Use of cone-beam imaging to correct for catheter displacement in high dose-rate prostate brachytherapy

Holly, R.; Morton, Gerard; Sankreacha, Raxa; Law, Niki; Cisecki, Thomas; Loblaw, D.A.; Chung, Hans T.

doi:10.1016/j.brachy.2010.11.007

Cited by 62 publications

(33 citation statements)

References 13 publications

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“…Furthermore, determination of the cumulative dose may be difficult, since a different treatment modality was used as primary treatment. We suggest that dose constraints based on Holly et al (for rectum and bladder D 1cc < 12 Gy, for urethra D 10% < 17.7 Gy) may be considered in clinical practice for both 1 st and 2 nd salvage HDR-BT [25]. …”

Section: Discussionmentioning

confidence: 99%

“…As no literature on second salvage dose prescription is available, dose constraints based on Holly et al . were used [13], for rectum and bladder a D 1cc < 12 Gy, for urethra a D 10% < 17.7 Gy. Also, post-implant MRI sequences (same sequences as the intra-operative MRI) were performed to assess dose differences caused by intra-operative catheter shifts.…”

Section: Methodsmentioning

confidence: 99%

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Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Maenhout

Vulpen

Moerland

et al. 2017

jcb

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PurposeSalvage treatments for localized radiorecurrent prostate cancer can be performed safely when a focal and image guided approach is used. Due to the low toxicity, the opportunity exists to investigate a second salvage treatment when a second locally recurrent prostate cancer occurs. Here, we describe a second salvage treatment procedure of 4 patients.Material and methodsFour patients with a pathologically proven second local recurrence were treated in an outpatient magnetic resonance imaging (MRI)-guided setting with a single fraction of 19 Gy focal high-dose-rate brachytherapy (HDR-BT). Delineation was performed using choline-PET-CT or a 68Ga-PSMA PET in combination with multiparametric 3 Tesla MRI in all four patients. Toxicity was measured using common toxicity criteria for adverse events (CTCAE) version 4.0.ResultsWith a median follow-up of 12 months (range, 6-15), there were 2 patients with biochemical recurrence as defined by the Phoenix-definition. There were no patients with grade 3 or more toxicity. In all second salvage HDR-BT treatments, the constraints for rectum, bladder, and urethra were met. Median treatment volume (GTV) was 4.8 cc (range, 1.9-6.6 cc). A median of 8 catheters (range, 6-9) were used, and the median dose to the treatment volume (GTV) was a D95: 19.3 Gy (SD 15.5-19.4 Gy).ConclusionsSecond focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Maenhout

Vulpen

Moerland

et al. 2017

jcb

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“…Holly et al . [110] used a cone-beam CT imaging technique to verify the positioning of HDR applicators prior to treatment delivery, in prostate brachytherapy. The mean internal displacement of the catheters was 11 mm, resulting in a decrease in mean volume receiving 100% of prescription dose (V100) from planned 97.6% to 77.3% ( p < 0.001).…”

Section: Review Of Physics-processes In Hdr Brachytherapymentioning

confidence: 99%

Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques

Palmer¹,

Bradley²,

Nisbet³

2012

jcb

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This study provides a review of recent publications on the physics-aspects of dosimetric accuracy in high dose rate (HDR) brachytherapy. The discussion of accuracy is primarily concerned with uncertainties, but methods to improve dose conformation to the prescribed intended dose distribution are also noted. The main aim of the paper is to review current practical techniques and methods employed for HDR brachytherapy dosimetry. This includes work on the determination of dose rate fields around brachytherapy sources, the capability of treatment planning systems, the performance of treatment units and methods to verify dose delivery. This work highlights the determinants of accuracy in HDR dosimetry and treatment delivery and presents a selection of papers, focusing on articles from the last five years, to reflect active areas of research and development. Apart from Monte Carlo modelling of source dosimetry, there is no clear consensus on the optimum techniques to be used to assure dosimetric accuracy through all the processes involved in HDR brachytherapy treatment. With the exception of the ESTRO mailed dosimetry service, there is little dosimetric audit activity reported in the literature, when compared with external beam radiotherapy verification.

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“…2 Intra-operatively planned HDR-BT requires imaging and segmentation of the prostate, nearby organs, and final needle positions to correctly assign the amount of time the radiation source spends at each position along each needle in order to irradiate the prostate and spare normal tissue. Originally, this imaging was performed using CT which provided high contrast between needles and tissue; 3 however, repositioning the patient for imaging was found to lead to needles shifts greater than 20 mm in 10% of needles prior to 4 Since needle insertions are monitored in real-time using the bi-planar TRUS probe, techniques were developed that enabled the imaging and segmentation of organs and needles using 2D TRUS images, thereby eliminating the need to reposition the patient intra-operatively. 5 By stepping the bi-plane TRUS probe in the superior/inferior direction in 1-5 mm intervals, a stack of 2D axial images traversing the bladder and prostate may be acquired for organ segmentation.…”

Section: Introductionmentioning

confidence: 99%

A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning

Hrinivich¹,

Hoover²,

Surry³

et al. 2016

Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling

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Background: High-dose-rate brachytherapy (HDR-BT) is a prostate cancer treatment option involving the insertion of hollow needles into the gland through the perineum to deliver a radioactive source. Conventional needle imaging involves indexing a trans-rectal ultrasound (TRUS) probe in the superior/inferior (S/I) direction, using the axial transducer to produce an image set for organ segmentation. These images have limited resolution in the needle insertion direction (S/I), so the sagittal transducer is used to identify needle tips, requiring a manual registration with the axial view. This registration introduces a source of uncertainty in the final segmentations and subsequent treatment plan. Our lab has developed a device enabling 3D-TRUS guided insertions with high S/I spatial resolution, eliminating the need to align axial and sagittal views. Purpose: To compare HDR-BT needle tip localization accuracy between 2D and 3D-TRUS. Methods: 5 prostate cancer patients underwent conventional 2D TRUS guided HDR-BT, during which 3D images were also acquired for post-operative registration and segmentation. Needle end-length measurements were taken, providing a gold standard for insertion depths. Results: 73 needles were analyzed from all 5 patients. Needle tip position differences between imaging techniques was found to be largest in the S/I direction with mean±SD of -2.5±4.0 mm. End-length measurements indicated that 3D TRUS provided statistically significantly lower mean±SD insertion depth error of -0.2±3.4 mm versus 2.3±3.7 mm with 2D guidance (p < .001). Conclusions: 3D TRUS may provide more accurate HDR-BT needle localization than conventional 2D TRUS guidance for the majority of HDR-BT needles.

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Use of cone-beam imaging to correct for catheter displacement in high dose-rate prostate brachytherapy

Cited by 62 publications

References 13 publications

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Physics-aspects of dose accuracy in high dose rate (HDR) brachytherapy: source dosimetry, treatment planning, equipment performance and in vivo verification techniques

A comparison of needle tip localization accuracy using 2D and 3D trans-rectal ultrasound for high-dose-rate prostate cancer brachytherapy treatment planning

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