Computed tomography-guided iodine-125 brachytherapy for unresectable hepatocellular carcinoma

Song, Zhaomin; Ye, Jiacheng; Wang, Yongzheng; Li, Yuliang; Wang, Wujie

doi:10.4103/jcrt.jcrt_629_19

Cited by 16 publications

(8 citation statements)

References 39 publications

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“…Computed tomography (CT)‐guided low‐dose‐rate (LDR) permanent seed brachytherapy is a safe and effective treatment for patients with large hepatic malignancies (>3 cm in diameter), lesions unsuitable for radiofrequency ablation, hepatocellular carcinoma (HCC) refractory to conventional transarterial chemoembolization, 1 or HCC combined with portal vein tumor thrombus 2 . Sealed radioactive seeds, such as iodine‐125 seed ( 125 I), can be implanted within or close to the tumor permanently after a percutaneous puncture operation 1–3 . In contrast to external radiation therapy, brachytherapy delivers a highly concentrated dose of radiation in tumors while sparing the surrounding healthy tissue 4 .…”

Section: Introductionmentioning

confidence: 99%

“…In the reported studies 1–3,7,8 on 125 I seed implantation for liver tumors, the TPS has been used to generate implantation plans, including Panther TPS (Prowess, Concord, USA), Beihang implantation TPS (BUAA, Beijing, China), and BT‐RSI model TPS (Yuanbo, Beijing, China). The gross tumor volume (GTV), which can generate planning target volume (PTV) of each HCC lesion and OAR, was manually delineated layer by layer on CT images.…”

Section: Introductionmentioning

confidence: 99%

“…2 Sealed radioactive seeds, such as iodine-125 seed ( 125 I), can be implanted within or close to the tumor permanently after a percutaneous puncture operation. [1][2][3] In contrast to external radiation therapy, brachytherapy delivers a highly concentrated dose of radiation in tumors while sparing the surrounding healthy tissue. 4 Therefore, designing the pose of the seeds based on the shape of the tumor and generating a conformal dose map is vital in the brachytherapy treatment planning system (TPS).…”

Section: Introductionmentioning

confidence: 99%

“…5 Meanwhile, the selection of the corresponding puncture pathway should be considered in the design of seed distribution where the puncture needle should avoid bones and other organs at risk (OAR). 6 In the reported studies [1][2][3]7,8 on 125 I seed implantation for liver tumors, the TPS has been used to generate implantation plans, including Panther TPS (Prowess, Concord, USA), Beihang implantation TPS (BUAA, Beijing, China), and BT-RSI model TPS (Yuanbo, Beijing, China). The gross tumor volume (GTV), which can generate planning target volume (PTV) of each HCC lesion and OAR, was manually delineated layer by layer on CT images.…”

Section: Introductionmentioning

confidence: 99%

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Embedding expertise knowledge into inverse treatment planning for low‐dose‐rate brachytherapy of hepatic malignancies

Zhu

Wang²,

Teng³

et al. 2023

Medical Physics

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BackgroundLeveraging the precision of its radiation dose distribution and the minimization of postoperative complications, low‐dose‐rate (LDR) permanent seed brachytherapy is progressively adopted in addressing hepatic malignancies.PurposeThe present study endeavors to devise a sophisticated treatment planning system (TPS) to optimize LDR brachytherapy for hepatic lesions.MethodsOur TPS encompasses four integral modules: multi‐organ segmentation, seed distribution initialization, puncture pathway selection, and inverse dose planning. By amalgamating an array of deep learning models, the segmentation module proficiently labels 17 discrete abdominal targets within the images. We introduce a knowledge‐based seed distribution initialization methodology that discerns the most analogous tumor shape in the reference treatment plan from the knowledge base. Subsequently, the seed distribution from the reference plan is transmuted to the current case, thus establishing seed distribution initialization. Furthermore, we parameterize the puncture needles and seeds, while concurrently constraining the puncture needle angle through the employment of a virtual puncture panel to augment planning algorithm efficiency. We also presented a user interface that includes a range of interactive features, seamlessly integrated with the treatment planning generation function.ResultsThe multi‐organ segmentation module, which is trained by 50 cases of in‐house CT scans and 694 cases of publicly available CT scans, achieved average Dice of 0.80 and Hausdorff distance of 5.2 mm in testing datasets. The results demonstrate that knowledge‐based initialization exhibits a marked enhancement in expediting the convergence rate. Our TPS also demonstrates a dominant advantage in dose‐volume‐histogram criteria and execution time in comparison to commercial TPS.ConclusionThe study proposes an innovative treatment planning system for low‐dose‐rate permanent seed brachytherapy for hepatic malignancies. We show that the generated treatment plans meet clinical requirement.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Embedding expertise knowledge into inverse treatment planning for low‐dose‐rate brachytherapy of hepatic malignancies

Zhu

Wang²,

Teng³

et al. 2023

Medical Physics

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“…CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT) is an ablative technique by which a radioactive source (Iridium 192) is inserted into tumor lesions through catheters which have been implanted in the tumor under CT guidance [ 13 , 14 ]. It is being used by a growing number of centers around the world with excellent treatment results for the treatment of solid primary and secondary tumors [ 15 , 16 , 17 , 18 ]. In contrast to radiofrequency ablation (RFA) and microwave ablation (MWA), CT-HDRBT overcomes size limitations and restrictions due to tumor location (e.g., proximity to the liver hilum or vessels).…”

Section: Introductionmentioning

confidence: 99%

Combining Transarterial Radioembolization (TARE) and CT-Guided High-Dose-Rate Interstitial Brachytherapy (CT-HDRBT): A Retrospective Analysis of Advanced Primary and Secondary Liver Tumor Treatment

Fleckenstein

Rösel

Krajewska

et al. 2021

Cancers

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Purpose: Treatment of patients with primary and secondary liver tumors remains challenging. This study analyzes the efficacy and safety of transarterial radioembolization (TARE) combined with CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT) for the treatment of primary and secondary liver tumors. Patients and Methods: A total of 77 patients (30 female) with various liver malignancies were treated. Primary endpoints were median overall survival (OS) and time to untreatable progression (TTUP). Additionally, subgroup analyses were performed in consideration of diagnosis and procedure sequence. Median OS and TTUP prediction were estimated using Kaplan–Meier analysis and hazard ratios (HR) were calculated using a multivariate Cox proportional hazard model. Results: A total of 115 CT-HDRBT and 96 TARE procedures were performed with no significant complications recorded. Median OS and TTUP were 29.8 (95% CI 18.1–41.4) and 23.8 (95% CI 9.6–37.9) months. Median OS for hepatocellular carcinoma (HCC)-, cholangiocarcinoma carcinoma (CCA) and colorectal cancer (CRC) patients was 29.8, 29.6 and 34.4 months. Patients starting with TARE had a median OS of 26.0 (95% CI 14.5–37.5) compared to 33.7 (95% CI 21.6–45.8) months for patients starting with CT-HDRBT. Hazard ratio of 1.094 per month was shown for patients starting with CT-HDRBT. Conclusion: Combining TARE and CT-HDRBT is effective and safe for the treatment of advanced stage primary and secondary liver tumors. Our data indicate that early TARE during the disease progression may have a positive effect on survival.

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CT-guided iodine-125 brachytherapy is an effective palliative treatment for the right lower paratracheal lymph nodes metastasis previously treatment failure

Yuan,

Song,

et al. 2024

Brachytherapy

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Computed tomography-guided iodine-125 brachytherapy for unresectable hepatocellular carcinoma

Cited by 16 publications

References 39 publications

Embedding expertise knowledge into inverse treatment planning for low‐dose‐rate brachytherapy of hepatic malignancies

Embedding expertise knowledge into inverse treatment planning for low‐dose‐rate brachytherapy of hepatic malignancies

Combining Transarterial Radioembolization (TARE) and CT-Guided High-Dose-Rate Interstitial Brachytherapy (CT-HDRBT): A Retrospective Analysis of Advanced Primary and Secondary Liver Tumor Treatment

CT-guided iodine-125 brachytherapy is an effective palliative treatment for the right lower paratracheal lymph nodes metastasis previously treatment failure

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