Performance of an integrated multimodality image guidance and dose-planning system supporting tumor-targeted HDR brachytherapy for prostate cancer

Grajales, David; Kadoury, Samuel; Shams, Roozbeh; Barkati, Maroie; Delouya, Guila; Béliveau-Nadeau, D.; Nicolas, Benedicte; Le, William; Benhacene-Boudam, M.K.; Juneau, Daniel; DaSilva, Jean N.; Carrier, Jean‐François; Hautvast, Gilion; Ménard, Cynthia

doi:10.1016/j.radonc.2021.11.026

Cited by 8 publications

(11 citation statements)

References 29 publications

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Section: Discussionmentioning

confidence: 99%

“…Some mpMRI-or PET-based methods have greater sensitivity and specificity (respectively) for the localized characterization of PCa, but require time-consuming processing by experts or could have potential side effects for some tracers. 41,48,54 The most frequently selected Raman shifts were related to three important spectra bands that are usually more predominant in healthy (or ISUP GG ≤ 1) tissue. The first one, from 990 to 1015 cm −1 , has a central peak usually related to proteins (phenylalanine).…”

Section: Discussionmentioning

confidence: 99%

“…Details of the intervention (brachytherapy workflow), image registration, and EM tracking can be found in Ref. 48 .…”

Section: Methodsmentioning

confidence: 99%

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Image-guided Raman spectroscopy navigation system to improve transperineal prostate cancer detection. Part 2: in-vivo tumor-targeting using a classification model combining spectral and MRI-radiomics features

et al. 2022

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. Significance: The diagnosis and treatment of prostate cancer (PCa) are limited by a lack of intraoperative information to accurately target tumors with needles for biopsy and brachytherapy. An innovative image-guidance technique using optical devices could improve the diagnostic yield of biopsy and efficacy of radiotherapy. Aim: To evaluate the performance of multimodal PCa detection using biomolecular features from in-situ Raman spectroscopy (RS) combined with image-based (radiomics) features from multiparametric magnetic resonance images (mpMRI). Approach: In a prospective pilot clinical study, 18 patients were recruited and underwent high-dose-rate brachytherapy. Multimodality image fusion (preoperative mpMRI with intraoperative transrectal ultrasound) combined with electromagnetic tracking was used to navigate an RS needle in the prostate prior to brachytherapy. This resulting dataset consisted of Raman spectra and co-located radiomics features from mpMRI. Feature selection was performed with the constraint that no more than 10 features were retained overall from a combination of inelastic scattering spectra and radiomics. These features were used to train support vector machine classifiers for PCa detection based on leave-one-patient-out cross-validation. Results: RS along with biopsy samples were acquired from 47 sites along the insertion trajectory of the fiber-optics needle: 26 were confirmed as benign or grade , and 21 as grade group , according to histopathological reports. The combination of the fingerprint region of the RS and radiomics showed an accuracy of 83% ( and a ), outperforming by more than 9% models trained with either spectroscopic or mpMRI data alone. An optimal number of features was identified between 6 and 8 features, which have good potential for discriminating grade group ( ) or grade group ( ). Conclusions: In-situ Raman spectroscopy combined with mpMRI radiomics features can lead to highly accurate PCa detection for improved in-vivo targeting of biopsy sample collection and radiotherapy seed placement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Image-guided Raman spectroscopy navigation system to improve transperineal prostate cancer detection. Part 2: in-vivo tumor-targeting using a classification model combining spectral and MRI-radiomics features

et al. 2022

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“…Following a selection based on the abstracts of said papers, the count was further reduced to 40 papers. A cross-check if all relevant papers were present was performed by utilizing ConnectedPapers [8] centering on the most cited paper [9] as well as validation through centering on the oldest [10] and the most recently published paper [11].…”

Section: Introductionmentioning

confidence: 99%

Electromagnetic tracking in interstitial brachytherapy: A systematic review

2022

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Brachytherapy is a well-established treatment option for different cancer types. One treatment option, namely temporary afterloading brachytherapy, utilizes an encapsulated radioactive source, which is guided through implanted applicators to pre-defined dwell positions, to deliver highly conformal and concentrated doses to the target volume. However, treatment errors and uncertainties might still occur. The treatment therefore requires a stringent verification on an individual patient level, particularly in the form of applicator reconstruction. Electromagnetic tracking (EMT) is a possible verification option whose application neither relies on direct line of sight nor does it increase the radiation exposure. However, its systematic clinical application is not yet realized. This review will separate the concept of treatment verification through the use of electromagnetic tracking into four focus groups and categorize the relevant papers within said groups. The four focus groups are geometric assessment, applicator reconstruction, patient-individual quality assurance and adaptive treatment planning. The reviewed papers can be mainly sorted into the focus groups of geometric assessment and applicator reconstruction underlining the potential of EMT as an asset for reconstruction and localization. A smaller group of papers can be associated with patient-individual quality assurance where the detection of implant variations such as swaps within the connector cohort or single catheter shifts take center stage. The final focus group, adaptive treatment planning, is sparsely represented, yet the feasibility of an adaptive treatment course can be derived. This review will close with a discussion of possible improvements and illustrate the path ahead to clinical implementation.

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“…3D multimodality imaging (3DMMI) is generated by radiologists using image registration and segmentation algorithms based on each imaging modality, where different images synergistically contribute to a more reliable computer-generated objective tumour building. Currently, 3DMMI is applied in neurosurgery, radiation therapy, and bone oncology surgery, where is demonstrates promising efficacy in clinical practice [10][11][12][13]. However, no relevant STS studies have been performed.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Planning Using Three-Dimensional Multimodality Imaging for Soft Tissue Sarcoma of the Axilla: A Pilot Study

Fang

Xiong

Yuan

et al. 2022

Cancers

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Axillary soft tissue sarcoma (STS) is challenging due to its proximity to vital neurovascular bundles. We conducted a prospective observational pilot study to explore whether 3D multimodality imaging (3DMMI) can improve preoperative planning for and surgical outcomes of patients with axillary STS. Twenty-one patients with STS (diameter > 5 cm) of the axilla were allocated, at their discretion, to either a control group undergoing traditional preoperative planning with separate computed tomography angiography, magnetic resonance imaging, and magnetic resonance neurography, or an intervention group where 3DMMI, digitally created based on these images, revealed the tumour and adjacent skeletomuscular and neurovascular structures in three dimensions. Primary outcome measures were surgical margins and surgical complications. Secondary outcomes included operative time, blood loss, serum C-reactive protein and interleukin-6, length of hospital stay, and limb function. The 3DMMI group had a lower, although not significantly different, inadvertent positive margin rate (1/12 vs. 3/9, p = 0.272), a significantly shorter operative time (p = 0.048), reduced blood loss (p = 0.038), and reduced length of hospital stay (p = 0.046). This endorses larger trials to improve complex surgical procedures and study how preoperative planning could be performed in the future.

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Performance of an integrated multimodality image guidance and dose-planning system supporting tumor-targeted HDR brachytherapy for prostate cancer

Cited by 8 publications

References 29 publications

Image-guided Raman spectroscopy navigation system to improve transperineal prostate cancer detection. Part 2: in-vivo tumor-targeting using a classification model combining spectral and MRI-radiomics features

Image-guided Raman spectroscopy navigation system to improve transperineal prostate cancer detection. Part 2: in-vivo tumor-targeting using a classification model combining spectral and MRI-radiomics features

Electromagnetic tracking in interstitial brachytherapy: A systematic review

Preoperative Planning Using Three-Dimensional Multimodality Imaging for Soft Tissue Sarcoma of the Axilla: A Pilot Study

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