Accuracy evaluation of a 3D-printed individual template for needle guidance in head and neck brachytherapy

Abstract

To transfer the preplan for the head and neck brachytherapy to the clinical implantation procedure, a preplan-based 3D-printed individual template for needle insertion guidance had previously been designed and used. The accuracy of needle insertion using this kind template was assessed in vivo. In the study, 25 patients with head and neck tumors were implanted with 125I radioactive seeds under the guidance of the 3D-printed individual template. Patients were divided into four groups based on the site of needle insertion: the parotid and masseter region group (nine patients); the maxillary and paranasal region group (eight patients); the submandibular and upper neck area group (five patients); and the retromandibular region group (six patients). The distance and angular deviations between the preplanned and placed needles were compared, and the complications and time required for needle insertion were assessed. The mean entrance point distance deviation for all 619 needles was 1.18 ± 0.81 mm, varying from 0.857 ± 0.545 to 1.930 ± 0.843 mm at different sites. The mean angular deviation was 2.08 ± 1.07 degrees, varying from 1.85 ± 0.93 to 2.73 ± 1.18 degrees at different sites. All needles were manually inserted to their preplanned positions in a single attempt, and the mean time to insert one needle was 7.5 s. No anatomical complications related to inaccurately placed implants were observed. Using the 3D-printed individual template for the implantation of 125I radioactive seeds in the head and neck region can accurately transfer a CT-based preplan to the brachytherapy needle insertion procedure. Moreover, the addition of individual template guidance can reduce the time required for implantation and minimize the damage to normal tissues.

The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.

“…The preliminary study confirmed that this approach was easier and more accurate. The D90, V100 and V150 were all meet the treatment requirements [35]. The carcinomas occurred in head and neck regions were relatively stable and superficial, so it is relatively easy for template to fix with the patient anatomic construction and the needles puncture deviation was infrequent.…”

125I interstitial brachytherapy in management of pediatric skull base tumors

“…The one‐ and two‐year LC rates were 96.7% and 74.8%, respectively. The modern brachytherapy techniques improve the target dose coverage (i.e., 3D template or navigation system). Four benign or low‐grade tumors survived throughout the follow‐up.…”

“…The 125 I radioactive seeds had a half‐life period of 59.4 days and a surface radioactivity of 18.5 to 25.9 MBq per seed (type 6711, Beijing Atom and High Technique Industries, Beijing, China). Three‐dimensional (3D)‐printed individual templates were used in 21 patients; in detail, preoperative CT data were transferred into Mimics10.01 (Materialise, Belgium) and Geomagic8.0 (Geomagic Company, USA); then, a 3D‐printed individual template for needle insertion guidance was designed prior to 125 I IBT, as was introduced previously in other articles . A far‐infrared navigation guidance system (iPlan 3.0, Brainlab, Feldkirchen, Germany) was used in eight patients, and intraoperative CT guidance was used in four patients (Figure ).…”

The Accuracy of Individualized Three Dimensional-printing Template Assisted I125 Radioactive Seed Implantation for Recurrent head and Neck Cancer

“…However, most of the previous studies involving 3D-PT assisted I 125 RSI were focused on the e cacy and safety pro les, mainly including local control, survival and complications [7,[11][12][13]. As the mean entrance deviation, planned and intraoperative deviation of needle depth and angular were deemed to represent the accuracy of needle related interventions, only 2 studies involving these parameters were published to described the accuracy of 3D-PT assisted I 125 RSI for head and neck cancer [9,14]. Indicated by existed evidence, 3D-PT assisted I 125 RSI may provide satis ed accuracy with consistent planed and post-plan dosimetry without additional complications [9,11,14], while cases reported in these studies was limited.…”