CT–ultrasound fusion prostate brachytherapy: A dynamic dosimetry feedback and improvement method. A report of 54 consecutive cases

Computed tomography–ultrasound fusion brachytherapy: Description and evolution of the technique

“…Our method for accomplishing CTeUS fusion prostate brachytherapy has been described in detail previously (9). Briefly, the technique represents a hybrid preplanned and dynamic intraoperative dosimetry method, that takes advantage of the complementary strengths of US and CT imaging, applied in real time.…”

“…In greater detail, the urethra, anterior prostate, lateral prostate, and dorsolateral prostate most typically fuse with 0e2 mm of registration error, whereas the midline posterior surface of the prostate poses more of a problem, in that it is distorted anteriorly by the US probe for the US image set, while residing in its native undistorted position for the CT set. This leads to a median registration error in the posterior prostate midline of 4 mm (range, 0e7), with the USdefined position invariably residing anteriorly to the CTdefined position (9). This distortion needs to be accounted for if remedial sources are placed in this region of the prostate.…”

“…Our previous report of 54 consecutive cases indicated that in addition to CTeUS fusion prostate brachytherapy accomplishing the objective of essentially assuring a prostate volume of interest receiving 100% of prescribed dose (V 100 ) value in excess of 95% and a prostate D 90 value greater than 100% of the prescription dose, the method also seemed to tightly control the prostate D 90 range, resulting in a final Day 0 prostate D 90 value within AE10% of the preplanned D 90 value in 98% of the cases (9). In this report, we update our result with 132 consecutive patients.…”

Needle position during 125I seed implantation: accurately recognized by sagittal transrectal ultrasonography

“…10,11 Although the seeds might move after they are deposited from the needle tip, we expect that any such movement is unlikely to be extensive, as seeds do not migrate into vessels. Detecting the actual needle tip position is therefore important.…”

2011 Mid-America Orthopaedic Association Dallas B. Phemister Physician in Training Award: Can Musculoskeletal Tumors be Diagnosed with Ultrasound Fusion-Guided Biopsy?

“…Accuracy reports of the technique come mainly from the work of Schlaier et al [20], whose experiments showed an accuracy of 1.08 mm to 1.6 mm when US/MRI fusion was used for localization of small spheres and arrows. Radiation oncologists have used fusion of US images with CT scans for radiotherapy [22] and prostate brachytherapy [8,9]. Its use also has been documented in neurosurgery for intraoperative localization [16].…”