Individual curved‐needle interstitial template created using three‐dimensional printing for brachytherapy for distal parauterine tumor recurrence

IF 3.2 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Medical physics Pub Date : 2024-09-18 DOI:10.1002/mp.17424

Jie Zhang, Chunli Luo, Wenjun Zhang, Junfang Yan, Lang Yu, Jie Qiu

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引用次数: 0

Abstract

BackgroundAchieving a clinically acceptable dose distribution with commercial vaginal applicators for brachytherapy of recurrent parauterine tumors is challenging. However, the application of three‐dimensional (3D) printing technology in brachytherapy has been widely acknowledged and can improve clinical treatment outcomes.PurposeThis study aimed to introduce an individual curved‐needle interstitial template (ICIT) created using 3D printing technology for high‐dose‐rate (HDR) brachytherapy with interstitial treatment to provide a clinically feasible approach to distal parauterine and vaginal cuff tumors. The entire workflow, including the design, optimization, and application, is presented.MethodsTen patients with pelvic cancer recurrence were examined at our center. The vaginal topography was filled with gauze strips soaked in developer solution, and images were obtained using computed tomography (CT) and magnetic resonance imaging (MRI). Curved needle paths were designed, and ICITs were 3D‐printed according to the high‐risk clinical target volume (HRCTV) and vaginal filling model. The dose and volume histogram parameters of the HRCTV (V100, V200, D90, and D98) and organs at risk (OARs) (D2cc) were recorded.ResultsAll patients completed interstitial brachytherapy treatment with the 3D‐printed ICIT. One patient experienced vaginal cuff tumor recurrence, and nine patients experienced parametrial tumor recurrence (four on the left and five on the right). We used two to five interstitial needles, and the maximum angle of the curved needle was 40°. No source obstruction events occurred during treatment of these 10 patients. The doses delivered to the targets and OARs of all patients were within the dose limits and based on clinical experience at our center.ConclusionThe ICIT is a treatment option for patients with distal parauterine tumor recurrence. This method addresses the limitations of vaginal intracavitary and standard interstitial applicators. The ICIT has the advantages of biocompatibility, personalization, and magnetic resonance imaging compatibility.

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利用三维打印技术创建用于远端子宫旁肿瘤复发近距离治疗的单个弯针间质模板

背景使用商用阴道涂抹器对复发性子宫旁肿瘤进行近距离治疗，实现临床可接受的剂量分布具有挑战性。本研究旨在介绍一种利用三维打印技术制作的个体弯针间质模板（ICIT），用于高剂量率（HDR）近距离间质治疗，为远端子宫旁和阴道袖带肿瘤的治疗提供一种临床可行的方法。方法本中心对 10 例盆腔癌复发患者进行了检查。用浸泡在显影液中的纱布条填充阴道地形图，并使用计算机断层扫描（CT）和磁共振成像（MRI）获取图像。根据高风险临床目标容积（HRCTV）和阴道填充模型，设计了弯曲的针道并三维打印了 ICIT。记录了HRCTV（V100、V200、D90和D98）和高危器官（OARs）（D2cc）的剂量和体积直方图参数。一名患者阴道袖带肿瘤复发，九名患者宫旁肿瘤复发（左侧四名，右侧五名）。我们使用了 2 到 5 个间隙针，弯曲针的最大角度为 40°。在对这10名患者的治疗过程中，未发生任何放射源阻塞事件。根据我们中心的临床经验，所有患者的靶点和OAR的剂量都在剂量限制范围内。这种方法解决了阴道腔内和标准间质应用器的局限性。ICIT 具有生物相容性、个性化和磁共振成像兼容性等优点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical physics 医学-核医学

CiteScore

6.80

自引率

15.80%

发文量

660

审稿时长

1.7 months

期刊介绍： Medical Physics publishes original, high impact physics, imaging science, and engineering research that advances patient diagnosis and therapy through contributions in 1) Basic science developments with high potential for clinical translation 2) Clinical applications of cutting edge engineering and physics innovations 3) Broadly applicable and innovative clinical physics developments Medical Physics is a journal of global scope and reach. By publishing in Medical Physics your research will reach an international, multidisciplinary audience including practicing medical physicists as well as physics- and engineering based translational scientists. We work closely with authors of promising articles to improve their quality.