经直肠超声引导会阴植入术用于机器人立体定向放疗中图像引导6d跟踪后前列腺基准标志物的几何形态及检出率

IF 2.5 3区 医学 Q3 ONCOLOGY
Strahlentherapie und Onkologie Pub Date : 2025-08-01 Epub Date: 2025-02-06 DOI:10.1007/s00066-024-02363-y
Arne Grün, Katharina Heil, Daniel Zips, Goda Kalinauskaite, Dirk Böhmer
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引用次数: 0

摘要

目的:基线标志物(FM)在前列腺机器人立体定向放射治疗(SBRT)中是必不可少的。Accuray®(Madison, WI, USA)提供了可靠检测的植入指南。我们报告了并发症的发生率,并分析了几何植入质量与后续检出率的关系。我们还研究了诸如单、双FM、身体质量指数(BMI)、前列腺体积和植入至治疗间隔等因素是否能预测几何形状和检测质量。方法:回顾性分析2011年1月至2021年5月接受经直肠超声(TRUS)引导下≥ 3前列腺FM和机器人SBRT经会阴植入术的64例患者。不良事件(AE)按照介入放射学会(SIR)分类系统进行分类。数字重建x线片(DRR)和规划CT构成了种植体几何计算的基础。标记物检测率由Synchrony®(Accuray®)测井获得。结果:并发症发生率低,多为轻度AE。双调频显着提高了获得最佳植入几何形状的率。在治疗过程中,高的FM检出率可以独立于种植体的几何形状和FM的类型。BMI和前列腺体积与几何形状和检测质量无关。植入至治疗间隔> 42天预示着较低的检出率。结论:经会阴前列腺内植入术是安全的。我们建议使用双标记来减少创伤(两次穿刺而不是四次),因此增加了患者的舒适度。双FM对实现最佳植入几何形状具有显著的预测作用,在五段式治疗过程中,这对于提高标记物检出率具有临界意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Implant geometry and detection rates of prostate fiducial markers after transrectal ultrasound-guided perineal implantation for image-guided 6D-tracking in robotic stereotactic body radiotherapy.

Implant geometry and detection rates of prostate fiducial markers after transrectal ultrasound-guided perineal implantation for image-guided 6D-tracking in robotic stereotactic body radiotherapy.

Implant geometry and detection rates of prostate fiducial markers after transrectal ultrasound-guided perineal implantation for image-guided 6D-tracking in robotic stereotactic body radiotherapy.

Purpose: Fiducial markers (FM) are essential in prostate robotic stereotactic body radiotherapy (SBRT). Accuray® (Madison, WI, USA) provides an implantation guideline for reliable detection. We report on complication rates and analyze how the geometrical implantation quality correlated with subsequent detection rates. We also investigated whether factors such as single vs. double FM, body mass index (BMI), prostatic gland volume, and implantation-to-treatment interval were predictive for geometry and detection quality.

Methods: A retrospective analysis of 64 patients receiving transrectal ultrasound (TRUS)-guided transperineal implantation of ≥ 3 prostate FM and robotic SBRT between January 2011 and May 2021 was performed. Adverse events (AE) were classified according to the Society of Interventional Radiology (SIR) classification system. Digitally reconstructed radiographs (DRR) and the planning CT constituted the basis for implant geometry calculations. Marker detection rates were obtained from the Synchrony® (Accuray®) log.

Results: Complication rates were low, with mostly mild AE. Double FM significantly improved the rate of obtaining an optimal implantation geometry. High FM detection rates during treatment could be achieved independent of implantation geometry and type of FM. BMI and prostatic gland volume did not correlate with geometry and detection quality. An implantation-to-treatment interval of > 42 days was predictive for lower detection rates.

Conclusion: Transperineal intraprostatic FM implantation is a safe procedure. We recommend the use of double markers for reduction of trauma (two punctures instead of four) and, hence, increased patient comfort. Double FM were significantly predictive for achieving an optimal implantation geometry, which was borderline significant for improved marker detection rates over the course of the five-fraction treatment.

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来源期刊
CiteScore
5.70
自引率
12.90%
发文量
141
审稿时长
3-8 weeks
期刊介绍: Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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