Dynamic Modulated Brachytherapy (DMBT) Balloon Applicator for Accelerated Partial Breast Irradiation

Guy, Christopher L.; Oh, Seungjong; Han, Dan; Kim, Siyong; Arthur, Douglas W.; Song, William Y.

doi:10.1016/j.ijrobp.2019.03.026

Cited by 2 publications

(2 citation statements)

References 51 publications

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“…Delivery times increased modestly by about 46% (4.09 from 2.8 min, for a new 192 Ir source). Guy et al (2019) proposed a clever two-channel applicator design that enables dynamic IMBT delivery. The balloon-type DMBT applicator consisted of a fixed central channel enabling real-time, in vivo dosimetry and an outer motion-dynamic, adjustable-radius channel capable of moving to any angular position within the balloon.…”

Section: Breastmentioning

confidence: 99%

Emerging technologies in brachytherapy

Song¹,

Robar²,

Morén³

et al. 2021

Phys. Med. Biol.

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Brachytherapy is a mature treatment modality. The literature is abundant in terms of review articles and comprehensive books on the latest established as well as evolving clinical practices. The intent of this article is to part ways and look beyond the current state-of-the-art and review emerging technologies that are noteworthy and perhaps may drive the future innovations in the field. There are plenty of candidate topics that deserve a deeper look, of course, but with practical limits in this communicative platform, we explore four topics that perhaps is worthwhile to review in detail at this time. First, intensity modulated brachytherapy (IMBT) is reviewed. The IMBT takes advantage of anisotropic radiation profile generated through intelligent high-density shielding designs incorporated onto sources and applicators such to achieve high quality plans. Second, emerging applications of 3D printing (i.e. additive manufacturing) in brachytherapy are reviewed. With the advent of 3D printing, interest in this technology in brachytherapy has been immense and translation swift due to their potential to tailor applicators and treatments customizable to each individual patient. This is followed by, in third, innovations in treatment planning concerning catheter placement and dwell times where new modelling approaches, solution algorithms, and technological advances are reviewed. And, fourth and lastly, applications of a new machine learning technique, called deep learning, which has the potential to improve and automate all aspects of brachytherapy workflow, are reviewed. We do not expect that all ideas and innovations reviewed in this article will ultimately reach clinic but, nonetheless, this review provides a decent glimpse of what is to come. It would be exciting to monitor as IMBT, 3D printing, novel optimization algorithms, and deep learning technologies evolve over time and translate into pilot testing and sensibly phased clinical trials, and ultimately make a difference for cancer patients. Today’s fancy is tomorrow’s reality. The future is bright for brachytherapy.

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Section: Breastmentioning

confidence: 99%

Emerging technologies in brachytherapy

Song¹,

Robar²,

Morén³

et al. 2021

Phys. Med. Biol.

View full text Add to dashboard Cite

show abstract

“…The IMBT provides at least one additional degree of freedom in the dose delivery process in order to achieve a higher degree of dose conformality, i.e., the directionality of the dose profile as opposed to the standard isotropic profile, achieved through incorporation of high-density shielding materials. One such innovation is termed direction modulated brachytherapy (DMBT) [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Of which, the DMBT tandem applicator, first proposed in 2014 [ 10 ], has six symmetric peripheral grooves along a paramagnetic tungsten alloy rod (95% W, 3.5% Ni, and 1.5% Cu) with a density of 18.0 g/cm 3 and a thickness of 5.4 mm.…”

Section: Introductionmentioning

confidence: 99%

A Novel Workflow with a Customizable 3D Printed Vaginal Template and a Direction Modulated Brachytherapy (DMBT) Tandem Applicator for Adaptive Interstitial Brachytherapy of the Cervix

Sohn

Polizzi

Richeson

et al. 2022

JCM

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A novel clinical workflow utilizing a direction modulated brachytherapy (DMBT) tandem applicator in combination with a patient-specific, 3D printed vaginal needle-track template for an advanced image-guided adaptive interstitial brachytherapy of the cervix. The proposed workflow has three main steps: (1) pre-treatment MRI, (2) an initial optimization of the needle positions based on the DMBT tandem positioning and patient anatomy, and a subsequent inverse optimization using the combined DMBT tandem and needles, and (3) rapid 3D printing. We retrospectively re-planned five patient cases for two scenarios; one plan with the DMBT tandem (T) and ovoids (O) with the original needle (ND) positions (DMBT + O + ND) and another with the DMBT T&O and spatially reoptimized needles (OptN) positions (DMBT + O + OptN). All retrospectively reoptimized plans have been compared to the original plan (OP) as well. The accuracy of 3D printing was verified through the image registration between the planning CT and the CT of the 3D-printed template. The average difference in D2cc for the bladder, rectum, and sigmoid between the OPs and DMBT + O + OptNs were −8.03 ± 4.04%, −18.67 ± 5.07%, and −26.53 ± 4.85%, respectively. In addition, these average differences between the DMBT + O + ND and DMBT + O + OptNs were −2.55 ± 1.87%, −10.70 ± 3.45%, and −22.03 ± 6.01%, respectively. The benefits could be significant for the patients in terms of target coverage and normal tissue sparing and increase the optimality over free-hand needle positioning.

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Dynamic Modulated Brachytherapy (DMBT) Balloon Applicator for Accelerated Partial Breast Irradiation

Cited by 2 publications

References 51 publications

Emerging technologies in brachytherapy

Emerging technologies in brachytherapy

A Novel Workflow with a Customizable 3D Printed Vaginal Template and a Direction Modulated Brachytherapy (DMBT) Tandem Applicator for Adaptive Interstitial Brachytherapy of the Cervix

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