Proof-of-concept of real-time electromagnetic guidance for gynecologic interstitial catheters in high dose rate brachytherapy

IF 3.4 Q2 ONCOLOGY

Physics and Imaging in Radiation Oncology Pub Date : 2024-10-01 DOI:10.1016/j.phro.2024.100661

Audrey Cantin , Marie-Claude Lavallée , Eric Poulin , Gilion Hautvast , William Foster , Luc Beaulieu

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引用次数: 0

Abstract

Background and Purpose

The addition of interstitial needles to intracavitary gynecologic (GYN) high dose rate (HDR) brachytherapy has been shown to improve target coverage and organs-at-risk (OAR) sparing. However, no commercial solution allows real-time guidance of interstitial catheter placement. This phantom study aimed to evaluate the feasibility of an electromagnetic (EM) tracking system guidance workflow for GYN HDR brachytherapy treatment in a magnetic resonance imaging (MRI) and real-time transrectal ultrasound (TRUS) fusion scenario.

Materials and Methods

A clinical investigational system combining a treatment planning system and the EM tracking technology was used. The 3D T2 weighted magnetic resonance (MR) image set of a patient treated with intracavitary and interstitial HDR brachytherapy was retrospectively chosen. The MR image set was used to delineate the target and the OARs. A preplan was generated to determine needles positions in advance. The implant was reproduced in a water phantom. A 3D TRUS scan was acquired, and a rigid registration between the MR and the TRUS images was performed.

Results

The accuracy of the EM tracking system was < 1 mm for both the sagittal and the transverse modes of the TRUS probe. Contours that were delineated on the MRI were propagated on the TRUS images after the rigid registration. Needle insertion was successfully guided in real time with the EM tracking system on the TRUS live image using the MRI contours for guidance.

Conclusion

Based on this proof-of-concept, real-time EM-guidance of interstitial needle for GYN HDR brachytherapy appears to be feasible.

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高剂量率近距离治疗中妇科间质导管的实时电磁引导概念验证

背景和目的在腔内妇科（GYN）高剂量率近距离放射治疗（HDR）中加入间质针已被证明可提高靶点覆盖率和危险器官（OAR）疏通率。然而，目前还没有一种商业解决方案可以实时引导间质导管的放置。这项模型研究旨在评估在磁共振成像（MRI）和实时经直肠超声（TRUS）融合的情况下，电磁（EM）跟踪系统引导妇科 HDR 近距离治疗工作流程的可行性。回顾性地选择了一名接受腔内和间质 HDR 近距离放射治疗的患者的三维 T2 加权磁共振（MR）图像集。核磁共振图像集用于划定靶点和OAR。生成预案以提前确定针头位置。在水模型中再现植入物。结果电磁跟踪系统对 TRUS 探头的矢状模式和横向模式的精确度均为 1 毫米。刚性配准后，MRI 上划定的轮廓在 TRUS 图像上得以传播。结论根据这一概念验证，妇科 HDR 近距离放射治疗间质针的实时电磁引导似乎是可行的。

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

Physics and Imaging in Radiation Oncology Physics and Astronomy-Radiation

CiteScore

5.30

自引率

18.90%

发文量

审稿时长

6 weeks