainties in clinical brachytherapy should result in improved outcome in terms of increased local control and reduced side effects. Types of uncertainties have to be identified, grouped, and quantified.MethodsA detailed literature review was performed to identify uncertainty components and their relative importance to the combined overall uncertainty.ResultsVery few components (e.g., source strength and afterloader timer) are independent of clinical disease site and location of administered dose. While the influence of medium on dose calculation can be substantial for low energy sources or non-deeply seated implants, the influence of medium is of minor importance for high-energy sources in the pelvic region. The level of uncertainties due to target, organ, applicator, and/or source movement in relation to the geometry assumed for treatment planning is highly dependent on fractionation and the level of image guided adaptive treatment. Most studies to date report the results in a manner that allows no direct reproduction and further comparison with other studies. Often, no distinction is made between variations, uncertainties, and errors or mistakes. The literature review facilitated the drafting of recommendations for uniform uncertainty reporting in clinical BT, which are also provided. The recommended comprehensive uncertainty investigations are key to obtain a general impression of uncertainties, and may help to identify elements of the brachytherapy treatment process that need improvement in terms of diminishing their dosimetric uncertainties. It is recommended to present data on the analyzed parameters (distance shifts, volume changes, source or applicator position, etc.), and also their influence on absorbed dose for clinically-relevant dose parameters (e.g., target parameters such as D90 or OAR doses). Publications on brachytherapy should include a statement of total dose uncertainty for the entire treatment course, taking into account the fractionation schedule and level of image guidance for adaptation.ConclusionsThis report on brachytherapy clinical uncertainties represents a working project developed by the Brachytherapy Physics Quality Assurances System (BRAPHYQS) subcommittee to the Physics Committee within GEC-ESTRO. Further, this report has been reviewed and approved by the American Association of Physicists in Medicine.

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“…During the prostate brachytherapy procedure, the needles are inserted into the prostate perpendicular to the transverse ultrasound beam and as such there can be errors in needle tip localisation and seed placement, as well as side lobes that can cause further issues with localisation. Peikari et al2012 [32] descried a Wire-Bridge test phantom that allows for elevation beamwidth measurements to examine the uncertainties associated with localisation. In a study by Sandhu et al 2010 [26], the improvements of tissue harmonic imagining over B-mode imagining for the application of ultrasound guided prostate brachytherapy were investigated for a number of the system parameters resolution, geometric accuracy, depth of penetration, dead zone, signal-to-noise ratio and tissue-toclutter ratio, to compare the two modes using an in house test phantom made from homogenized milk based Tissue mimicking material.…”

Section: Test Phantomsmentioning

confidence: 99%

Pilot Investigation into the Use of an Anthropomorphic Breast Sonography Phantom as a Training and Assessment Tool

Browne

Cannon

McDermott

et al. 2017

Ultrasound in Medicine & Biology

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A device for the training and quantitative assessment of the competency of trainee radiologists in the technically challenging area of breast sonography was developed and evaluated. Currently, suitable commercially available devices are lacking, and there is a growing realization that the reliance on direct exposure to patients for learning may not represent best practice from either the trainees' or patients' perspective. Three devices (PI, PII and PIII) were designed to produce very realistic sonographic images of breast morphology with a range of embedded pathologies. The pilot evaluation used a case study research design to evaluate the role of the anthropomorphic breast sonography training device in training and assessment in a clinical environment. Through the case study, it was possible to evaluate the process and relationships when using this type of training intervention for a small group of radiology resident trainees. The investigation involved a baseline assessment of trainees' (n = 4) ability to detect and characterize all lesions in PI, followed by a 4-wk training period on PII and a post-training assessment using PIII. The evaluation revealed an improvement of 30% ± 8% in the trainee's performance from pre- to post-training. It was expected that the performance of the trainees would improve as the training phantom described in this study aligns with the learning theory of constructivism and fits the ideal specifications of a medical training device in terms of its realism and facilitation of self-directed learning and deliberate practice of the trainees. The device provides a useful platform upon which training and assessment can be facilitated.

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Characterization of ultrasound elevation beamwidth artifacts for prostate brachytherapy needle insertion

Abstract: The authors found properly adjusting the TRUS imaging settings to lower the ultrasound gain and power effectively minimized the appearance of elevation beamwidth artifacts and in turn reduced the localization errors of the needle tip.

Cited by 20 publications

References 24 publications

Real-time catheter tracking for high-dose-rate prostate brachytherapy using an electromagnetic 3D-guidance device: A preliminary performance study

Real-time catheter tracking for high-dose-rate prostate brachytherapy using an electromagnetic 3D-guidance device: A preliminary performance study

Review of clinical brachytherapy uncertainties: Analysis guidelines of GEC-ESTRO and the AAPM

Pilot Investigation into the Use of an Anthropomorphic Breast Sonography Phantom as a Training and Assessment Tool

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