Clinical and Translational Radiation Oncology最新文献

{"title":"Comparison of 18F-FET-PET- and MRI-based target definition for re-irradiation treatment of recurrent diffuse glioma","authors":"Albert Everard ,&nbsp;Daniel Versnel ,&nbsp;Veerle Ruijters ,&nbsp;Nelleke Tolboom ,&nbsp;Marielle Philippens ,&nbsp;Tom Snijders ,&nbsp;Joost Verhoeff ,&nbsp;Szabolcs David ,&nbsp;Casper Beijst","doi":"10.1016/j.ctro.2025.100931","DOIUrl":"10.1016/j.ctro.2025.100931","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The target area definition for re-irradiation of recurrent glioma typically relies on T1-weighted gadolinium-enhanced MRI (T1Gd), but T1Gd fails to capture glioma infiltration. While T2 FLAIR and CTV margins can address this limitation, their extend in re-irradiation remains debated to minimize toxicity. In contrast, ¹⁸F-FET-PET imaging can better visualize infiltrative components, improving target definition. This study investigates the role of ¹⁸F-FET-PET in target definition by analyzing shape differences and gray-white matter tissue composition.</div></div><div><h3>Material and methods</h3><div>Retrospective data from 36 patients with recurrent glioma were used. These patients underwent ¹⁸F-FET-PET, on which Biological Tumor Volume (BTV_PET) was delineated, and T1Gd, on which Gross Tumor Volume (GTV_MRI) and Clinical tumor volume (CTV_MRI) were delineated. Lesion volume, shape (Hausdorff distance (HD) and Center of Mass Distance (CoM-D)), tissue composition and re-recurrence volume were compared between the delineations.</div></div><div><h3>Results</h3><div>BTV_PET and the non-overlapping BTV_PET-GTV_MRI volumes were significantly larger than GTV_MRI and non-overlapping GTV_MRI-BTV_PET (P &lt; 0.001), but significantly smaller than the CTV_MRI (P &lt; 0.001). The median HD and CoM-D were 19 mm and 6 mm. A correlation was found between the white matter (WM) ratio in GTV_MRI and WM in non-overlapping BTV_PET (slope = 0.36, R² = 0.36;P &lt; 0.001) and a correlation with gray matter (GM) in non-overlapping BTV_PET (slope = -0.15, R² = 0.11;P &lt; 0.05). Recurrence after reirradiation was significantly higher within BTV_PET than GTV_MRI (P &lt; 0.001). The ratio of the GTV_MRI which recurred was significantly higher than the non-overlapping BTV_PET (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our results suggest that ¹⁸F-FET-PET reveals a more complete extent of glioma’s infiltration, suggesting that the current practice of using isotropic CTV margins around the T1Gd-GTV should be reconsidered in favor of anisotropic CTV based on ¹⁸F-FET-PET.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100931"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fully automated machine-learning-based workflow for radiation treatment planning in prostate cancer","authors":"Jan-Hendrik Bolten ,&nbsp;David Neugebauer ,&nbsp;Christoph Grott ,&nbsp;Fabian Weykamp ,&nbsp;Jonas Ristau ,&nbsp;Stephan Mende ,&nbsp;Elisabetta Sandrini ,&nbsp;Eva Meixner ,&nbsp;Victoria Navarro Aznar ,&nbsp;Eric Tonndorf-Martini ,&nbsp;Kai Schubert ,&nbsp;Christiane Steidel ,&nbsp;Lars Wessel ,&nbsp;Jürgen Debus ,&nbsp;Jakob Liermann","doi":"10.1016/j.ctro.2025.100933","DOIUrl":"10.1016/j.ctro.2025.100933","url":null,"abstract":"<div><h3>Introduction</h3><div>The integration of artificial intelligence into radiotherapy planning for prostate cancer has demonstrated promise in enhancing efficiency and consistency. In this study, we assess the clinical feasibility of a fully automated machine learning (ML)-based “one-click” workflow that combines ML-based segmentation and treatment planning. The proposed workflow was designed to create a clinically acceptable radiotherapy plan within the inter-observer variation of conventional plans.</div></div><div><h3>Methods</h3><div>We evaluated the fully-automated workflow on five low-risk prostate cancer patients treated with external beam radiotherapy and compared the results with conventional optimized and inverse planned radiotherapy plans based on the contours of six different experienced radiation oncologists. Both qualitative and quantitative metrics were analyzed. Additionally, we evaluated the dose distribution of the ML-based and conventional radiation treatment plans on the different segmentations (manual vs. manual and manual vs. automation).</div></div><div><h3>Results</h3><div>The automatic deep-learning segmentation of the target volume revealed a close agreement between the deep-learning based and expert contours referring to Dice Similarity- and Hausdorff index. However, the deep-learning based CTVs had a significantly smaller volume than the expert CTVs (47.1 cm3 vs. 62.6 cm³). The fully automated ML-based plans provide clinically acceptable dose coverage within the range of inter-observer variability observed in the manual plans. Due to the smaller segmentation of the CTV the dose coverage of the CTV and PTV (expert contours) were significantly lower than that of the manual plans.</div></div><div><h3>Conclusion</h3><div>Our study indicates that the tested fully automated ML-based workflow is clinically feasible and leads to comparable results to conventional radiation treatment plans. This represents a promising step towards efficient and standardized prostate cancer treatment. Nevertheless, in the evaluated cohort, auto segmentation was associated with smaller target volumes compared to manual contours, highlighting the necessity of improving segmentation models and prospective testing of automation in radiation therapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100933"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of metformin as a radiosensitiser in solid tumours: A systematic review","authors":"Elísabet González del Portillo ,&nbsp;Alejandro Olivares-Hernández ,&nbsp;Luis Corral Gudino ,&nbsp;Laura Corvo Félix ,&nbsp;Lorena Bellido Hernández ,&nbsp;Luis Posado Domínguez ,&nbsp;David León Jiménez ,&nbsp;Rogelio González Sarmiento ,&nbsp;Edel del Barco Morillo ,&nbsp;Emilio Fonseca Sánchez ,&nbsp;José Pablo Miramontes-Gonzáleze","doi":"10.1016/j.ctro.2025.100930","DOIUrl":"10.1016/j.ctro.2025.100930","url":null,"abstract":"<div><h3>Background</h3><div>Metformin is an antidiabetic drug that has shown its benefit in increasing the effect of radiotherapy in the treatment of solid tumors in preclinical studies. The objective of this systematic review is to study the effect of metformin as a radiosensitizer in studies carried out in clinical practice.</div></div><div><h3>Methods</h3><div>Systematic review carried out according to PRISMA criteria of clinical trials, systematic reviews and observational studies focused on the influence of metformin as a radiosensitizer in solid tumors. The studies were published between the years 2010 and 2022. The results of the studies have been analyzed in terms of survival (OS, PFS, DFS, DMFS) and response (ORR) between patients treated with metformin and without it.</div></div><div><h3>Results</h3><div>A total of 16 studies have been found in the literature (the most frequent tumor was prostate cancer, 5 studies). External radiotherapy was administered in all the studies and in two of them to greater brachytherapy. The use of metformin with radiotherapy showed a consistent benefit in terms of survival and response in tumors of prostate, hepatic and gynecological origin. The benefit in the rest of the tumors analyzed (lung, rectal, and head and neck cancer) is doubtful, and the results are contradictory. The greatest benefits were observed in prostate tumors both in OS and SLE.</div></div><div><h3>Conclusions</h3><div>The use of metformin in combination with radiotherapy in solid tumors is one of the most promising treatments under development in oncology. The benefit observed in real-life studies makes it necessary to develop clinical trials that specifically evaluate its use in clinical practice in the future.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100930"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients","authors":"Femke Vaassen ,&nbsp;David Hofstede ,&nbsp;Catharina M.L. Zegers ,&nbsp;Jeanette B. Dijkstra ,&nbsp;Ann Hoeben ,&nbsp;Monique H.M.E. Anten ,&nbsp;Ruud M.A. Houben ,&nbsp;Frank Hoebers ,&nbsp;Inge Compter ,&nbsp;Wouter van Elmpt ,&nbsp;Daniëlle B.P. Eekers","doi":"10.1016/j.ctro.2025.100929","DOIUrl":"10.1016/j.ctro.2025.100929","url":null,"abstract":"<div><h3>Purpose</h3><div>Assess cognitive changes after radiotherapy (RT) in brain and head-and-neck (HN) cancer patients using patient-reported outcome measures (PROMs) and evaluate a dose–effect relationship for brain structures.</div></div><div><h3>Materials and methods</h3><div>Primary brain and HN cancer patients treated with RT between 2012–2021 were included. Patient characteristics, clinical parameters, and PROMs at baseline and 1-year follow-up were collected. Cognitive functioning (CF) from the EORTC QLQ-C30, communication deficit (CD) from the QLQ-BN20, and one cognition-related questions from the EQ6D questionnaire were used, the latter two only for brain patients. Missing data were imputed and the four-point scale scores were transformed to a 100-point scale. Change in scores from baseline to 1-year were categorized into improvement/constant or deterioration. Organs-at-risk (OARs) were contoured either clinically or retrospectively using autocontouring and dose to the OARs were calculated.</div></div><div><h3>Results</h3><div>A total of 110 brain and 356 HN cancer patients were included. Median age was 56 (brain) and 67.5 (HN) years. Baseline and 1-year CF was significantly lower for brain patients (p &lt; 0.001). Univariate analysis for ΔCF showed that age at start RT ≤ 65 years, receiving chemotherapy, higher CF Baseline score, brain mean dose &gt; 3 Gy, and multiple dose levels to left and right hippocampus were statistically associated with cognitive deterioration. Multivariate analysis for ΔCF identified age at RT ≤ 65 years, higher CF Baseline score, and brain mean dose &gt; 3 Gy as significant predictors.</div></div><div><h3>Conclusion</h3><div>This study identified risk factors for subjective cognitive decline and suggests that patients’ self-perceived cognitive deterioration may be related to age, CF baseline score and brain radiation dose above 3 Gy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100929"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute enteritis with pelvic SBRT: Influence of bowel delineation methods","authors":"Akshay Dinesan,&nbsp;Maneesh Singh,&nbsp;Prachi Mehta,&nbsp;Priyamvada Maitre,&nbsp;Vedang Murthy","doi":"10.1016/j.ctro.2025.100926","DOIUrl":"10.1016/j.ctro.2025.100926","url":null,"abstract":"<div><h3>Purpose</h3><div>One fourth of the patients receiving SBRT to prostate and pelvis develop mild to moderate acute enteritis. In this study, we aim to study bowel dosimetry for different methods of bowel delineation in patients with and without acute bowel toxicity after whole-pelvic SBRT (WP-SBRT).</div></div><div><h3>Methods and materials</h3><div>In this prospective study, patients with high-risk prostate cancer treated with WP-SBRT were identified. Patients with acute bowel toxicity (CTCAE v5.0) were included as cases while those without were controls. All the patients had previously received 35–36.25 Gy in 5 fractions to the prostate and 25 Gy in 5 fractions to the pelvis. The bowel was contoured on the planning CT scan using seven different methods, namely- bowel bag (BB), small bowel loop (SB), large bowel loop (LB), combined bowel loop (BL) and bowel loops with margins (BL + 0.5 cm, BL + 1 cm and BL + 1.5 cm). The original clinically used plan was applied to all the contouring methods and dose-volume parameters studied.</div></div><div><h3>Results</h3><div>A total of 102 patients treated with WP-SBRT were screened and only those with properly documented acute toxicity were included for further analysis. While none of the patients had grade 3 bowel toxicity, 23 (22.5 %) patients had grade 1–2 acute enteritis, and 23 patients without were selected as cases and controls respectively. On visual assessment, the composite dose volume histogram (DVH) were similar for cases and controls for all the delineation methods studied. Objectively, the volume of the bowel structures receiving 7 Gy, 14 Gy, and 25 Gy did not show any statistically significant difference between cases and controls. One in five patients treated with WP-SBRT using bowel bag dose constraints of V₇ &lt; 1500 cc, V₁₄ &lt; 500 cc and V₂₅ &lt; 50 cc had acute enteritis.</div></div><div><h3>Conclusion</h3><div>There was no significant difference in planned bowel doses for different bowel delineation methods in patients with prostate cancer treated with WP-SBRT with or without acute bowel toxicity.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100926"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143279376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of perineural tumor spread in head and neck adenoid cystic carcinoma for carbon-ion radiotherapy","authors":"Atsushi Musha ,&nbsp;Nobuteru Kubo ,&nbsp;Hidemasa Kawamura ,&nbsp;Naoko Okano ,&nbsp;Masahiro Onishi ,&nbsp;Takeru Ohtaka ,&nbsp;Midori Tamura ,&nbsp;Osamu Nikkuni ,&nbsp;Yuichi Tomidokoro ,&nbsp;Satoshi Yokoo ,&nbsp;Kazuaki Chikamatsu ,&nbsp;Tatsuya Ohno","doi":"10.1016/j.ctro.2025.100928","DOIUrl":"10.1016/j.ctro.2025.100928","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Despite recognizing the effectiveness of carbon-ion radiotherapy (C-ion RT) in treating head and neck adenoid cystic carcinoma (HN-ACC), the impact of perineural tumor spread (PNTS) on treatment outcomes and the relationship between PNTS and post-treatment marginal recurrences remain unexplored. Therefore, we analyzed the efficacy of C-ion RT in HN-ACC, focusing on PNTS including details of post-treatment marginal recurrence and indicators for future treatment strategies.</div></div><div><h3>Materials and methods</h3><div>In this retrospective study, we included 74 patients diagnosed with HN-ACC who underwent C-ion RT between June 2010 and July 2022. Treatment dosages were either 57.6 or 64.0 Gy (relative biological effectiveness) delivered in 16 fractions. Patients undergoing C-ion RT were identified retrospectively from medical records. PNTS was evaluated by magnetic resonance imaging for detecting extratumoral extension to peritumoral nerves.</div></div><div><h3>Results</h3><div>The median duration of follow-up was 46.4 months. Local recurrence developed in 19 patients. Moreover, most marginal recurrences occurred within the irradiated margins. The 5-year rates for local control (LC), progression-free survival (PFS), and overall survival (OS) were 67.6 %, 47.7 %, and 79.0 %, respectively. LC (<em>p</em> = 0.005) and PFS (<em>p</em> = 0.013) demonstrated significant variances on analysis based on PNTS occurrence; however, OS did not exhibit a similar pattern.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the importance for considering disease-specific characteristics and the need for developing targeted strategies that address the complex nature of HN-ACC, particularly in cases involving PNTS, to enhance treatment outcomes and potentially reduce recurrence rates.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100928"},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143216948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of FLASH proton therapy on primary bronchial epithelial cell organoids","authors":"Merian E. Kuipers ,&nbsp;Floriane van Liefferinge ,&nbsp;Ernst van der Wal ,&nbsp;Marta Rovituso ,&nbsp;Annelies M. Slats ,&nbsp;Pieter S. Hiemstra ,&nbsp;Krista C.J. Van Doorn-Wink","doi":"10.1016/j.ctro.2025.100927","DOIUrl":"10.1016/j.ctro.2025.100927","url":null,"abstract":"<div><h3>Purpose</h3><div>The effects of conventional (CONV) and FLASH proton therapy on primary bronchial epithelial cell (PBEC) organoids from individuals with chronic obstructive pulmonary disease (COPD) were investigated. The primary objective was to compare the effect of FLASH and CONV on COPD PBEC organoids with a focus on DNA damage, organoid formation, and gene expression.</div></div><div><h3>Methods</h3><div>PBECs were obtained from six COPD donors, cultured as three-dimensional (3D) organoids and exposed to 2 and 8 Gy CONV and FLASH proton radiation at the Holland Proton Therapy Center. DNA damage was assessed by γH2AX staining. Organoid formation capacity was assessed by counting the organoids formed after reseeding irradiated cells at 24 h and 7 days. Bulk RNA sequencing (RNAseq) and qPCR analyses were performed to identify pathways and differences in the radiation response.</div></div><div><h3>Results</h3><div>γH2AX foci analysis showed a significant dose-dependent increase in DNA damage at 1 h for both CONV and FLASH treatments, without differences between the two modalities. Organoid formation assays revealed a dose-dependent decrease in organoid formation capacity at 24 h for both treatments. At 7 days, 2 Gy FLASH-treated samples showed significantly reduced organoid formation compared to 2 Gy CONV (p = 0.008). RNAseq identified CONV and FLASH-induced changes in expression of DNA-damage response and apoptosis pathway genes. A dose-dependent upregulation of MDM2, GDF15, DDB2, BAX, P21, AEN and a decrease in MKi67 expression was confirmed by qPCR analysis.</div></div><div><h3>Conclusion</h3><div>No significant differences were found in DNA damage or gene expression profiles between CONV and FLASH. The organoid formation assay showed a prolonged detrimental effect in the FLASH-treated organoids, suggesting a more complex interaction of FLASH with lung epithelial cells. The results of this study contribute to the advancement of robust <em>in vitro</em> human lung models for investigating the mechanisms of action of FLASH, potentially facilitating the treatment of NSCLC patients with proton FLASH therapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100927"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brachytherapy: Perspectives for combined treatments with immunotherapy","authors":"Raphaël Serre ,&nbsp;Alexandra Gabro ,&nbsp;Mickael Andraud ,&nbsp;Jean-Marc Simon ,&nbsp;Jean-Philippe Spano ,&nbsp;Philippe Maingon ,&nbsp;Cyrus Chargari","doi":"10.1016/j.ctro.2025.100924","DOIUrl":"10.1016/j.ctro.2025.100924","url":null,"abstract":"<div><div>Combining brachytherapy with immunotherapies, particularly immune checkpoint inhibitors (ICIs), is a promising approach for potentiating both local control of the tumor and fully exploiting the synergies between pharmaceutic immunomodulation and radiotherapy. Compared to other radiotherapy techniques, BT has a potential to better spare lymphatic drainage areas and gut microbiota, thus reducing the immunosuppressive effects of radiation therapy. In addition, it delivers a broad range of doses due to inherent dose inhomogeneity within the implanted volume. This variability increases the probability that immune infiltrates would be activated, particularly since the optimal dose for immune activation is not yet firmly established. Even if preclinical models show that radiotherapy can stimulate immune responses, it can also induce toxic effects on immune effectors and combination trials show conflicting outcomes. There is a need for refining radiation modalities to enhance immune potentiation. The dosimetric specificities of BT may offer various advantages and should be explored further. Scarce clinical data on combining brachytherapy with ICIs in advanced cancer suggest potential benefits, with case reports of complete local responses and abscopal effects. However, validation requires a large number of patients in randomized clinical trials for which ideal design is discussed. In parallel with ongoing clinical developments, there is a need to refine preclinical models in order to better analyze the specific biological effects involved in BT, in light of immunomodulatory systemic treatments.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100924"},"PeriodicalIF":2.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully automatic reconstruction of prostate high-dose-rate brachytherapy interstitial needles using two-phase deep learning-based segmentation and object tracking algorithms","authors":"Mohammad Mahdi Moradi ,&nbsp;Zahra Siavashpour ,&nbsp;Soheib Takhtardeshir ,&nbsp;Eman Showkatian ,&nbsp;Ramin Jaberi ,&nbsp;Reza Ghaderi ,&nbsp;Bahram Mofid ,&nbsp;Farzad Taghizadeh-Hesary","doi":"10.1016/j.ctro.2025.100925","DOIUrl":"10.1016/j.ctro.2025.100925","url":null,"abstract":"<div><div>The critical aspect of successful brachytherapy (BT) is accurate detection of applicator/needle trajectories, which is an ongoing challenge. This study proposes a two-phase deep learning-based method to automate localization of high-dose-rate (HDR) prostate BT catheters through the patient’s CT images. The whole process is divided into two phases using two different deep neural networks. First, BT needles segmentation was accomplished through a pix2pix Generative Adversarial Neural network (pix2pix GAN). Second, a Generic Object Tracking Using Regression Networks (GOTURN) was used to predict the needle trajectories. These models were trained and tested on a clinical prostate BT dataset. Among the total 25 patients, 5 patients that consist of 592 slices was dedicated to testing sets, and the rest were used as train/validation set. The total number of needles in these slices of CT images was 8764, of which the employed pix2pix network was able to segment 98.72 % (8652 of total). Dice Similarity Coefficient (DSC) and IoU (Intersection over Union) between the network output and the ground truth were 0.95 and 0.90, respectively. Moreover, the F1-score, recall, and precision results were 0.95, 0.93, and 0.97, respectively. Regarding the location of the shafts, the proposed model has an error of 0.41 mm. The current study proposed a novel methodology to automatically localize and reconstruct the prostate HDR-BT interstitial needles through the 3D CT images. The presented method can be utilized as a computer-aided module in clinical applications to automatically detect and delineate the multi-catheters, potentially enhancing the treatment quality.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100925"},"PeriodicalIF":2.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness, toxicity and impact on quality of life of high-dose-rate brachytherapy delivered in two fractions as monotherapy in patients with prostate cancer","authors":"Johan Staby Olsén ,&nbsp;Antonis Valachis ,&nbsp;Bengt Johansson","doi":"10.1016/j.ctro.2025.100923","DOIUrl":"10.1016/j.ctro.2025.100923","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this retrospective, single-center cohort study was to evaluate the effectiveness and safety of two-fraction high-dose-rate brachytherapy (HDR-BT) as monotherapy in a consecutive cohort of prostate cancer patients.</div></div><div><h3>Methods</h3><div>We included consecutive patients who received 28 Gy HDR-BT in two fractions (14 Gy × 2) as monotherapy during 2005 to 2021 at our institution. Eligible patients were derived from an institutional database consisting of prospectively collected data. Primary endpoint was biochemical recurrence (BCR) and secondary endpoints included toxicity (assessed through both healthcare provider and patient-reported outcomes) and quality-of-life (QoL) assessment.</div></div><div><h3>Results</h3><div>In total, 175 patients with prostate cancer (94 % classified as low- or intermediate-risk) were treated with HDR-BT during the study period with a median age of 68 years (range: 51–80), and a median follow-up of 60 months (range: 0–174). The estimated five-year cumulative BCR rate was 3.0 % (95 % Confidence Interval (CI): 0 %–13.3 %) for low-risk patients and 9.6 % (95 % CI: 4.7 %–16.7 %) for intermediate-risk patients. PSA exceeding 10 ng/mL at diagnosis was a significant risk factor for BCR (Odds Ratio (OR) = 3.29, 95 % CI: 1.01–10.67) whereas PSA of ≤0.1 ng/ml as nadir was a significant positive prognostic factor, associated with lower risk of BCR (OR = 0.11, 95 % CI: 0.03–0.33). At 12 months, 22 % of the patients had grade 2 and 3 % grade 3 urinary toxicity whereas 2 % of patients had grade 2 and none grade 3 bowel toxicity. At 12 months, 49 % of the patients with at least some erectile function before the treatment, had an impaired function.</div></div><div><h3>Conclusion</h3><div>We found that two-fraction HDR-BT as monotherapy among patients with mainly low- and intermediate-risk prostate cancer appears to be safe in terms of biochemical recurrence, with a low proportion of severe urinary and bowel toxicity.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100923"},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}