Implementation of needle-tracking technology for real-time transrectal ultrasound-guided interstitial gynecological HDR brachytherapy: A feasibility study

IF 2.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2025-05-08 DOI:10.1002/acm2.70100

Lindsey H. Bloom, Diandra Ayala-Peacock, Rajesh Venkataraman, Brett Eckroate, Ryan Sanford, Junzo Chino, Yongbok Kim, Julie Raffi, Oana Craciunescu

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引用次数: 0

Abstract

Purpose

To investigate the feasibility of adapting a commercial prostate biopsy system for transrectal ultrasound (TRUS)-guided hybrid gynecological (GYN) high-dose-rate (HDR) brachytherapy (BT). Leveraging 3D-TRUS and MR image fusion, the prototype system aims to improve real-time needle placement accuracy.

Materials and Methods

A second-generation, multi-imaging modality female pelvic phantom was developed to validate the system's feasibility. Software and hardware modifications, including user-accessible calibration modules and a redesigned needle guide for multi-needle insertion, were made to the pre-existing commercial system to enable use for GYN BT applications. An end-to-end feasibility test was performed to acquire 3D-TRUS images, perform contour-based registration with pre-implant MR, and insert six needles to targeted locations under real-time TRUS guidance. A 30° tandem without ovoids was added to mimic a hybrid GYN implant. The most proximal and most distal distances between the planned needle track and the visible portion of each inserted needle were measured. A CT/MR image-based treatment plan with a prescribed dose of 6 Gy was generated for the resulting 3D-TRUS-guided implant (tandem and needles) within the phantom.

Results

The modified phantom improved needle visualization and insertion range by de-gassing the silicone and increasing the window size. The system accuracy for average ± standard deviations from intended needle tracks was 1.31 ± 1.36 mm (proximal) and 2.04 ± 2.05 mm (distal). Post-implant imaging confirmed needle placement and good target coverage. Needle placement was verified on CT/MR images and treatment plan quality was clinically acceptable.

Conclusions

With enhanced needle placement accuracy and integrated clinical workflow, this study demonstrates the feasibility of adapting a commercially available prostate biopsy system for 3D-TRUS-guided hybrid GYN HDR BT.

Abstract Image

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实时经直肠超声引导间质性妇科HDR近距离放射治疗中针迹追踪技术的可行性研究

目的：探讨经直肠超声（TRUS）引导下混合妇科（GYN）高剂量率（HDR）近距离放射治疗（BT）采用商用前列腺活检系统的可行性。利用3D-TRUS和MR图像融合，原型系统旨在提高实时针头放置精度。材料和方法：第二代，多成像模式的女性骨盆幻影被开发来验证系统的可行性。软件和硬件修改，包括用户可访问的校准模块和重新设计的多针插入针导，对现有的商业系统进行了修改，使GYN BT应用能够使用。进行端到端可行性测试，获取3D-TRUS图像，使用预植入MR进行基于轮廓的配准，并在实时TRUS引导下将6根针插入目标位置。添加无卵泡的30°串联假体来模拟混合GYN假体。测量计划的针迹与每个插入针的可见部分之间的最近和最远距离。生成基于CT/MR图像的治疗计划，规定剂量为6 Gy，用于生成3d - truss引导的假体内植入物（串联和针）。结果：改进的假体通过脱气硅胶和增加窗口大小，提高了针的可视性和插入范围。系统对预定针径的平均±标准偏差精度为1.31±1.36 mm（近端）和2.04±2.05 mm（远端）。植入后成像证实针头放置和良好的目标覆盖。CT/MR图像验证置针，治疗方案质量临床可接受。结论：通过提高针头放置准确性和整合临床工作流程，本研究证明了将市上可用的前列腺活检系统用于3d - trus引导的混合GYN HDR BT的可行性。

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

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic