Brachytherapy最新文献

{"title":"Escalating the dose of high-dose-rate brachytherapy combined with external beam radiotherapy improves the disease control rate in patients with high- or very-high-risk prostate cancer","authors":"Takaya Inagaki ,&nbsp;Yasutaka Noda ,&nbsp;Yuya Iwahashi ,&nbsp;Takahiro Naka ,&nbsp;Maria Kojima ,&nbsp;Riki Inagaki ,&nbsp;Ryuki Shimono ,&nbsp;Azusa Awaya ,&nbsp;Yasuo Kohjimoto ,&nbsp;Isao Hara ,&nbsp;Tetsuo Sonomura","doi":"10.1016/j.brachy.2024.10.011","DOIUrl":"10.1016/j.brachy.2024.10.011","url":null,"abstract":"<div><h3>PURPOSE</h3><div>High-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) is an effective treatment for patients with high- and very-high-risk prostate cancer. We sought to identify the factors associated with reduced biochemical recurrence rates following HDR-BT.</div></div><div><h3>METHODS</h3><div>A total of 304 patients with high- or very-high-risk prostate cancer who underwent HDR-BT and EBRT were analyzed. EBRT comprised 50 Gy in 25 fractions and HDR-BT comprised 18 Gy in 2 fractions. Biochemical recurrence was defined as an increase in prostate specific antigen (PSA) by ≥2.0 ng/mL from the nadir level.</div></div><div><h3>RESULTS</h3><div>The median follow-up time was 8.2 years (range, 3.4‒13.7 years) after HDR-BT. The 5-year biochemical progression-free survival (bPFS), overall survival, and cause-specific survival rates were 87.4%, 93.3%, and 100%, respectively. In univariate and multivariable analyses, a biologically effective dose (α/β = 1.5) ≥ 240 Gy and androgen deprivation therapy (ADT) were significantly associated with better bPFS (<em>p</em> = 0.020 and 0.007, respectively), whereas pretreatment PSA ≥ 40 ng/mL and Gleason score group 5 were significantly associated with worse bPFS (<em>p</em> = 0.080 and 0.021, respectively). Grade ≥ 3 rectal toxicities occurred in 0.3% of patients and grade ≥ 3 urinary toxicities occurred in 3.4% of patients.</div></div><div><h3>CONCLUSION</h3><div>In patients with high- and very-high-risk prostate cancer treated with EBRT and HDR-BT, dose escalation and ADT were associated with improved tumor control. By comparison, Gleason score group 5 and pretreatment PSA &gt;40 ng/mL were associated with worse tumor control.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 223-230"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916566","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":"High-dose-rate (2 fractions of 13.5 Gy) and low-dose-rate brachytherapy as monotherapy in prostate cancer. Long term outcomes and predictive value of nadir prostate-specific antigen","authors":"Silvia Rodríguez Villalba ,&nbsp;Diana Guevara Barrera ,&nbsp;Luis Suso-Martí ,&nbsp;Enrique Sanchis-Sánchez ,&nbsp;Jose Pérez-Calatayud ,&nbsp;Jose Domingo Lago Martín ,&nbsp;Francisco Blázquez Molina ,&nbsp;Manuel Santos Ortega","doi":"10.1016/j.brachy.2024.10.014","DOIUrl":"10.1016/j.brachy.2024.10.014","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the outcomes of patients treated for low-risk (LR) and favorable intermediate risk (FIR) prostate cancer with brachytherapy (BT) in monotherapy with LDR or HDR and its relationship with nadir PSA (nPSA).</div></div><div><h3>Materials and Methods</h3><div>We retrospectively analyzed 139 patients (2005-2019) with exclusive LDR (46%. 145/160 Gy) /HDR (54%. 2 implants of 13.5 Gy each separated 10 days). 69% LR and 31% FIR. PSA nadir was grouped into two categories: ≤ 0.2 ng/mL and &gt; 0.2 ng/mL.</div></div><div><h3>Results</h3><div>Median patient age was 69 years (46-84). Seventy-six patients (55%) received androgen deprivation therapy, and 37% received neoadjuvant therapy. Median follow-up period was 90 months. Actuarial biochemical failure-free survival (BFFS), local control (LC), overall survival (OS), and cause-specific survival (CSS) rates for the total cohort were 78%, 87%, 68%, and 98% at 10 years, respectively. BFFS, LC, OS and CSS in nPSA ≤ 0,2 ng/ml was 90%, 96%, 67%, 100% at 10 years respectively, whereas, those with a nPSA &gt; 0.2 ng/ml had a BFFS, LC, OS and CSS of was 37%, 51%, 72%, 90% at 10 years respectively Statistical significance between both groups was reached in BFFS (p=0,000), LC (p=0,000) and CSS (p=0,007)). In the univariate analysis, there was no difference between risk stratification, BT technique, ADT, or the development of bouncing.</div></div><div><h3>Conclusions</h3><div>Prostate brachytherapy as monotherapy (LDR and HDR) is an effective treatment option for patients with LR and FIR prostate cancer. nPSA ≤0,2 ng/ml is a representative value that provides prognostic information for favorable outcomes in this group of patients.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 310-317"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition from point A to volume based image guided brachytherapy across a network of centers in India through workshop and mentoring","authors":"Harjot Kaur Bajwa ,&nbsp;Manikumar Singamsetty ,&nbsp;Mohan Lal ,&nbsp;Manjinder Singh Sidhu ,&nbsp;Sumeet Aggarwal ,&nbsp;Ritu Agarwal ,&nbsp;Midhun Murali ,&nbsp;Dhanya K S ,&nbsp;Rajesh Natte ,&nbsp;Suresh Chaudhari ,&nbsp;Vibhor Gupta ,&nbsp;Sushil Beriwal","doi":"10.1016/j.brachy.2024.11.005","DOIUrl":"10.1016/j.brachy.2024.11.005","url":null,"abstract":"<div><h3>AIM</h3><div>To demonstrate how workshop and mentoring across a network of radiotherapy centers helped in transitioning from point A to volume-based image guided brachytherapy in carcinoma cervix.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Based on discussion with different centers across the network, the lapses in cervical cancer treatment were identified and a workshop was designed to change the practice pattern. The main focus of the workshop was to streamline EBRT dose prescription protocols and implement volume based image guided brachytherapy through mentoring and hands on training. Patient data was analyzed 1 year post workshop to assess the impact in changing practice pattern.</div></div><div><h3>RESULTS</h3><div>A total of 246 cervical cancer patients treated with radical chemo radiotherapy and image guided brachytherapy were analyzed. 207 patients received CT based intracavitary brachytherapy whereas 39 patients received MR based hybrid brachytherapy. In patients who received EBRT and brachytherapy at the same center, the EBRT prescription dose was 45Gy in 25 fractions in 95% patients. The mean dose received by 90% of the HRCTV was 80.8Gy EQD2 in CT based intracavitary brachytherapy and 89.48Gy EQD2 in MR based hybrid brachytherapy. The mean bladder, rectum, sigmoid and small bowel D2cc doses were 63.87Gy, 62.18Gy, 61.2Gy and 55.1Gy EQD2 respectively.</div></div><div><h3>CONCLUSION</h3><div>This report demonstrates successful implementation and change of carcinoma cervix treatment practice pattern through workshop and mentoring across a network of radiotherapy centers in India.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 348-353"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HDR brachytherapy salvage for nodular prostate fossa recurrence: A mechanistic review and initial report of clinical outcomes","authors":"Lauren M. Andring ,&nbsp;Rebecca F. Krc ,&nbsp;Elleana Paradise ,&nbsp;Brandon Li ,&nbsp;Arjit Baghwala ,&nbsp;Brian Miles ,&nbsp;Raj Satkunasivam ,&nbsp;Dharam Kaushik ,&nbsp;Ramiro Pino ,&nbsp;Bin S. Teh ,&nbsp;E. Brian Butler ,&nbsp;Andrew M. Farach","doi":"10.1016/j.brachy.2024.12.006","DOIUrl":"10.1016/j.brachy.2024.12.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Biochemical recurrence (BCR) occurs in approximately 30% of men after upfront prostatectomy (RP) for prostate cancer. Salvage fossa brachytherapy offers a promising local treatment option. Here we describe a salvage technique and report initial outcomes.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Patients with local BCR and no evidence of distant metastases were included. Clinical, toxicity and dosimetry were collected.</div></div><div><h3>RESULTS</h3><div>At a single institution, 23 patients completed prostate fossa brachytherapy salvage. Seven patients had received prior pelvic EBRT for an initial recurrence after RP and received HDR BT as definitive treatment for a second local recurrence. The remaining 16 patients were treated with combination EBRT + BT for initial recurrence after RP. Median age was 69 and PSA prior to salvage was 1.12 ng/mL. Ten patients (43.5%) received androgen directed therapy at the time of salvage, and 13 (56.5%) received local therapy only. After median follow up of 12 months, the median PSA decreased to 0.1 ng/mL. Eight patients (34.8%) remain on ADT. All patients have local disease control. Three patients developed locoregional failures, and two developed distant metastases. There were 17 (73.9%) acute grade 1 GU toxicities, two acute grade 2 GU toxicities (8.7%), and a single grade 3 (4.3%) GU toxicity. There were 6 acute grade 1 GI toxicities (26.1%), and a single patient with late grade 3 GU toxicity (4.3%). No grade 4 or higher toxicities were reported.</div></div><div><h3>CONCLUSIONS</h3><div>This study found prostate bed BT to be safe and feasible for patients with nodular prostate fossa recurrences in both the initial salvage and salvage reirradiation setting. On preliminary follow up, PSA control rates are acceptable.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 404-412"},"PeriodicalIF":1.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the value of an EM tracking quality assurance system for pretreatment verification of needle digitization accuracy in ultrasound-based prostate HDR brachytherapy","authors":"Christopher L. Deufel,&nbsp;Eric E. Brost,&nbsp;Justine M. Dupere,&nbsp;Jessica M. Wilson,&nbsp;Mark R. Waddle,&nbsp;Bradley J. Stish","doi":"10.1016/j.brachy.2025.01.003","DOIUrl":"10.1016/j.brachy.2025.01.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To develop and deploy an electromagnetic (EM) tracking-based platform for pretreatment, patient-specific quality assurance of brachytherapy applicator digitization, with the goals of intercepting human errors and quantifying treatment planning dose uncertainties.</div></div><div><h3>METHODS</h3><div>An EM tracking platform, EMQA, was developed for patient-specific quality assurance of HDR treatment plan needle reconstructions. EMQA compared needle geometry between a manually digitized clinical HDR treatment plan and EM-tracked positions. Pretreatment quality assurance (QA) was performed for 25 implants (20 patients). Distance and dose metric differences were reported. Factors influencing accuracy were analyzed, including radial distance from the ultrasound probe and EM field generator (EFG), needle ‘shadowing’ artifacts, needle depth adjustments using exposed needle length protruding from the implant template, and TRUS calibrated speed of sound, <span><math><msub><mi>v</mi><mrow><mtext>Sound</mtext><mspace></mspace><mtext>Effective</mtext></mrow></msub></math></span>.</div></div><div><h3>RESULTS</h3><div>Needle digitization differences between the clinical plan and EM tracking had a magnitude (mean ± standard deviation [minimum, maximum]) of 0.46 ± 0.36 (0.002, 2.19) millimeters for the needle depths and 0.62 ± 0.44 (0.01, 3.26) millimeters for needle shafts. Dose metric differences (% of Rx) for PTV, CTV, bladder, rectum, and urethra were &lt;1.7% on average, but differences &gt;5% were observed in two patients. Accuracy was notably worse for locations shadowed by more than one needle, decreased with distance from the probe and EFG, and was optimal for <span><math><msub><mi>v</mi><mrow><mtext>Sound</mtext><mspace></mspace><mtext>Effective</mtext></mrow></msub></math></span>=1570 m/s.</div></div><div><h3>CONCLUSION</h3><div>Clinical evaluation of an EMQA platform demonstrated the potential to intercept errors in the digital reconstruction of ultrasound-based prostate HDR brachytherapy needles prior to radiation delivery, which may be due to poor image quality or human error. Manual needle digitization accuracy was typically submillimeter, however errors as great as 3 mm were observed. The adoption of EMQA as standard of care is expected to reduce the potential for mistreatment.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 450-460"},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed needle guides for cervical cancer brachytherapy: Optimized dosimetry and improved local control outcomes","authors":"Santino Butler,&nbsp;Thomas Niedermayr ,&nbsp;Elizabeth A. Kidd","doi":"10.1016/j.brachy.2025.01.001","DOIUrl":"10.1016/j.brachy.2025.01.001","url":null,"abstract":"<div><h3>PURPOSE</h3><div>We previously designed three-dimensionally-printed needle guides (3D-NG) for cervical cancer brachytherapy, which improved procedure efficiency and tumor coverage while achieving similar organs at risk (OAR) sparing compared to non-3D-printed techniques (non-3D). The subject of this study was whether 3D-NG can help improve local control and other brachytherapy outcomes.</div></div><div><h3>METHODS</h3><div>This single institution cohort study includes 130 patients who underwent definitive external-beam radiotherapy and high-dose-rate intracavitary +/− interstitial brachytherapy from February 2017 to July 2023. 3D-NG were implemented for all cases after December 2019 (N = 77). Non-3D included applicator-only/no-needles (N = 28) or freehand-placed needles (N = 25).</div></div><div><h3>RESULTS</h3><div>Median follow-up was 24 months. 3D-NG, versus non-3D, achieved higher mean D90 (+5.2 Gy, <em>p</em> &lt; 0.001), D98 (+4.3 Gy, <em>p</em> &lt; 0.001), and V100_average (+5.9%, <em>p</em> &lt; 0.001)—with greater improvement for larger tumors (high-risk[HR]-CTV&gt;30 cubic-centimeters[cc]) (P_interaction&lt;0.10 for all). Maximum D2cc for all OAR were comparable between 3D-NG and non-3D (<em>p</em> &gt; 0.05). 2-year LF was lower with 3D-NG compared to non-3D (8.2% vs. 22.0%; aHR 0.31, <em>p</em> = 0.036)—and compared to freehand-needles alone (8.2% vs. 20.6%, <em>p</em> &lt; 0.001 [log-rank])—particularly among cases with higher cumulative HR-CTV dose (D90 &gt;85 Gy; <em>p</em>_interaction = 0.013) and lower HR-CTV volume (≤30 cc; <em>p</em>_interaction = 0.048). 2-year LF was also lower with concurrent cisplatin (aHR 0.20, <em>p</em> = 0.001) and ≥40% decrease in tumor diameter after EBRT (aHR 0.16, <em>p</em> = 0.010); but higher among minority race (aHR 4.21, <em>p</em> = 0.06).</div></div><div><h3>CONCLUSIONS</h3><div>3D-NG for cervix brachytherapy were associated with improved 2-year LF compared to non-3D/freehand-needles, with higher achievement of EMBRACE II goals for D90 and D98, with similar OAR doses. This study highlights the potential for 3D-NG to simplify needle insertion while simultaneously improving needle position, dosimetry, and disease control outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 379-388"},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed template design to improve 125I seed plaque assembly accuracy for uveal brachytherapy","authors":"Kaitlyn Calabresi ,&nbsp;Jacqueline Emrich ,&nbsp;Sara Belko ,&nbsp;Robert Pugliese ,&nbsp;Lydia Komarnicky-Kocher ,&nbsp;Firas Mourtada","doi":"10.1016/j.brachy.2025.01.004","DOIUrl":"10.1016/j.brachy.2025.01.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To demonstrate the utility of a QA program for seed localization, and to design a 3D-printed template to improve the accuracy of seed placement on custom-built ¹²⁵I eye plaques for uveal brachytherapy.</div></div><div><h3>Methods and Materials</h3><div>A seed localization analysis tool (SLAT) was developed in MATLAB to detect variations in seed placement relative to a treatment plan. A flexible seed placement template (3D-FSPT) was designed in CAD and printed using a Formlabs Form-3 3D printer. The 3D-FSPT and SLAT were tested using 3D-printed model eye plaques with nonradioactive seeds arranged following clinically-relevant treatment plans. Five clinical plaques were also evaluated.</div></div><div><h3>Results</h3><div>SLAT detected submillimeter scale variations in seed position with 2.3% error relative to the plan's seed coordinates, and with an uncertainty of ± 0.01 mm. The average seed displacement on the model plaques with free-handed seed placement was 1.31 mm (SD = 0.61), and the average seed orientation difference was 5.27 degrees (SD = 4.77). The average seed displacement on the clinical plaques was 0.77 mm (SD = 0.42), and the average seed orientation difference was 4.41 degrees (SD = 3.00). For the clinical plaques, changes in dosimetry to the tumor apex and critical eye structures were within acceptable tolerances. Seed displacement (mm) (<em>p</em> &lt; 0.001) and seed orientation differences (degrees) (<em>p</em> = 0.008) were significantly lower using the template to guide seed placement on the model plaques compared to free-handed seed placement.</div></div><div><h3>Conclusions</h3><div>The feasibility of a 3D-FSPT and SLAT is demonstrated for improving seed placement accuracy relative to a treatment plan.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 420-430"},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do you do it?: Gynecologic brachytherapy best practices at high volume institutions within the United States and Canada","authors":"Christina Small ,&nbsp;Saryleine Ortiz ,&nbsp;Meena Bedi ,&nbsp;Melissa Joyner ,&nbsp;Emma Fields ,&nbsp;Scott Glaser ,&nbsp;Beth Erickson","doi":"10.1016/j.brachy.2024.11.011","DOIUrl":"10.1016/j.brachy.2024.11.011","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Definitive treatment including chemoradiation and brachytherapy for patients diagnosed with locally advanced cervical cancer requires significant multidisciplinary coordination. Our goal was to assess and share gynecologic brachytherapy best practices from high volume brachytherapy centers.</div></div><div><h3>METHODS</h3><div>A survey was sent to 42 centers within the United States and Canada that perform a high volume of complex gynecologic brachytherapy.</div></div><div><h3>RESULTS</h3><div>Responses were collected from 32/42 (76%) institutions. 41% of responding institutions perform &gt; 100 complex brachytherapy procedures per year. Most departments have &gt;1 brachytherapist and 85% of respondents complete 1–2 complex brachytherapy procedures per day. 91% of surveyed departments have support staff specifically devoted to brachytherapy. Approximately 50% of intracavitary/hybrid procedures are performed in departmental brachytherapy suites. Institutions use MRI (35%), CT (24%) or a combination (24%) for treatment planning. 88% of respondents use sedation for tandem based procedures. Respondents cite high complexity of care, insufficient reimbursement, untimely referrals, shared operative and clinical duties, expensive applicator acquisition and complex scheduling as challenging aspects of providing brachytherapy services. Conversely, respondents cite a dedicated team, departmental brachytherapy suite, well organized coordination of procedures and personnel, anesthesia support, a full range of applicators, image-based planning near the department and supportive administration as integral components in providing brachytherapy.</div></div><div><h3>CONCLUSIONS</h3><div>Most surveyed institutions have &gt;1 brachytherapist who perform 1–2 procedures per day in a dedicated brachytherapy space with a team that assists with coordination and scheduling efforts. A well supported multidisciplinary team is vital to ensure state of the art brachytherapy which is essential in curing these challenging malignancies.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 365-370"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality control study of cervical cancer interstitial brachytherapy treatment plans using statistical process control","authors":"Xiao Chen ,&nbsp;Xiangxiang Shi ,&nbsp;Huaiwen Zhang ,&nbsp;Haowen Pang","doi":"10.1016/j.brachy.2024.12.007","DOIUrl":"10.1016/j.brachy.2024.12.007","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study explored using statistical process control for quality control of cervical cancer interstitial brachytherapy treatment plans.</div></div><div><h3>MATERIALS AND METHODS</h3><div>For retrospective analysis, interstitial brachytherapy treatment plans were divided into first (<em>n</em> = 300) and second phases (<em>n</em> = 200). The first phase was chronologically divided 2:1 into training and validation sets. The Dn2cm³ (D2cm³ divided by the high-risk clinical target volume D90) of the organs at risk (the bladder, rectum, and sigmoid colon) were analyzed to draw individual control charts. Process capability analysis charts were drawn, and the statistical process capability was evaluated using the process capability index C_pk. The centerline of the organ at risk dose in the first-phase plan's training set was used as the optimization parameter for the second-phase dataset plan.</div></div><div><h3>RESULTS</h3><div>The Dn2cm³ centerlines for the bladder, rectum, and sigmoid colon were 0.6980, 0.5440, and 0.4910 in the training set and 0.6845, 0.4528, and 0.4144 in the second phase, respectively. The first-phase δ values were 0.0099, 0.0530, and 0.0268, respectively. The process capability analysis for the first and second phases showed that all indicators had a C_pk &gt;1.</div></div><div><h3>CONCLUSION</h3><div>For all organs at risk, the Dn2cm³ centerlines were lower in the second phase than in the first phase, indicating that quality control of cervical cancer interstitial brachytherapy treatment plans continuously improved through statistical process control. This method is simple and practical and warrants promotion for application in radiotherapy treatment plan quality control.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 371-378"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haralick texture feature analysis for Monte Carlo dose distributions of permanent implant prostate brachytherapy","authors":"Iymad R. Mansour ,&nbsp;Nelson Miksys ,&nbsp;Luc Beaulieu ,&nbsp;Éric Vigneault ,&nbsp;Rowan M. Thomson","doi":"10.1016/j.brachy.2024.08.256","DOIUrl":"10.1016/j.brachy.2024.08.256","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Demonstrate quantitative characterization of 3D patient-specific absorbed dose distributions using Haralick texture analysis, and interpret measures in terms of underlying physics and radiation dosimetry.</div></div><div><h3>METHODS</h3><div>Retrospective analysis is performed for 137 patients who underwent permanent implant prostate brachytherapy using two simulation conditions: “TG186” (realistic tissues including 0–3.8% intraprostatic calcifications; interseed attenuation) and “TG43” (water-model; no interseed attenuation). Five Haralick features (homogeneity, contrast, correlation, local homogeneity, entropy) are calculated using the original Haralick formalism, and a modified approach designed to reduce grey-level quantization sensitivity. Trends in textural features are compared to clinical dosimetric measures (D90; minimum absorbed dose to the hottest 90% of a volume) and changes in patient target volume % intraprostatic calcifications by volume (%IC).</div></div><div><h3>RESULTS</h3><div>Both original and modified measures quantify the spatial differences in absorbed dose distributions. Strong correlations between differences in textural measures calculated under TG43 and TG186 conditions and %IC are observed for all measures. For example, differences between measures of contrast and correlation increase and decrease respectively as patients with higher levels of %IC are evaluated, reflecting the large differences across adjacent voxels (higher absorbed dose in voxels with calcification) when calculated under TG186 conditions. Conversely, the D90 metric is relatively weakly correlated with textural measures, as it generally does not characterize the spatial distribution of absorbed dose.</div></div><div><h3>CONCLUSION</h3><div>Patient-specific 3D dose distributions may be quantified using Haralick analysis, and trends may be interpreted in terms of fundamental physics. Promising future directions include investigations of novel treatment modalities and clinical outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 122-133"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634411","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}