Dosimetry verification of 3D-printed individual template based on CT-MRI fusion for radioactive 125I seed implantation in recurrent high-grade gliomas

Abstract

Purpose: To verify the accuracy and efficacy of three-dimensional printing individual template (3D-PIT) with computed tomography-magnetic resonance imaging (CT-MRI) fusion for radioactive iodine-125 (125 I) seed implantation in high-grade brain gliomas. Material and methods: Between June 2017 and June 2018, 16 patients with recurrent high-grade gliomas (rHGG) underwent radioactive seed implantation with 3D-PIT. The prescribed dose was 120-140 Gy. We compared the dose distribution of the postoperative plan with the preoperative plan. Dose parameters included D 90 , V 100 , V 200 , conformity index (CI), and external index of the target volume (EI). Local control and early complications were also analyzed. Results: Sixteen treatment areas were reported in our study. Median gross tumor volume (preoperative) of patients was 64.2 cm 3 , median needle number was 8, and median number of implanted 125 I seeds was 60. For postoperative plans, the median D 90 , V 100 , and V 200 was 152.1 Gy, 96.8%, and 49.1%, respectively, and 151.7 Gy, 97.0%, and 48.9%, respectively, in preoperative plans. Comparing with the preplanned cases, the dose of the target volume was slightly higher; the high-dose area of the target volume was larger in postoperative cases, but the difference was not statistically significant (p > 0.05). Actual dose conformity of the target volume was greater than preplanned, and the difference was not statistically significant (p > 0.05). Local control was 81.25% and 75% at 3 and 6 months after implantation, respectively. No serious early toxicities were observed. Conclusions: 3D-PIT based on the CT-MRI fusion images can result in good accuracy for positioning and dose distribution in radioactive seed implantation for treatment of rHGG.

Dosimetric comparison of computed tomography-guided iodine-125 seed implantation assisted with and without three-dimensional printing non-coplanar template in locally recurrent rectal cancer: a propensity score matching study

“…Liu et al . [ 9 ] investigated 16 patients with brain gliomas, and no difference was found between pre-operative and post-operative parameters. Besides, some scholars further confirmed that CT-guided RIS implantation assisted with 3D-PNCT was safe and effective.…”

“…To further improve the accuracy of RIS implantation, Huang et al . were the first to employ three-dimensional printing non-coplanar template (3D-PNCT) for CT-guided RIS implantation in the treatment of head and neck tumor [ 6 ], and their results were proved safe, effective, and accurate [ 7 , 8 , 9 ]. However, few studies have compared dosimetric parameters of CT-guided RIS implantation assisted with and without 3D-PNCT.…”

<p>Efficacy and Safety of Iodine-125 Brachytherapy in the Treatment of Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma</p>

“…35 Liu et al reported that in the treatment of recurrent high-grade gliomas, 3D-PIT based on CT/MRI fusion images can enable better positioning accuracy and dose distribution of radioactive I125 particle implantation. 36 Jiang et al studied the acute and late side effects of 3D- PNCT used in CT-guided radioactive I125 particles (RIS) implanted in recurrent cancer of the head and neck. Those authors found that 3D-PNCT-assisted RIS implantation can provide good positioning accuracy, and there were no obvious adverse reactions for locally recurring malignant head and neck tumors.…”

Intra-operative 3D hologram support with mixed reality technique based on CT-MRI fusion images: operation guidance for brain brachytherapy

“…Both computed tomography (CT) and magnetic resonance imaging (MRI) have deficiencies in facilitating target delineation for brain tumors. Our previous research registered CT-MRI fusion images into brachytherapy TPS and three-dimensional printing individual template (3D-PIT) to guide brachytherapy for the treatment of brain gliomas and metastases, and achieved good results [ 3 , 4 ].…”