Initial results for patient setup verification using transperineal ultrasound and cone beam CT in external beam radiation therapy of prostate cancer

Richter, Anne; Polat, Bülent; Lawrenz, Ingulf; Weick, Stefan; Sauer, Otto A.; Flentje, Michael; Mantel, Frederick

doi:10.1186/s13014-016-0722-7

Cited by 13 publications

(7 citation statements)

References 25 publications

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“…The low-dose PTV (margin of 10 mm, 7 mm towards posterior) was covered by the 60 Gy isodose. To ensure precise application, an integrated offline/online protocol of volumetric cone beam CT-guided radiotherapy was strictly implemented at our institution [ 11 , 27 – 30 ]. Accurate positioning with daily IGRT contributes to improved tumor control and minimizes dose deviations [ 31 – 33 ], which is especially important for small PTV margins in high-risk disease with possible microscopic extracapsular extension [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis

et al. 2020

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Purpose Evaluation of long-term outcome and toxicity of moderately hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost treatment planning and cone beam CT-based image guidance for localized prostate cancer. Methods Between 2005 and 2015, 346 consecutive patients with localized prostate cancer received primary radiotherapy using cone beam CT-based image-guided intensity-modulated radiotherapy (IG-IMRT) and volumetric modulated arc therapy (IG-VMAT) with a simultaneous integrated boost (SIB). Total doses of 73.9 Gy (n = 44) and 76.2 Gy (n = 302) to the high-dose PTV were delivered in 32 and 33 fractions, respectively. The low-dose PTV received a dose (D95) of 60.06 Gy in single doses of 1.82 Gy. The pelvic lymph nodes were treated in 91 high-risk patients to 45.5 Gy (D95). Results Median follow-up was 61.8 months. The 5‑year biochemical relapse-free survival (bRFS) was 85.4% for all patients and 93.3, 87.4, and 79.4% for low-, intermediate-, and high-risk disease, respectively. The 5‑year prostate cancer-specific survival (PSS) was 94.8% for all patients and 98.7, 98.9, 89.3% for low-, intermediate-, and high-risk disease, respectively. The 5‑year and 10-year overall survival rates were 83.8 and 66.3% and the 5‑year and 10-year freedom from distant metastasis rates were 92.2 and 88.0%, respectively. Cumulative 5‑year late GU toxicity and late GI toxicity grade ≥2 was observed in 26.3 and 12.1% of the patients, respectively. Cumulative 5‑year late grade 3 GU/GI toxicity occurred in 4.0/1.2%. Conclusion Moderately hypofractionated radiotherapy using SIB treatment planning and cone beam CT image guidance resulted in high biochemical control and survival with low rates of late toxicity.

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Section: Discussionmentioning

confidence: 99%

Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis

et al. 2020

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“…Other US image guidance methods have also been tested in prostate cancer patients, where a range of uncertainties from 1.4 to 7.9 mm (SD) have been reported [6] . A representative example, Richter et al [21] , compared the use of transperitoneal US to CBCT in patient alignment, where lateral, vertical and longitudinal uncertainties were measured to be 2.3, 2.4 and 2.7 mm (SD), respectively, with a mean Euclidean error of 3.1 mm (SD) and an overall mean discrepancy of 6 mm. In this study, the US-based platform was able to align the bladder (target) within the phantom independent of the surrounding skeletal structure.…”

Section: Discussionmentioning

confidence: 99%

An ultrasound based platform for image-guided radiotherapy in canine bladder cancer patients

Sick

Rancilio

Fulkerson

et al. 2019

Physics and Imaging in Radiation Oncology

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Background and purpose: Ultrasound (US) is a non-invasive, non-radiographic imaging technique with high spatial and temporal resolution that can be used for localizing soft-tissue structures and tumors in real-time during radiotherapy (RT) (inter-and intra-fraction). A comprehensive approach incorporating an in-house 3D-US system within RT is presented. This system is easier to adopt into existing treatment protocols than current US based systems, with the aim of providing millimeter intra-fraction alignment errors and sensitivity to track intrafraction bladder movement. Materials and methods: An in-house integrated US manipulator and platform was designed to relate the computed tomographic (CT) scanner, 3D-US and linear accelerator coordinate systems. An agar-based phantom with measured speed of sound and densities consistent with tissues surrounding the bladder was rotated (0-45°) and translated (up to 55 mm) relative to the US and CT coordinate systems to validate this device. After acquiring and integrating CT and US images into the treatment planning system, US-to-US and US-to-CT images were coregistered to realign the phantom relative to the linear accelerator. Results: Statistical errors from US-to-US registrations for various patient orientations ranged from 0.1 to 1.7 mm for x, y, and z translation components, and 0.0-1.1°for rotational components. Statistical errors from US-to-CT registrations were 0.3-1.2 mm for the x, y and z translational components and 0.1-2.5°for the rotational components. Conclusions: An ultrasound-based platform was designed, constructed and tested on a CT/US tissue-equivalent phantom to track bladder displacement with a statistical uncertainty to correct and track inter-and intra-fractional displacements of the bladder during radiation treatments.

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“…One study [ 21 ] also compared the results of a surface imaging system (AlignRT, VisionRT, London, UK) with TAUS imaging. The four most recent studies [ 22 – 25 ] examined the use of TPUS imaging in comparison with volumetric imaging only, such as CBCT and an additionally acquired planning CT.…”

Section: Interfraction Monitoringmentioning

confidence: 99%

The Use of Ultrasound Imaging in the External Beam Radiotherapy Workflow of Prostate Cancer Patients

Camps

Fontanarosa

Verhaegen

et al. 2018

BioMed Research International

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External beam radiotherapy (EBRT) is one of the curative treatment options for prostate cancer patients. The aim of this treatment option is to irradiate tumor tissue, while sparing normal tissue as much as possible. Frequent imaging during the course of the treatment (image guided radiotherapy) allows for determination of the location and shape of the prostate (target) and of the organs at risk. This information is used to increase accuracy in radiation dose delivery resulting in better tumor control and lower toxicity. Ultrasound imaging is harmless for the patient, it is cost-effective, and it allows for real-time volumetric organ tracking. For these reasons, it is an ideal technique for image guidance during EBRT workflows. Review papers have been published in which the use of ultrasound imaging in EBRT workflows for different cancer sites (prostate, breast, etc.) was extensively covered. This new review paper aims at providing the readers with an update on the current status for prostate cancer ultrasound guided EBRT treatments.

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Initial results for patient setup verification using transperineal ultrasound and cone beam CT in external beam radiation therapy of prostate cancer

Cited by 13 publications

References 25 publications

Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis

Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis

An ultrasound based platform for image-guided radiotherapy in canine bladder cancer patients

The Use of Ultrasound Imaging in the External Beam Radiotherapy Workflow of Prostate Cancer Patients

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