Journal of Contemporary Brachytherapy最新文献

{"title":"Quality control strategies for head and neck brachytherapy (interventional radiotherapy).","authors":"Bruno Fionda, Elisa Placidi, Enrico Rosa, Valentina Lancellotta, Maria Vaccaro, Patrizia Cornacchione, Martina De Angeli, Sara Scalise, Gabriele Ciasca, Francesco Pastore, Víctor González-Pérez, Francesco Miccichè, Mariangela Massaccesi, Maria Antonietta Gambacorta, Jacopo Galli, Francesco Bussu, Marco De Spirito, Luca Tagliaferri","doi":"10.5114/jcb.2025.150065","DOIUrl":"10.5114/jcb.2025.150065","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate quality control (QC) strategies to enhance treatment delivery in interventional radiotherapy (IRT) for head and neck (H&N) cancers, focusing on ensuring the accuracy of therapy while addressing specific challenges, such as catheter displacement and tube misconnection.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted among 30 patients treated with IRT for nasal vestibule or eyelid cancers at our institutional center from January 2022 to December 2023. All treatments involved 14 fractions over nine days. QC measures were implemented to monitor catheter placement and prevent misconnection, with daily visual checks and mid-course CT evaluations. Distance measurements between catheter markers were compared across scans, and variations exceeding 2 mm prompted re-planning. Statistical analyses included one-way <i>t</i> tests to assess marker displacement significance.</p><p><strong>Results: </strong>A total of 420 fractions were delivered, and 360 marker distance measurements were analyzed. No significant differences were observed between initial and mid-course CT scans (mean distances, 35.2 ±10.5 mm and 35.9 ±10.5 mm, respectively). However, in 16.6% of cases, re-planning was required due to catheter displacement or marker variation exceeding 2 mm. Notably, patients with nasal vestibule cancers demonstrated higher number of catheters and increased risk of displacement. Dosimetric evaluation confirmed significant dose distribution changes in a sub-set of cases, highlighting the clinical importance of QC.</p><p><strong>Conclusions: </strong>Quality control strategies are essential to ensure precise treatment delivery in H&N IRT, especially in complex anatomical sites and risk of catheter displacement. Implementation of systematic checks and re-planning criteria enhances patient safety and treatment efficacy. Further research is warranted to refine QC measures and evaluate their impact on clinical outcomes.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"127-132"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 risk factors for difficult-to-control pain (VAS score > 3) at two months after late-stage non-small cell lung cancer treatment with iodine-125 radioactive particle implantation combined with chemotherapy.","authors":"Tingting Ding, Jinjin Liu, Wenwen Zhang, Guoxu Zhang","doi":"10.5114/jcb.2025.151520","DOIUrl":"10.5114/jcb.2025.151520","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the risk factors associated with difficult-to-control pain (visual analog scale [VAS] score > 3) experienced by patients with advanced non-small cell lung cancer (NSCLC) assessed at two months after receiving iodine-125 (¹²⁵I) radioactive seed implantation combined with chemotherapy, in order to improve pain management and enhance patient quality of life.</p><p><strong>Material and methods: </strong>A total of 87 patients diagnosed with advanced NSCLC were included in the study, all of whom underwent treatment using ¹²⁵I radioactive seed radiotherapy and chemotherapy. Through univariate and multivariate analyses, the risk factors affecting pain control at two months post-treatment were identified. Predictive and survival analyses were done using ROC curves and Kaplan-Meier survival curves.</p><p><strong>Results: </strong>The results indicated that minimal pleural distance, smoking history, and pleural effusion were independent risk factors influencing the control of pain shown in VAS scores. Moreover, a non-linear relationship between minimal pleural distance and difficulty of pain control was observed, indicating that the risk of uncontrolled pain decreases when the minimal pleural distance reaches ≥ 10.84 millimeters. ROC curve analysis demonstrated that the predictive capability of minimal pleural distance was the highest.</p><p><strong>Conclusions: </strong>Minimal pleural distance, smoking history, and pleural effusion are significant factors in predicting the difficulty of pain control in patients with advanced NSCLC receiving ¹²⁵I radioactive seed implantation combined with chemotherapy at two months post-treatment. Patients with a minimal pleural distance of less than 10.84 millimeters are more likely to experience uncontrolled pain after treatment. Therefore, developing predictive models may assist clinicians in more accurately evaluating treatment efficacy and patients' pain management needs.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"115-126"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of acute myocardial infarction due to Kounis syndrome after brachytherapy for prostate cancer.","authors":"Shoji Mori, Takashi Fukagai, Kazuhiko Oshinomi, Masakazu Nagata, Masashi Morita, Masako Kato, Madoka Morota, Yoshinori Ito, Takahiro Furuya","doi":"10.5114/jcb.2025.151224","DOIUrl":"10.5114/jcb.2025.151224","url":null,"abstract":"<p><p>Major systemic complications during and immediately after brachytherapy are rare. Herein, we described a case of acute myocardial infarction due to Kounis syndrome after low-dose-rate brachytherapy in a 70-year-old man with a banana allergy. Following low-dose-rate brachytherapy under general anesthesia, the patient complained of itching throughout his body; electrocardiography showed ventricular fibrillation. Cardiac catheterization revealed 99% stenosis in the left anterior descending artery; consequently, percutaneous coronary intervention was performed promptly. In this case, Kounis syndrome was considered, which was caused by latex allergy to condoms used during trans-rectal ultrasound examinations.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"149-152"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of rectal dose with thermoluminescent in vivo dosimetry in high-dose-rate cobalt-60 intracavitary brachytherapy for cervical cancer: A two-arm cohort study using orthogonal images planning.","authors":"Omega Moses Mlawa, Justin Emmanuel Ngaile, Pradumna Prasad Chaurasia, Aloyce Isaya Amasi","doi":"10.5114/jcb.2025.150247","DOIUrl":"10.5114/jcb.2025.150247","url":null,"abstract":"<p><strong>Purpose: </strong>High-dose-rate intracavitary brachytherapy delivers high radiation doses to tumors while minimizing exposure to surrounding normal cells. However, inappropriate administration can lead to radiation-induced toxicity by overdosing organs at risk. This study evaluated and compared the rectum doses planned by treatment planning system and measured using a thermoluminescent dosimeter.</p><p><strong>Material and methods: </strong>Thermoluminescent dosimeters (TLD) were employed to measure radiation dose to the rectum across two patient groups: one treated using first fraction-based planning (FFP), and the other with each fraction planned individually (EFP).</p><p><strong>Results: </strong>The mean dose measured by TLD (3.99 ±1.63 Gy) was higher than the mean dose planned by TPS (3.23 ±1.16 Gy, <i>p</i> < 0.001). The mean dose difference was higher in second fraction (0.87 ±1.89 Gy) for first fraction-based planning group; however, the differences between first and second fractions were not statistically significant in either group.</p><p><strong>Conclusions: </strong>For patients transferred from a brachytherapy couch to a hospital stretcher during applicator insertion and dose delivery, first fraction-based planning is feasible. However, caution is needed to minimize applicator shifts, as these changes can alter the geometric position between fractions.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"133-141"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of dosimetry correlation and clinical outcomes in image-guided brachytherapy vs. intensity-modulated radiotherapy photon boost after whole breast hypofractionated radiation in post-breast conserving surgery: A 5-year median follow-up data from a tertiary care institution in India.","authors":"Rakesh Kapoor, Gokula Krishnan, Divya Khosla, Parsee Tomar, Arun S Oinam, Arnav Tiwari, J S Shahi","doi":"10.5114/jcb.2025.151229","DOIUrl":"10.5114/jcb.2025.151229","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated dosimetry and clinical correlations between intensity modulated radiation therapy (IMRT) boost and image-guided multicatheter interstitial brachytherapy (MIBT) boost, after whole breast hypofractionated radiation post-breast conserving surgery.</p><p><strong>Material and methods: </strong>A mono-institutional randomized prospective controlled trial was conducted in the Department of Radiotherapy and Clinical Oncology at PGIMER, Chandigarh, India, among fifty patients (<i>n</i> = 50) enrolled between September 2018 and January 2020. Each patient received 3D-CRT whole breast radiotherapy (WBRT), 40 Gy in 16 fractions was administered, and delivered within 3.5 weeks. Subsequently, either an IMRT boost (<i>n</i> = 25) with 16 Gy in 8 fractions, or a MIBT boost (<i>n</i> = 25) with 15 Gy in 5 fractions (bid) were delivered. Follow-up visits were scheduled at 6 months, 1 year, 2 years, and 5 years post-treatment to assess toxicity and cosmesis. Cumulative EQD₂ and boost phase EQD₂ doses for dosimetry comparisons were computed. Toxicity was evaluated using RTOG grading, whereas cosmesis was assessed with patient-reported number scores and physician-reported standards based on Harvard criteria. Dosimetry was compared using <i>t</i>-tests, toxicity and cosmesis with a likelihood ratio test, and loco-regional recurrence (LRR) was estimated using Fisher's exact test. Progression-free survival (PFS) and overall survival (OS) were analyzed with Kaplan-Meier method and log-rank test.</p><p><strong>Results: </strong>The MIBT group had significantly lower mean cumulative skin and rib D_max (54.3 Gy and 57.4 Gy) than the IMRT group (62.8 Gy and 64.5 Gy), with a <i>p</i>-value of less than 0.001. This also applied to all organs at risk (OARs) EQD₂ doses during the boost phase, with a <i>p</i>-value of less than 0.001, except for NTB V₉₀ and V₅₀. Nonetheless, there were no significant differences in the cumulative EQD₂ doses of other OARs, or acute toxicity, late toxicity, patient- and physician-reported cosmesis as well as LRR, PFS, and OS.</p><p><strong>Conclusions: </strong>In left-sided breast cancer, image-guided MIBT outperforms photon boost by reducing the cardiac dose. Despite no statistical significance in cosmesis differences, MIBT exhibited marginally enhanced cosmesis than IMRT boost.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"91-103"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 spatial correlation of external beam radiotherapy and interstitial brachytherapy with deformable image registration (DIR)-based dose summation in early head and neck squamous cell carcinoma.","authors":"Ashutosh Mukherji, Sambit S Nanda, Shubham Dokania, Sanju Sanju, Ajay K Choubey, Ninad H Patil, Kaushik Kashyap, Ajay S Krishnan, Pritam Mondal, Satyajit Pradhan","doi":"10.5114/jcb.2025.151519","DOIUrl":"10.5114/jcb.2025.151519","url":null,"abstract":"<p><strong>Purpose: </strong>Oral cavity squamous cell carcinoma (SCC) is conventionally treated with surgery followed by adjuvant radiation therapy. Multiple studies have demonstrated clinical utility of interstitial brachytherapy (BT) alone or external beam radiotherapy (EBRT) with BT boost for T1-T2N0 cancers of lip and buccal mucosa. In case of combined EBRT and BT, dose summation and optimizing doses received by planning target volume (PTV) and organs at risk (OARs) remains challenging.The aim of this study was to generate and evaluate dosimetric parameters of PTV and OARs as a sum of high-dose-rate (HDR)-BT boost and EBRT in early T1-T2N0 cancers of lip and buccal mucosa, using deformable image registration (DIR) software (Velocity^®). 2 Gy equivalent dose (EQD₂) calculated manually (EQD₂-D₉₀ BT + EQD₂-D₉₈ EBRT) was compared with that estimated using DIR.</p><p><strong>Material and methods: </strong>An analysis was performed in patients with histopathologically proven T1-T2N0 SCC of lip and buccal mucosa, who underwent interstitial BT boost followed by EBRT. Planning computed tomography (CT) images and respective treatment plans of both BT and EBRT were imported into Velocity^® software, and DIR was employed to fuse these images for all patients. A synthetic plan incorporating both plans was generated. Dosimetric parameters of both PTV and OAR (mandible) were analyzed.</p><p><strong>Results: </strong>This study included a total of 10 patients (cT1N0: <i>n</i> = 6, and cT2N0: <i>n</i> = 4), with median age of 57 years (range, 30-69 years) and male : female ratio of 7 : 3. The median dose to PTV using HDR-BT was 21 Gy (range, 20-21 Gy), delivered in 5-6 fractions, 3.5-4 Gy per fraction. The median dose to PTV using EBRT was 44 Gy (range, 40-46 Gy), delivered in 20-23 fractions, 1.8-2 Gy per fraction.</p><p><strong>Conclusions: </strong>DIR software-based dose summation provides accurate dose delivery to target and OARs. If performed prospectively, it can potentially enable optimization of limiting the doses to critical OARs, thus, reducing post-RT morbidity.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"104-114"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality-guided simulation of brachytherapy: Two case reports.","authors":"Kae Okuma, Hiroki Nakayama, Madoka Sakuramachi, Shintaro Kimura, Wakako Yatsuoka, Akane Yoshiba, Koji Inaba, Tomoya Kaneda, Tairo Kashihara, Kana Takahashi, Ayaka Nagao, Yuko Nakayama, Hiroshi Igaki","doi":"10.5114/jcb.2025.150246","DOIUrl":"10.5114/jcb.2025.150246","url":null,"abstract":"<p><strong>Purpose: </strong>Brachytherapy requires precise applicator placement, especially in complex cases, where standard imaging may not provide sufficient guidance. Virtual reality (VR) technology has emerged as a valuable tool for pre-simulation, enabling improved anatomical understanding and procedural planning. We reported two cases, in which VR pre-simulation was used to enhance brachytherapy planning in challenging anatomical regions.</p><p><strong>Cases description: </strong>Case 1: A 51-year-old woman with carcinoma of unknown primary and poorly differentiated adenocarcinoma had previously undergone chemotherapy and radiation therapy for a large tumor in the right common iliac region. The tumor recurred and invaded the sacrum, requiring interstitial brachytherapy due to prior radiation dose constraints. Applicator placement was challenging, necessitating collaboration with an interventional radiology (IR) physician. VR pre-simulation facilitated multi-disciplinary communication and optimized puncture, leading to a safer and more accurate procedure. Case 2: A 46-year-old man with floor of the mouth cancer was initially scheduled for total glossectomy and laryngectomy, but opted for radiotherapy after significant tumor shrinkage. To minimize radiation dose to the mandible, interstitial brachytherapy was added. Due to safety concerns regarding prolonged applicator placement, a strategy of daily insertion and removal was adopted. A custom-made mouthpiece with a single guiding applicator was prepared by a dentist, and multiple needle-type applicators were employed. VR pre-simulation enabled precise needle insertion and facilitated procedural consistency, even among radiation oncologists unfamiliar with head and neck brachytherapy.</p><p><strong>Conclusions: </strong>VR technology enhances pre-procedural planning, improve multi-disciplinary coordination, and optimize needle placement in brachytherapy for complex anatomical sites. By integrating VR into brachytherapy workflows, treatment precision and safety can be improved across various anatomical regions.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"142-148"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auxetic solution for enhanced esophageal brachytherapy applicator.","authors":"Jerome Jean-Joseph, Nikolaus Balagiannis, Markus W Scheppach, Selin Temizel, Alanna Ebigbo, Helmut Messmann, Tilman Janzen, Georg Stüben","doi":"10.5114/jcb.2025.147780","DOIUrl":"10.5114/jcb.2025.147780","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, a novel auxetic applicator equipped with four-channel catheters for esophageal brachytherapy was presented.</p><p><strong>Material and methods: </strong>The applicator, made of a new biocompatible material, has an auxetic helical structure with four channels. Details of applicator modeling, construction, commissioning, and insertion were provided. Initial <i>ex vivo</i> trial conducted on a porcine model was outlined.</p><p><strong>Results: </strong>Simulations and dose calculations closely matched experimental measurements, validating the modeling approach. This applicator achieved highly asymmetric dose distributions. Its unique auxetic helical design allowed smooth insertion, while mitigating sequential inter-fraction hot spot formation.</p><p><strong>Conclusions: </strong><i>Ex vivo</i> implementation of the applicator demonstrated feasibility, resulting in consistent and reproducible dose distributions. Initial outcomes showed promise for the applicator's efficacy and versatility in intra-luminal or intra-cavitary applications.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 1","pages":"33-42"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric and dosimetric comparison of computed tomography- and trans-abdominal ultrasound-based volumes for image-guided cervix cancer brachytherapy.","authors":"Juan Carlos Pari Salas, Kevin Aguirre Urviola, Paola Cynthia Smith Benavides, Digna Cristina Santos Flores, Albert Bedregal Cruz, Danny Giancarlo Apaza Véliz","doi":"10.5114/jcb.2025.147944","DOIUrl":"10.5114/jcb.2025.147944","url":null,"abstract":"<p><strong>Purpose: </strong>In cervical cancer, brachytherapy is a key component of multi-disciplinary treatment. Wide scale studies, such as EMBRACE, demonstrate benefits of volume-oriented and image-guided brachytherapy. However, MRI and CT are too expensive for health systems with scarce resources. The aim of the study was to assess whether ultrasound- and CT-based volumes of high-risk clinical target volume (HR-CTV) in organs at risk (OARs) as well as dose values in a given plan are comparable.</p><p><strong>Material and methods: </strong>Eighteen applications were evaluated. After CT scans, axial ultrasound images were acquired in 5 mm steps, serving as a secondary set. Post-prescription, HR-CTV, bladder, and rectum were contoured on ultrasound images. Image sets were compared using CT-based volumes as primary reference. Dice coefficient and Jaccard index were calculated. CT-based dosimetric plan was then compared with ultrasound-based volumes to determine D₉₀ HR-CTV, D_2cc bladder, and D_2cc rectum, and these were compared with CT-based values.</p><p><strong>Results: </strong>The mean dose differences between CT and ultrasound volumes for HR-CTV and D_2cc rectum were less than 5%, with the bladder slightly above 5%. Wilcoxon test showed no significant difference between the mean doses for CT and ultrasound. Dice coefficients indicated good to very good correlation for these volumes.</p><p><strong>Conclusions: </strong>Ultrasound-based volume acquisition appears comparable with CT volumetric acquisition in both dosimetric and volumetric terms. Further studies are needed to validate this technique, potentially offering a more affordable and feasible volume-based brachytherapy option for low-income health systems.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 1","pages":"15-21"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diaphragm and lung dose in liver high-dose-rate interstitial brachytherapy: A dosimetry and toxicity report.","authors":"Keerthaanaa Yogabalan, Gokula Kumar Appalanaido, Ch'ng Ewe Seng, Jasmin Bin Jalil, Jayapramila Jayamani, Nor Hafizah Ishak, Nursyatina Abdul Raof, Reduan Bin Abdullah, Ahamed Badusha Mohamed Yoosuf, Muhamad Zabidi Ahmad, Bazli Md Yusoff, Mohd Zahri Abdul Aziz","doi":"10.5114/jcb.2025.148297","DOIUrl":"10.5114/jcb.2025.148297","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to retrospectively analyze and report on dose-volume and clinical toxicity of liver high-dose-rate interstitial brachytherapy (HDR-IBT) used in diaphragm and lung tissue.</p><p><strong>Material and methods: </strong>Computed tomography (CT)-based liver HDR-IBT using Oncentra Brachy treatment planning system (TPS) plans of patients with malignant liver tumor (MLT) from September 2018 to June 2023 were reviewed to identify patients, whose diaphragm and lung tissue were within 100% prescription isodose. These organs at risk (OARs) were contoured in axial CT slices. Maximum point dose (D_max), dose to 0.2 cc, 0.5 cc, 1 cc (D_0.2cc, D_0.5cc, D_1cc), and volume receiving 30 Gy and 50 Gy (V_30Gy and V_50Gy) were analyzed. Toxicity data of these patients were retrieved from hospital electronic records.</p><p><strong>Results: </strong>The analysis included 27 patients with 43 and 36 MLTs, whose 100% prescription isodose of liver HDR-IBT plan was within diaphragm and lung tissue. Median prescription dose was 25 Gy (range, 15-25 Gy) in single-fraction. Median D_max, D_0.2cc, D_0.5cc, and D_1cc of the diaphragm were 302 Gy (range, 54-396 Gy), 68 Gy (range, 38-234 Gy), 48 Gy (range, 32-128 Gy), and 35 Gy (range, 27-88 Gy), while for the lung, 90 Gy (range, 39-295 Gy), 55 Gy (range, 32-207 Gy), 44 Gy (range, 29-117 Gy), and 34 Gy (range, 25-79 Gy), respectively. Median V_30Gy and V_50Gy for the diaphragm were 1.1 cc (range, 0-5.8 cc) and 0.2 cc (range, 0-2.5 cc), while for the lung, 0.8 cc (range, 0-10.1 cc) and 0.1 cc (range, 0-2.3 cc), receptively. Two patients with repeated HDR-IBT sessions received cumulative D_max diaphragm of 698 Gy and 792 Gy. At median follow-up of 23 months, no patient reported any suspicious symptom of radiation-induced diaphragm or lung injury.</p><p><strong>Conclusions: </strong>This is the first publication reporting diaphragm and lung tissue dose-volume and clinical toxicity in liver HDR-IBT. Small volume of diaphragm and lung tissue tolerated extreme high radiation doses [5 times of stereotactic body radiotherapy (SBRT) range in single fraction] without clinically significant toxicity. A standardized reporting for diaphragm and lung dose volume is needed for future liver HDR-IBT studies. The results of the current study can be employed in future for expanded indication of brachytherapy, such as CT-guided trans-thoracic lung brachytherapy.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 1","pages":"28-32"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}