Comparative study for CT-guided 125 I seed implantation assisted by 3D printing coplanar and non-coplanar template in peripheral lung cancer

Abstract

Purpose We compared the three-dimensional printed non-coplanar template (3DPNCT) plans with 3D-printed coplanar template (3DPCT) plans for radioactive seed implantation (RSI) in lung cancer and explored the differences between the two technologies. Material and methods 33 patients with peripheral lung cancer that received 3DPCT-assisted RSI in our department between June 2017 and February 2018 were analyzed. A 3DPNCT plan was re-designed for all patients. The prescribed dose and seed activity in the new plan were the same as the 3DPCT plan. The data in the two plans were compared, including seed number, needle number, number of needles needed to cross the ribs, and dosimetry parameters. Dosimetry parameters included D 90 , D mean , MPD (minimum peripheral dose), V 100 , V 150 , CI (conformity index), EI (external index), HI (homogeneity index) of target volume, D 2cc of spinal cord and aorta, and V 20 of affected side lung. We used a paired t -test and two groups of related non-parameters tests to examine statistical significance. A p value < 0.05 was considered statistically significant. Results We found no significant difference in dosimetry parameters ( p > 0.05), except MPD. The mean MPD of the 3DPNCT plan was significantly higher than the 3DPCT plan (88.5 Gy and 81.8 Gy, respectively, p = 0.017). The number of needles used in the 3DPNCT plan and the number of needles needed to cross the ribs were significantly less compared with the 3DPCT plan ( p = 0.000). Conclusions The dose distributions of the two 3DPCT plans were similar. 3DPNCT plan had a higher dose in target volume margin, with fewer needles and fewer breaks to the ribs.

Evaluation of radioactive 125I seed implantation for the treatment of refractory malignant tumors based on CT-guided 3D template assisted technique: efficacy and safety

“…were not statistically different from the preoperative plan. Considering that is related with the seed implantation under template control, as it decrease the bleeding and relative motion, therefore it can guarantee the precise control of target dose on the basis of better control of tumor target volume, this is consistent with the recent literature reports [13,14].…”

“…No patients were given systemic chemotherapy and other treatments from seed implantation to followup deadline. The analysis of prognostic factors in this study also suggested that tumor location and disease types are the influencing factors affecting CT-guided 3D template-assisted 125 I particle implantation techniques, and factors such as template types are not the factors that affecting prognosis [13].…”

“…Due to the need to adjust the needle during surgery, and the larger the tumor, the more significant the number of implants increased, and there were no domestic reports on whether puncture needle can promote the release and escape of tumor cells, thus leading complications, such as puncture tract transfer and recent distant organ metastasis.In this study, 25 patients with advanced refractory malignant tumors underwent continuous seed implantation, and no serious complications occurred in the whole group, such as implant metastasis and distant organs, indicating that although the number of implanted needle increased, the application of 3D printing technology make the template-assisted seed implantation not only accurate, but also can shorten the operation time and the number of repeated adjustments of the needle during the operation, thus reducing the complications caused by repeated punctures. The study also further illustrated the feasibility and safety of radioactive 125 I seed implantation with 3D template guidance for the treatment of malignant tumors.It is precisely because of the preoperative use of BTPS to develop a reasonable treatment plan and the accurate implementation of the treatment plan during the operation, CT-guided 3D template assisted 125 I seed implantation for the treatment of malignant tumors is more accurate[4,[13][14][15], and this further extended the survival time and quality of life in patients with advanced malignancies.…”

Evaluation of radioactive 125I seed implantation for the treatment of refractory malignant tumours based on a CT-guided 3D template-assisted technique: efficacy and safety

“…No patients were administered systemic chemotherapy or other treatments from seed implantation to the completion of follow-up. The analysis of prognostic factors in this study also suggested that the tumour site and type are influential factors for CT-guided 3D template-assisted 125 I particle implantation technology, and other factors, such as template type, are not factors that affect prognosis [13].…”

Evaluation of radioactive 125I seed implantation for the treatment of refractory malignant tumours based on a CT-guided 3D template-assisted technique: efficacy and safety

“…As the product of several minimally invasive disciplines, radioactive 125 I particle implantation technology is a relatively accurate treatment in clinical practice. With the pre-operative use of the BTPS to develop a rational treatment plan and the implementation of the treatment plan intra-operatively, CT-guided 3D template-assisted 125 I seed implantation for the treatment of malignant tumours is more accurate [4,[13][14][15] and extends the survival time and quality of life of patients with advanced malignancies. Mo et al [11] applied CT-guided seed implantation combined with chemotherapy to treat metastatic soft tissue tumours after 4-6 cycles of first-line chemotherapy.…”