Dose reduction in LDR brachytherapy by implanted prostate gold fiducial markers

Landry, Guillaume; Reniers, Brigitte; Lutgens, Ludy; Murrer, L.; Afsharpour, Hossein; Haas-Kock, Danielle de; Visser, P.; Gils, Francis van; Verhaegen, Frank

doi:10.1118/1.3685582

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…4,5 Known dose delivery inaccuracies occur due to the presence of metal bodies and their concomitant streaking artifacts in CT images in case of photon or proton beam treatments 7-9 or combinations with low dose rate (LDR) brachytherapy. 6 The presence of the FMs can cause localized dose reductions between the calculated and delivered dose for proton therapy of up to 38% (Ref. 7) or 47%, 8 depending on the marker and the reference consulted.…”

Section: Ivb Comparison Of the Two Igrt Techniquesmentioning

confidence: 99%

“…9 In the case where LDR brachytherapy is used as a boost after external beam radiotherapy the dose perturbation can be quite severe with localized brachytherapy dose reductions of 50%. 6 But can US replace the FM workflow? Johnston et al 16 used an earlier research version of the Clarity system with a different workflow than in our study, and they report slightly larger variation between US and FM with a similar number of patients.…”

Section: Ivb Comparison Of the Two Igrt Techniquesmentioning

confidence: 99%

“…4,5 In addition, the presence of the FMs can cause localized differences between the calculated and delivered dose for various treatment modalities. [6][7][8][9] Various other imaging methods have been investigated to localize the prostate during treatment: prostate implanted electromagnetic transponders, 10 kilovolt (kV) projection imaging or MV-EPI (Ref. 11) of the bony anatomy, calcification and soft tissue imaging with cone-beam computed tomography (CBCT), 12,13 magnetic resonance imaging (MRI), 14 and ultrasound (US) imaging.…”

Section: Introductionmentioning

confidence: 99%

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Critical assessment of intramodality 3D ultrasound imaging for prostate IGRT compared to fiducial markers

et al. 2013

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The overall accuracy of US (3.0 mm) is comparable to our FM workflow (2.2 mm). Since neither US nor FM can be considered a gold standard no conclusions can be drawn on the superiority of either method. Because US imaging captures the prostate itself instead of surrogates no invasive procedure is required. It requires more effort to standardize US imaging than FM detection. Since US imaging does not involve a radiation burden, US prostate imaging offers an alternative for FM EPI positioning.

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Section: Ivb Comparison Of the Two Igrt Techniquesmentioning

confidence: 99%

Section: Ivb Comparison Of the Two Igrt Techniquesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Critical assessment of intramodality 3D ultrasound imaging for prostate IGRT compared to fiducial markers

et al. 2013

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“…The goal of this research was to quantify the effects of calcifications on the dosimetric parameters of low dose rate prostate brachytherapy treatments, which are used to evaluate clinical outcomes inpatient treatments. Previous studies showed that inaccurate modelling of LDR-BT in commercial treatment planning systems can significantly affect the dosimetric outcome of the treatment [11], [12], [13]. A study evaluating the impact of interseed attenuation for I-125 permanent seed implants found that variation in seed density causes reductions in the CTV D 90 value of up to 3% [11].…”

Section: Iintroductionmentioning

confidence: 99%

The investigation of prostatic calcifications using μ-PIXE analysis and their dosimetric effect in low dose rate brachytherapy treatments using Geant4

et al. 2015

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Low dose rate brachytherapy is a widely used modality for the treatment of prostate cancer. Most clinical treatment planning systems currently in use approximate all tissue to water, neglecting the existence of inhomogeneities, such as calcifications. The presence of prostatic calcifications may perturb the dose due to the higher photoelectric effect cross section in comparison to water. This study quantitatively evaluates the effect of prostatic calcifications on the dosimetric outcome of brachytherapy treatments by means of Monte Carlo simulations and its potential clinical consequences.Four pathological calcification samples were characterised with micro-particle induced x-ray emission (μ-PIXE) to determine their heavy elemental composition. Calcium, phosphorus and zinc were found to be the predominant heavy elements in the calcification composition. Four clinical patient brachytherapy treatments were modelled using Geant4 based Monte Carlo simulations, in terms of the distribution of brachytherapy seeds and calcifications in the prostate. Dose reductions were observed to be up to 30% locally to the calcification boundary, calcification size dependent. Single large calcifications and closely placed calculi caused local dose reductions of between 30-60%. Individual calculi smaller than 0.5 mm in diameter showed minimal dosimetric impact, however, the effects of small or diffuse calcifications within the prostatic tissue could not be determined using the methods employed in the study. The simulation study showed a varying reduction on common dosimetric parameters. D90 showed a reduction of 2-5%, regardless of calcification surface area and volume. The parameters V100, V150 and V200 were also reduced by as much as 3% and on average by 1%. These reductions were also found to relate to the surface area and volume of calcifications, which may have a significant dosimetric impact on brachytherapy treatment, however, such impacts depend strongly on specific factors in the patient's individual treatment. These factors include the number, size, composition and spatial distribution of calcifications in the prostate as well as the distribution of brachytherapy seeds.

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“…Elas também podem ser utilizadas como terapia primária, adjunta e para tratamento de recidiva de tumores. Há vastas descrições na literatura que demonstram as aplicações das sementes de 125 I no tratamento de diversos tumores, como neoplasias oculares (SANCHEZ, 2006;STANNARD et al, 2002), câncer de fígado (ZHOU et al, 2007), carcinomas pancreáticos (MAAROUF et al, 2002) e principalmente no câncer de próstata (CHIBANI; TODOR, 2005;LANDRY et al, 2012).…”

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Estudo dos efeitos na dose devido à heterogeneidade em braquiterapia com fontes de I<sup>125</sup>

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Agradeço a toda a minha família, especificamente aos meus pais, Hélio Lopes Branco e Solange Regina Soares Branco, e a minha irmã Thais Soares Lopes Branco por todo o carinho, amparo, amizade, ensinamentos e por sempre estarem presentes, ainda que à distância. Ao Prof. Dr. Hélio Yoriyaz por todas as orientações e dedicação no desenvolvimento e elaboração deste projeto, pela oportunidade de crescimento científico, além do ensino e experiências partilhadas. Ao Prof. Dr. Marco Antônio Rodrigues Fernandes, primeiro orientador, incentivador na área acadêmica, agradeço pelo auxilio na realização deste e outros estudos.

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Dose reduction in LDR brachytherapy by implanted prostate gold fiducial markers

Abstract: There is a major local impact of FM present in LDR brachytherapy seed implant dose distributions. Therefore, reduced tumor control could be expected from FM implanted in tumors, although our results are too limited to draw conclusions regarding clinical significance.

Cited by 8 publications

References 16 publications

Critical assessment of intramodality 3D ultrasound imaging for prostate IGRT compared to fiducial markers

Critical assessment of intramodality 3D ultrasound imaging for prostate IGRT compared to fiducial markers

The investigation of prostatic calcifications using μ-PIXE analysis and their dosimetric effect in low dose rate brachytherapy treatments using Geant4

Estudo dos efeitos na dose devido à heterogeneidade em braquiterapia com fontes de I<sup>125</sup>

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