M. de Vries , M.E.M.C. Christianen , L. Luthart , K.C. de Vries , I.K.K. Kolkman-Deurloo , J.J. van den Dobbelsteen
{"title":"可转向针在 HDR 前列腺近距离放射治疗中的剂量学优势和临床前性能","authors":"M. de Vries , M.E.M.C. Christianen , L. Luthart , K.C. de Vries , I.K.K. Kolkman-Deurloo , J.J. van den Dobbelsteen","doi":"10.1016/j.medengphy.2024.104177","DOIUrl":null,"url":null,"abstract":"<div><p>Prostate cancer patients with an enlarged prostate and/or excessive pubic arch interference (PAI) are generally considered non-eligible for high-dose-rate (HDR) brachytherapy (BT). Steerable needles have been developed to make these patients eligible again. This study aims to validate the dosimetric impact and performance of steerable needles within the conventional clinical setting.</p><p>HDR BT treatment plans were generated, needle implantations were performed in a prostate phantom, with prostate volume > 55 cm<sup>3</sup> and excessive PAI of 10 mm, and pre- and post-implant dosimetry were compared considering the dosimetric constraints: prostate V<sub>100</sub> > 95 % (13.50 Gy), urethra D<sub>0.1cm</sub><sup>3</sup> < 115 % (15.53 Gy) and rectum D<sub>1cm</sub><sup>3</sup> < 75 % (10.13 Gy).</p><p>The inclusion of steerable needles resulted in a notable enhancement of the dose distribution and prostate V<sub>100</sub> compared to treatment plans exclusively employing rigid needles to address PAI. Furthermore, the steerable needle plan demonstrated better agreement between pre- and post-implant dosimetry (prostate V<sub>100</sub>: 96.24 % vs. 93.74 %) compared to the rigid needle plans (79.13 % vs. 72.86 % and 87.70 % vs. 81.76 %), with no major changes in the clinical workflow and no changes in the clinical set-up.</p><p>The steerable needle approach allows for more flexibility in needle positioning, ensuring a highly conformal dose distribution, and hence, HDR BT is a feasible treatment option again for prostate cancer patients with an enlarged prostate and/or excessive PAI.</p></div>","PeriodicalId":49836,"journal":{"name":"Medical Engineering & Physics","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S135045332400078X/pdfft?md5=ba76818e3a49cfd1abb83c86f3ee3956&pid=1-s2.0-S135045332400078X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Dosimetric benefits and preclinical performance of steerable needles in HDR prostate brachytherapy\",\"authors\":\"M. de Vries , M.E.M.C. Christianen , L. Luthart , K.C. de Vries , I.K.K. Kolkman-Deurloo , J.J. van den Dobbelsteen\",\"doi\":\"10.1016/j.medengphy.2024.104177\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Prostate cancer patients with an enlarged prostate and/or excessive pubic arch interference (PAI) are generally considered non-eligible for high-dose-rate (HDR) brachytherapy (BT). Steerable needles have been developed to make these patients eligible again. This study aims to validate the dosimetric impact and performance of steerable needles within the conventional clinical setting.</p><p>HDR BT treatment plans were generated, needle implantations were performed in a prostate phantom, with prostate volume > 55 cm<sup>3</sup> and excessive PAI of 10 mm, and pre- and post-implant dosimetry were compared considering the dosimetric constraints: prostate V<sub>100</sub> > 95 % (13.50 Gy), urethra D<sub>0.1cm</sub><sup>3</sup> < 115 % (15.53 Gy) and rectum D<sub>1cm</sub><sup>3</sup> < 75 % (10.13 Gy).</p><p>The inclusion of steerable needles resulted in a notable enhancement of the dose distribution and prostate V<sub>100</sub> compared to treatment plans exclusively employing rigid needles to address PAI. Furthermore, the steerable needle plan demonstrated better agreement between pre- and post-implant dosimetry (prostate V<sub>100</sub>: 96.24 % vs. 93.74 %) compared to the rigid needle plans (79.13 % vs. 72.86 % and 87.70 % vs. 81.76 %), with no major changes in the clinical workflow and no changes in the clinical set-up.</p><p>The steerable needle approach allows for more flexibility in needle positioning, ensuring a highly conformal dose distribution, and hence, HDR BT is a feasible treatment option again for prostate cancer patients with an enlarged prostate and/or excessive PAI.</p></div>\",\"PeriodicalId\":49836,\"journal\":{\"name\":\"Medical Engineering & Physics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-05-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S135045332400078X/pdfft?md5=ba76818e3a49cfd1abb83c86f3ee3956&pid=1-s2.0-S135045332400078X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Engineering & Physics\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S135045332400078X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Engineering & Physics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S135045332400078X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Dosimetric benefits and preclinical performance of steerable needles in HDR prostate brachytherapy
Prostate cancer patients with an enlarged prostate and/or excessive pubic arch interference (PAI) are generally considered non-eligible for high-dose-rate (HDR) brachytherapy (BT). Steerable needles have been developed to make these patients eligible again. This study aims to validate the dosimetric impact and performance of steerable needles within the conventional clinical setting.
HDR BT treatment plans were generated, needle implantations were performed in a prostate phantom, with prostate volume > 55 cm3 and excessive PAI of 10 mm, and pre- and post-implant dosimetry were compared considering the dosimetric constraints: prostate V100 > 95 % (13.50 Gy), urethra D0.1cm3 < 115 % (15.53 Gy) and rectum D1cm3 < 75 % (10.13 Gy).
The inclusion of steerable needles resulted in a notable enhancement of the dose distribution and prostate V100 compared to treatment plans exclusively employing rigid needles to address PAI. Furthermore, the steerable needle plan demonstrated better agreement between pre- and post-implant dosimetry (prostate V100: 96.24 % vs. 93.74 %) compared to the rigid needle plans (79.13 % vs. 72.86 % and 87.70 % vs. 81.76 %), with no major changes in the clinical workflow and no changes in the clinical set-up.
The steerable needle approach allows for more flexibility in needle positioning, ensuring a highly conformal dose distribution, and hence, HDR BT is a feasible treatment option again for prostate cancer patients with an enlarged prostate and/or excessive PAI.
期刊介绍：
Medical Engineering & Physics provides a forum for the publication of the latest developments in biomedical engineering, and reflects the essential multidisciplinary nature of the subject. The journal publishes in-depth critical reviews, scientific papers and technical notes. Our focus encompasses the application of the basic principles of physics and engineering to the development of medical devices and technology, with the ultimate aim of producing improvements in the quality of health care.Topics covered include biomechanics, biomaterials, mechanobiology, rehabilitation engineering, biomedical signal processing and medical device development. Medical Engineering & Physics aims to keep both engineers and clinicians abreast of the latest applications of technology to health care.
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