Brachytherapy最新文献

{"title":"MRI-guided neurovascular bundle avoidance in high dose rate prostate brachytherapy","authors":"Drew G. Gerber,&nbsp;Sean Dresser,&nbsp;Xiaofeng Yang,&nbsp;Richard L.J. Qiu,&nbsp;Xiaojun Jiang,&nbsp;Sona Desai,&nbsp;Joseph Harms,&nbsp;Sagar A. Patel,&nbsp;Bruce Hershatter,&nbsp;Nikhil Sebastian,&nbsp;Vishal Dhere,&nbsp;Tian Liu,&nbsp;Ashesh B. Jani,&nbsp;Pretesh R. Patel","doi":"10.1016/j.brachy.2025.08.001","DOIUrl":"10.1016/j.brachy.2025.08.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The neurovascular bundles (NVBs) play a role in erectile function and are not well visualized on ultrasound or computed tomography (CT). In this study we hypothesize that treatment planning MRI will allow avoidance of the NVB during HDR prostate brachytherapy.</div></div><div><h3>Materials and Methods</h3><div>This was a retrospective review of patients who had HDR prostate brachytherapy as monotherapy (two implants 1-2 weeks apart each delivering 13.5 Gy). All patients underwent TRUS-guided HDR catheter placement followed by CT and MRI simulation. The left and right NVB were contoured on the treatment planning MRI. Standard clinical plans were optimized for prostate coverage and avoidance of organs at risk (OARs). Experimental NVB-sparing plans were generated to add avoidance of the NVBs. Differences between target and OAR doses in the original and NVB-sparing plans were assessed pairwise using a 2-tailed t-test.</div></div><div><h3>Results</h3><div>34 patients were included and segmentation of the left and right NVB was feasible for all cases. Compared to their paired original plans, NVB-sparing plans reduced left and right NVB D0.01cc (130% vs. 102% and 130% vs. 108%, <em>p</em> &lt; 0.01, respectively). There was no difference in prostate D90 (108% vs 108%, <em>p</em> = 0.19) and V100 (96.1 vs 95.9%, <em>p</em> = 0.17) between plans; prostate V150% (35.8% vs. 34.7%, <em>p</em> &lt; 0.01) and V200% (14.0% vs 13.4%, <em>p</em> &lt; 0.01) slightly decreased in the NVB-sparing plans. Mean bladder V75 (0.3 cc), rectum V75 (0.2 cc), and urethra V125 (0.03 cc) were similar between plans.</div></div><div><h3>Conclusions</h3><div>Using MRI-based treatment planning, NVB-sparing prostate HDR brachytherapy is feasible and merits further study.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 9-14"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941520","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":"A review of NRC medical event reports related to brachytherapy, 2005-2024","authors":"Jussi Sillanpaa ,&nbsp;Joseph Santoro","doi":"10.1016/j.brachy.2025.09.012","DOIUrl":"10.1016/j.brachy.2025.09.012","url":null,"abstract":"<div><h3>Methods</h3><div>We analyzed the Nuclear Regulatory Commission event notifications related to brachytherapy events that occurred between January 1, 2005, and December 31, 2024.</div><div>The events were categorized and their distribution and time evolution analyzed.</div></div><div><h3>Results</h3><div>A total of 818 events (227 LDR, 203 HDR, 21 intravascular, 367 microsphere) were identified, excluding events that related purely to shipping. We analyzed the events for the whole period and in consecutive 5-year intervals. The total number of events rose by 27% from the first to the last interval (2005–09:179, 2020–24:227), with the LDR events decreasing by 81% (2005–2009:98, 2020–24: 19) and microsphere events increasing by 588% (2005–09:25, 2020–24:172). HDR events decreased by 15% (2005-09:53, 2020–24:45), while intravascular events increased (2005-09:3, 2020–2024:7) but stayed very rare. . For HDR, the three most frequent categories were treatment planning error (26%), transfer tube issues (13%) and other/unknown issues (13%); the frequency of treatment planning events decreased with time (2005-09: 38%, 2020-24: 18%). For LDR, the three most frequent categories were lost or leaking source (39%), other/unknown issues (24%) and permanent implant sources implanted into wrong tissue (18%). For microspheres, most events were related to the sphere remaining in the delivery apparatus and for intravascular brachytherapy, to the source not retracting. The radioisotopes of LDR events were I-125 (72%), Pd-103 (11%), Cs-137 (8%), Ir-192 (4%), Cs-131 (3%) and Sr-90 (2%); no events relating to Ir-192 or Cs-137 occurred in 2020-24.</div></div><div><h3>Conclusion</h3><div>The reduction in the LDR events is probably explained by the decreased frequency of prostate implants and LDR gynecological procedures. Microspheres now account for most event reports.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 191-197"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535092","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":"Image guided brachytherapy quality assurance on NRG GY017 investigating immunotherapy in addition to chemoradiation for locally advanced cervical cancer","authors":"Hayeon Kim ,&nbsp;Wei Deng ,&nbsp;Dimitriy Zamarin ,&nbsp;Ying Xiao ,&nbsp;Junzo Chino ,&nbsp;Stanley Benedict ,&nbsp;Hannah Nguyen ,&nbsp;Jessica Lowenstein ,&nbsp;Susan McNulty ,&nbsp;Sharad Ghamande ,&nbsp;Catherine Ferguson ,&nbsp;Loren Mell ,&nbsp;Laura L. Holman ,&nbsp;Cara Mathews ,&nbsp;Allison Quick ,&nbsp;Alexander Olawaiye ,&nbsp;Elizabeth Hopp ,&nbsp;Robert Mannel ,&nbsp;Charles A. Leath-III ,&nbsp;Roisin-E. O’Cearbhaill ,&nbsp;Jyoti Mayadev","doi":"10.1016/j.brachy.2025.09.011","DOIUrl":"10.1016/j.brachy.2025.09.011","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Brachytherapy is a critical component of curative treatment in locally advanced cervical cancer. NRG GY-017 is a randomized Phase I trial of the anti-PD-L1 antibody atezolizumab administered neoadjuvantly and concurrently with chemoradiation (Arm A) or only concurrently with chemoradiation (Arm B) in patients with node positive locally advanced cervical cancer. Image guided brachytherapy (IGBT) was mandated in the protocol with a quality assurance (QA) workflow. Herein, we report the BT quality data on NRG GY-017 trial and practice patterns from the participating centers in this trial as a guide for future protocol brachytherapy QA.</div></div><div><h3>METHODS</h3><div>The participating sites were to submit brachytherapy plans online after BT was completed. IROC QA center compiled the BT fractions for each patient using the trial specific dosimetry evaluation template. An expert physician reviewer scored the contours and plans as per protocol, variation acceptable or major deviation as prespecified in the protocol dose metrics.</div></div><div><h3>RESULTS</h3><div>The BT dosimetry results were available for 32 patients. Seventeen patients (53%) had intracavitary applicator, and 15 patients (47%) had hybrid or interstitial applicators. Point A directed planning was performed for 4 patients (12.5%) and 28 patients had volume directed plans (87.5%). For imaging use, 2 patients had MRI based plans, and 30 had CT based planning (94%). For the dose constraints compliance per protocol, 7 patients had 9 events scored as major deviations (22%).</div></div><div><h3>CONCLUSION</h3><div>BT trial specific QA has the potential to enhance BT quality for clinical trials. This report will help guide future gynecologic BT trial data collection and QA process.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 127-135"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314297","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":"Long-term oncologic outcomes of high-dose-rate interstitial brachytherapy (interventional radiotherapy) in oral tongue squamous cell carcinoma; 15 years of experience from a tertiary cancer center","authors":"Mahdi Aghili ,&nbsp;Fatemeh Jafari ,&nbsp;Kasra Kolahdouzan ,&nbsp;Fatemeh Biglar ,&nbsp;Ava Yousefi ,&nbsp;Mansoureh Nabavi ,&nbsp;Ramin Jaberi ,&nbsp;Ata Garajei ,&nbsp;Alireza Abdshah ,&nbsp;Ali Kazemian ,&nbsp;Luca Tagliaferri","doi":"10.1016/j.brachy.2025.09.009","DOIUrl":"10.1016/j.brachy.2025.09.009","url":null,"abstract":"<div><h3>PURPOSE</h3><div>High-dose-rate interstitial brachytherapy (HDR-IBT) is commonly used for treating oral tongue squamous cell carcinoma (OTSCC). This study aims to evaluate long-term outcomes, survival predictors, chronic side effects, and failure patterns in patients receiving adjuvant HDR-IBT after surgical resection.</div></div><div><h3>METHODS AND MATERIALS</h3><div>We analyzed records of 239 early-stage OTSCC patients treated with surgery, and adjuvant HDR-IBT at a tertiary cancer center from October 2010 to February 2024. Follow-up included assessing survival status, disease recurrence, and chronic adverse events.</div></div><div><h3>RESULTS</h3><div>Among the patients, 142 received HDR-IBT as monotherapy, 73 as a boost to external beam radiotherapy (EBRT), and 24 as salvage therapy. The 5-year overall survival (OS) rates were 78.4%, 56.0%, and 53.5%, while disease-free survival (DFS) rates were 74.7%, 57.7%, and 32.6%, respectively. The monotherapy group demonstrated the best outcomes, whereas the salvage group had the poorest results. Age and T stage were independent predictors of OS, with local recurrence within 5 years linked to initial T stage in monotherapy (<em>p</em> = 0.057) and EBRT boost patients (<em>p</em> = 0.046). Chronic adverse events such as xerostomia, fibrosis, and dysesthesia were more prevalent in the salvage group compared to the other groups.</div></div><div><h3>CONCLUSIONS</h3><div>HDR-IBT is an effective treatment for early-stage OTSCC, yielding favorable survival rates and manageable acute and chronic side effects, particularly when used in low-risk patients for regional recurrence.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 163-172"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535202","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":"Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: A single institutional experience","authors":"Henna Kärkkäinen ,&nbsp;Ester Jääskeläinen ,&nbsp;Jan-Erik Palmgren ,&nbsp;Janne Heikkilä ,&nbsp;Maarit Anttila","doi":"10.1016/j.brachy.2025.09.008","DOIUrl":"10.1016/j.brachy.2025.09.008","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The aim was to evaluate the toxicities and survival of patients with inoperable vulvar cancer treated using brachytherapy (BT).</div></div><div><h3>STUDY Design</h3><div>Patients treated at Kuopio University Hospital, Finland, during years 2007-2022 were retrospectively analyzed.</div></div><div><h3>RESULTS</h3><div>Twenty-seven patients with vulvar cancer received high-dose-rate (HDR) interstitial brachytherapy (BT), most of them after external beam radiotherapy (EBRT). Nineteen had primary locally advanced vulvar cancer, and 8 had recurrent cancer. The mean EBRT prescription dose was 48.5 Gy (39-60 Gy) in 13-33 fractions. Eighteen patients (67%) had cisplatin as a radiosensitizer. EBRT was followed by BT (16-36 Gy in 3-8 fractions). The mean HR-CTV (high-risk clinical target volume) D90 EBRT + BT dose was 71.2 Gy (EQD₂).</div><div>The mean follow-up time was 30 months. The 2-year progression-free survival (PFS) was 41% in the primary cancer group and 38% in the recurrence group. The 2-year overall survival (OS) was 56% and 63%, respectively. There were 12/19 (63%) recurrences in the primary cancer group. In the recurrent cancer group, 4 out of 8 (50%) patients had a subsequent recurrence. 7/27 (26%) patients suffered from grade 3-4 late toxicities.</div><div>Before EBRT, the median size of the tumors was 3.8 cm. Patients with a tumor ≥ 3.8 cm had significantly worse OS than patients with tumors &lt;3.8 cm, 45 months and 54 months, respectively (<em>p</em> = 0.022). The use of radiosensitizing chemotherapy also predicted better overall survival (<em>p</em> = 0.037).</div></div><div><h3>CONCLUSIONS</h3><div>Definitive radiation therapy, including EBRT and BT, is a potential option in the management of inoperable vulvar cancer. To avoid toxicities, the proper radiation doses are to be found.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 63-73"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395911","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":"Evaluation of a commercial deep-learning-based contouring software for CT-based gynecological brachytherapy","authors":"Haechan J Yang ,&nbsp;John Patrick ,&nbsp;Jason Vickress ,&nbsp;David D’Souza ,&nbsp;Vikram Velker ,&nbsp;Lucas Mendez ,&nbsp;Maria Mansur Starling ,&nbsp;Aaron Fenster ,&nbsp;Douglas Hoover","doi":"10.1016/j.brachy.2025.08.005","DOIUrl":"10.1016/j.brachy.2025.08.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate a commercial deep-learning based auto-contouring software specifically trained for high-dose-rate gynecological brachytherapy.</div></div><div><h3>METHODS AND MATERIALS</h3><div>We collected CT images from 30 patients treated with gynecological brachytherapy (19.5-28 Gy in 3-4 fractions) at our institution from January 2018 to December 2022. Clinical and artificial intelligence (AI) generated contours for bladder, bowel, rectum, and sigmoid were obtained. Five patients were randomly selected from the test set and manually re-contoured by 4 radiation oncologists. Contouring was repeated 2 weeks later using AI contours as the starting point (“AI-assisted” approach). Comparisons amongst clinical, AI, AI-assisted, and manual retrospective contours were made using various metrics, including Dice similarity coefficient (DSC) and unsigned D2cc difference.</div></div><div><h3>RESULTS</h3><div>Between clinical and AI contours, DSC was 0.92, 0.79, 0.62, 0.66, for bladder, rectum, sigmoid, and bowel, respectively<strong>.</strong> Rectum and sigmoid had the lowest median unsigned D2cc difference of 0.20 and 0.21 Gy/fraction respectively between clinical and AI contours, while bowel had the largest median difference of 0.38 Gy/fraction. Agreement between fully automated AI and clinical contours was generally not different compared to agreement between AI-assisted and clinical contours. AI-assisted interobserver agreement was better than manual interobserver agreement for all organs and metrics. The median time to contour all organs for manual and AI-assisted approaches was 14.8 and 6.9 minutes/patient (<em>p</em> &lt; 0.001), respectively.</div></div><div><h3>CONCLUSIONS</h3><div>The agreement between AI or AI-assisted contours against the clinical contours was similar to manual interobserver agreement. Implementation of the AI-assisted contouring approach could enhance clinical workflow by decreasing both contouring time and interobserver variability.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 40-49"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202480","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":"Feasibility of combining high-dose-rate prostate brachytherapy with dose intensification to the MRI dominant lesion followed by real-time adaptive MR-guided pelvic radiotherapy for high-risk prostate cancer","authors":"Gil’ad N. Cohen,&nbsp;Jason Gurewitz,&nbsp;Jennifer Johnson,&nbsp;Jeffrey Cooney,&nbsp;Yuhao Shi,&nbsp;Harry Adler,&nbsp;Matthew Long,&nbsp;David J. Byun ,&nbsp;Michael J. Zelefsky","doi":"10.1016/j.brachy.2025.10.013","DOIUrl":"10.1016/j.brachy.2025.10.013","url":null,"abstract":"<div><h3>Purpose</h3><div>Optimizing radiotherapy delivery for higher-risk prostate cancer often requires dose escalation while minimizing dose to surrounding normal tissues. We report on the feasibility of combining high-dose-rate (HDR) brachytherapy with dose intensification to the dominant intra-prostatic lesion (DIL) followed by magnetic resonance-guided stereotactic body radiotherapy (MRgSBRT).</div></div><div><h3>Methods and Materials</h3><div>Eighty-eight patients were treated with a single fraction of 15-Gy HDR brachytherapy boost followed by MRgSBRT to prostate, or prostate and pelvic lymph nodes, to a dose of 25 Gy in five fractions. The DIL noted on multi-parametric MR imaging was defined as a PIRADS-4/-5 lesion with an associated diffusion-weighted abnormality(s), and was intraoperatively boosted during brachytherapy to 120% of the prescription dose. Dosimetric objectives included D99% &gt;120% to the DIL, D1% &lt;120% for the urethra and D1cc &lt;80% for the rectum. Real-time adaptive SBRT was delivered with a 1.5-T Unity MR Linac.</div></div><div><h3>Results</h3><div>For the HDR procedure, the mean prostate and DIL D90% were 108.3% ± 2.7% and 135.9% ± 12.2%, respectively. Mean urethra Dmax and D20% were 116.5% ± 4.5% and 108.2% ± 3.8%, respectively. Mean rectal V100 and D1cc were 0.0 ± 0.0cc and 73.6% ± 7.0%, respectively. DIL objective was not met in two lesions owing to proximity of the urethra and bladder neck. At a median follow-up of 6.8 months, Grade 2 genitourinary acute toxicity was observed in 33% of patients and Grade 2 acute gastrointestinal toxicity was observed in 1%.</div></div><div><h3>Conclusions</h3><div>HDR boost with dose escalation to the DIL in combination with MRgSBRT is a feasible and effective treatment protocol. No significant genitourinary or gastrointestinal acute toxicity was observed.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 235-240"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535195","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":"Automated daily check QA of treatment channel adjustments (TCA), active, and dummy source positioning using bravos after loader","authors":"Joel Beaudry,&nbsp;Antonio L. Damato,&nbsp;David Aramburu Núñez","doi":"10.1016/j.brachy.2025.08.008","DOIUrl":"10.1016/j.brachy.2025.08.008","url":null,"abstract":"<div><h3>PURPOSE</h3><div>As HDR afterloader technology evolves, new treatment delivery capabilities create opportunities to reinforce quality assurance (QA) procedures. We present a novel method of automated log file analysis for daily, longitudinal tracking of channel length offsets, and active and dummy source positional accuracy. Leveraging features of the Bravos afterloader system, the method supplements visual inspections and functional tests, enhancing QA accuracy and reliability.</div></div><div><h3>METHODS/MATERIALS</h3><div>Our clinic utilizes 3 HDR afterloaders across 4 vaults, delivering over 900 treatments annually. Applicators and transfer guide tubes (TGTs) vary in length and connectors. We collected treatment reports and daily Position Verification Test (PVT) logs over 9 months resulting in 694 and 455 treatment reports and PVT logs, respectively. Each TGT is assigned a unique identifier (UID) to monitor readings over time, including dedicated TGTs used in PVT readings. Statistical analysis was performed per afterloader across 3 CamScales, and later grouped by CamScale to assess deviations from expected distances and identify trends in TGT and PVT measurements.</div></div><div><h3>RESULTS</h3><div>PVT readings for dummy (and active) sources are within 0.05 cm, for 97% (91%), 90% (97%), and 97% (94%) of readings for Afterloaders A1, A2, and A3, respectively, across all CamScales. Postcalibration distances compared to the precalibration distances result in an average difference of &lt;0.03 cm for active and dummy sources. Across 7421 treatment channels adjustments (TCAs), 74 exceeded the overall threshold of 2 mm, decreasing to 7 when group-specific thresholds were applied.</div></div><div><h3>CONCLUSION</h3><div>The implementation of an automated QA program of treatment channel adjustments in HDR brachytherapy has benefits in maintaining the accuracy and reliability of TGT measurements and applicators. Daily QA checks provide a comprehensive overview of trends, enabling early detection of potential issues and timely interventions.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 120-126"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314269","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":"Novel use of 3D printing for preoperative dose estimation in the first case of GammaTile spine implantation","authors":"Jessie Huang ,&nbsp;Anthony Doemer ,&nbsp;Salim Siddiqui ,&nbsp;Mira Shah ,&nbsp;Ali Al Asadi ,&nbsp;Amanda DiCarlo ,&nbsp;Kundan Thind ,&nbsp;Alexandra Moceri ,&nbsp;Lisa Scarpace ,&nbsp;Ian Lee ,&nbsp;Adam Robin","doi":"10.1016/j.brachy.2025.08.006","DOIUrl":"10.1016/j.brachy.2025.08.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>For a patient who had two previous courses of external beam radiation therapy for rectosigmoid adenocarcinoma and presented with painful, recurrent disease in the sacrum, this study describes the first use of Cs-131 LDR GammaTile therapy outside of the brain and demonstrates a novel use of 3D printing for preoperative dose estimation.</div></div><div><h3>MATERIAL AND METHODS</h3><div>A personalized 3D-printed model of the patient's spine was created using segmented MRI data, differentiating uninvolved bone, tumor, and thecal sac and nerve roots, with a Stratasys J5 MediJet® Printer. This model was used to simulate surgical resection and placement of dummy radioactive sources. A CT scan of the model facilitated preoperative dose calculations, including physical dose using Eclipse planning software and biologically effective dose (BED) using MIM Maestro software. The predicted dose was then compared to the postimplant dosimetry for the actual patient.</div></div><div><h3>RESULTS</h3><div>For the relevant organ at risk (thecal sac), the max dose (D_0.035cc) was calculated accurately within 8.0% for physical dose and within 10.0% for BED when comparing the dose estimated using our 3D-printed model and the patient’s postimplant dosimetry.</div></div><div><h3>CONCLUSIONS</h3><div>3D printing can be used preoperatively to estimate dose to critical organs at risk for patients receiving surgical resection followed by Cs-131 LDR implantation in the spine and can be especially valuable in the context of reirradiation.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 115-119"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139628","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":"Radiomics-based machine-learning approach to predict response at brachytherapy using pretreatment magnetic resonance imaging in locally advanced cervical cancer","authors":"Prashant Nayak ,&nbsp;Supriya Chopra ,&nbsp;Yashna Gupta ,&nbsp;Washim Saahil ,&nbsp;Prachi Mittal ,&nbsp;Ankita Gupta ,&nbsp;Subhojit Panda ,&nbsp;Palak Popat ,&nbsp;Sudeep Gupta ,&nbsp;Jai Prakash Agarwal ,&nbsp;Jayant S. Goda","doi":"10.1016/j.brachy.2025.08.007","DOIUrl":"10.1016/j.brachy.2025.08.007","url":null,"abstract":"<div><h3>PURPOSE</h3><div>We investigated baseline magnetic resonance imaging (MRI) radiomic features for predicting tumor response in patients with locally advanced cervical cancer (LACC) at brachytherapy (BT).</div></div><div><h3>METHODS</h3><div>Seventy-four patients underwent baseline T2W MRI. Gross tumor volume at diagnosis (GTV-T initial) was delineated. Tumor radiomic features were extracted using TexRAD software. Feature enrichment using parameters indicative of response was done using least absolute shrinkage and selection operator (LASSO) regression. The support vector machine (SVM) algorithm was used to generate the model. Response to chemo-radiotherapy was based on the criteria GTV-BT/GTV-T initial ratio &lt; or &gt;0.20 was used for classifying good versus poor responders.</div></div><div><h3>RESULTS</h3><div>Fifty-six radiomic features were extracted. LASSO enriched the number of features to 11 for the GTV-BT/GTV-T initial ratio. The SVM classifier with a 10-fold internal cross-validation demonstrated an AUC of 0.82 and 76.8% accuracy when the response was assessed using the GTV-BT/GTV-T initial ratio for response evaluation. When SVM was modeled using clinical features, the AUC was 0.55, and the accuracy was 62.6% for the GTV-BT/GTV-T initial ratio,</div></div><div><h3>CONCLUSION</h3><div>Machine learning model employing radiomic features extracted from pre-treatment MRI reliably predicted treatment response in patients with LACC.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 74-84"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423536","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}