Image guided, adaptive, accelerated, high dose brachytherapy as model for advanced small volume radiotherapy

Haie-Méder, Christine; Siebert, Frank‐André; Pötter, Richard

doi:10.1016/j.radonc.2011.09.011

Cited by 29 publications

(11 citation statements)

References 220 publications

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“…Strategies for precise irradiation of moving tumors (gating/tracking) have been developed. As part of the brachytherapy procedure, patients increasingly receive some form of three-dimensional (3D) imaging [CT or magnetic resonance imaging (MRI)] to verify the application [3,4]. With these technological innovations in RT, an improvement in tumor control is no longer invariably associated with an increase in radiation-induced toxicity [2,5].…”

Section: Introductionmentioning

confidence: 99%

Functional MRI for radiotherapy dose painting

Heide

Houweling

Groenendaal

et al. 2012

Magnetic Resonance Imaging

138

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Modern radiation therapy techniques are exceptionally flexible in the deposition of radiation dose in a target volume. Complex distributions of dose can be delivered reliably, so that the tumor is exposed to a high dose, whereas nearby healthy structures can be avoided. As a result, an increase in curative dose is no longer invariably associated with an increased level of toxicity. This modern technology can be exploited further by modulating the required dose in space so as to match the variation in radiation sensitivity in the tumor. This approach is called dose painting. For dose painting to be effective, functional imaging techniques are essential to identify regions in a tumor that require a higher dose. Several techniques are available in nuclear medicine and radiology. In recent years, there has been a considerable research effort concerning the integration of magnetic resonance imaging (MRI) into the external radiotherapy workflow motivated by the superior soft tissue contrast as compared to computed tomography. In MRI, diffusion-weighted MRI reflects the cell density of tissue and thus may indicate regions with a higher tumor load. Dynamic contrast-enhanced MRI reflects permeability of the microvasculature and blood flow, correlated to the oxygenation of the tumor. These properties have impact on its radiation sensitivity. New questions must be addressed when these techniques are applied in radiation therapy: scanning in treatment position requires alternative solutions to the standard patient setup in the choice of receive coils compared to a diagnostic department. This standard positioning also facilitates repeated imaging. The geometrical accuracy of MR images is critical for high-precision radiotherapy. In particular, when multiparametric functional data are used for dose painting, quantification of functional parameters at a high spatial resolution becomes important. In this review, we will address these issues and describe clinical developments in MRI-guided dose painting.

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Section: Introductionmentioning

confidence: 99%

Functional MRI for radiotherapy dose painting

Heide

Houweling

Groenendaal

et al. 2012

Magnetic Resonance Imaging

138

View full text Add to dashboard Cite

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“…The current UK Code of Practice for HDR brachytherapy dosimetry [5] recommends a well chamber for the primary source strength measurement, but allows some flexibility in the method used to obtain the second independent verification value. Table 1 lists methods used for source calibration and their relative popularity within UK centres.…”

Section: Resultsmentioning

confidence: 99%

“…Brachytherapy is currently undergoing a period of significant innovation and rapid modernisation [3], including a shift from 2D to 3D basis [4], the enhanced use of imaging [5], patient-specific treatment plan optimisation, fully volume-based prescribing [6], inverse-planning [7], advanced planning algorithms [8], use of advanced treatment applicators [9, 10], and in-vivo dosimetry verification systems [11]. It is essential that QC test schedules keep pace with the changing technology and clinical practice.…”

Section: Purposementioning

confidence: 99%

Physics Contributions A survey of quality control practices for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy in the United Kingdom

Palmer¹,

Bidmead²,

Nisbet³

2012

jcb

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PurposeA survey of quality control (QC) currently undertaken in UK radiotherapy centres for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy has been conducted. The purpose was to benchmark current accepted practice of tests, frequencies and tolerances to assure acceptable HDR/PDR equipment performance. It is 20 years since a similar survey was conducted in the UK and the current review is timed to coincide with a revision of the IPEM Report 81 guidelines for quality control in radiotherapy.Material and methodsAll radiotherapy centres in the UK were invited by email to complete a comprehensive questionnaire on their current brachytherapy QC practice, including: equipment type, patient workload, source calibration method, level of image guidance for planning, prescribing practices, QC tests, method used, staff involved, test frequencies, and acceptable tolerance limits.ResultsSurvey data was acquired between June and August 2012. Of the 64 centres invited, 47 (73%) responded, with 31 centres having brachytherapy equipment (3 PDR) and fully completing the survey, 13 reporting no HDR/PDR brachytherapy, and 3 intending to commence HDR brachytherapy in the near future. All centres had comprehensive QC schedules in place and there was general agreement on key test frequencies and tolerances. Greatest discord was whether source strength for treatment planning should be derived from measurement, as at 58% of centres, or from the certified value, at 42%. IPEM Report 81 continues to be the most frequently cited source of QC guidance, followed by ESTRO Booklet No. 8.ConclusionsA comprehensive survey of QC practices for HDR/PDR brachytherapy in UK has been conducted. This is a useful reference to which centres may benchmark their own practice. However, individuals should take a risk-assessment based approach, employing full knowledge of local equipment, clinical procedures and available test equipment in order to determine individual QC needs.

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“…It means that volume of irradiated tissue is relatively low comparing to EBRT. It also makes high dose escalation possible, but interstitial implant is needed [12, 13]. Radiotherapy complications are acute and late, mostly in bladder and rectum, like incontinence, diarrhea, urinary stricture, impotence and proctitis.…”

Section: Purposementioning

confidence: 99%

Educational Corner Prostate cancer brachytherapy: guidelines overview

Wojcieszek¹,

Białas²

2012

jcb

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Prostate cancer, due to wide availability of PSA tests, is very often diagnosed in early stage, nowadays. This makes management of this disease even harder in every day oncology care. There is a wide range of treatment options including surgery, radiotherapy and active surveillance, but essential question is which treatment patient and oncologist should decide for. Due to recent publication of Prostate Cancer Results Study Group, in which brachytherapy is one of supreme curative options for prostate cancer, we decided to overview most present european and north american recommendations. National Comprehensive Cancer Network, American Society for Radiation Oncology, American Brachytherapy Society, European Association of Urology and Groupe Européen de Curiethérapie of European Society for Therapeutic Radiation Oncology guidelines are overviewed, particularly focusing on HDR and LDR brachytherapy.

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Image guided, adaptive, accelerated, high dose brachytherapy as model for advanced small volume radiotherapy

Cited by 29 publications

References 220 publications

Functional MRI for radiotherapy dose painting

Functional MRI for radiotherapy dose painting

Physics Contributions A survey of quality control practices for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy in the United Kingdom

Educational Corner Prostate cancer brachytherapy: guidelines overview

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