Multiple direction needle-path planning and inverse dose optimization for robotic low-dose rate brachytherapy

Aumüller, Philipp; Rothfuss, Andreas; Poledník, Martin; Abo-Madyan, Yasser; Ehmann, Michael; Giordano, Frank A.; Clausen, Sven

doi:10.1016/j.zemedi.2021.06.003

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…Including the optimization of needle configurations in the inverse treatment planning problem has been proposed before. [14][15][16][17][18][19] However, a major unaddressed challenge in the context of prostate BT is the tissue deformation and displacement during the insertion which may influence the position and shape of the prostate and OARs. 20 Additionally, the deviation between the planned and actually inserted needle position can influence the dose distribution.…”

Section: Introductionmentioning

confidence: 99%

Robust stochastic optimization of needle configurations for robotic HDR prostate brachytherapy

Gerlach,

Siebert,

Schlaefer

2023

Medical Physics

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BackgroundIdeally, inverse planning for HDR brachytherapy (BT) should include the pose of the needles which define the trajectory of the source. This would be particularly interesting when considering the additional freedom and accuracy in needle pose which robotic needle placement enables. However, needle insertion typically leads to tissue deformation, resulting in uncertainty regarding the actual pose of the needles with respect to the tissue.PurposeTo efficiently address uncertainty during inverse planning for HDR BT in order to robustly optimize the pose of the needles before insertion, that is, to facilitate path planning for robotic needle placement.MethodsWe use a form of stochastic linear programming to model the inverse treatment planning problem. To account for uncertainty, we consider random tissue displacements at the needle tip to simulate tissue deformation. Conventionally for stochastic linear programming, each simulated deformation is reflected by an addition to the linear programming problem which increases problem size and computational complexity substantially and leads to impractical runtime. We propose two efficient approaches for stochastic linear programming. First, we consider averaging dose coefficients to reduce the problem size. Second, we study weighting of the slack variables of an adjusted linear problem to approximate the full stochastic linear program. We compare different approaches to optimize the needle configurations and evaluate their robustness with respect to different amounts of tissue deformation.ResultsOur results illustrate that stochastic planning can improve the robustness of the treatment with respect to deformation. The proposed approaches approximating stochastic linear programming better conform to the tissue deformation compared to conventional linear programming. They show good correlation with the plans computed after deformation while reducing the runtime by two orders of magnitude compared to the complete stochastic linear program. Robust optimization of needle configurations takes on average 59.42 s. Skew needle configurations lead to mean coverage improvements compared to parallel needles from 0.39 to 2.94 percentage points, when 8 mm tissue deformation is considered. Considering tissue deformations from 4 to 10 mm during planning with weighted stochastic optimization and skew needles generally results in improved mean coverage from 1.77 to 4.21 percentage points.ConclusionsWe show that efficient stochastic optimization allows selecting needle configurations which are more robust with respect to potentially negative effects of target deformation and displacement on the achievable prescription dose coverage. The approach facilitates robust path planning for robotic needle placement.

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Section: Introductionmentioning

confidence: 99%

Robust stochastic optimization of needle configurations for robotic HDR prostate brachytherapy

Gerlach,

Siebert,

Schlaefer

2023

Medical Physics

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Brachytherapy is an effective and safe salvage option for re-irradiation in recurrent glioblastoma (rGBM): A systematic review

Xiang,

Ji,

Jin

2024

Radiotherapy and Oncology

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Phantom study of a fully automatic radioactive seed placement robot for the treatment of skull base tumours

Fanhao,

Dongsheng,

Nenghao

et al. 2024

BMC Oral Health

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Background Interstitial brachytherapy is a form of intensive local irradiation that facilitates the effective protection of surrounding structures and the preservation of organ functions, resulting in a favourable therapeutic response. As surgical robots can perform needle placement with a high level of accuracy, our team developed a fully automatic radioactive seed placement robot, and this study aimed to evaluate the accuracy and feasibility of fully automatic radioactive seed placement for the treatment of tumours in the skull base. Methods A fully automatic radioactive seed placement robot was established, and 4 phantoms of skull base tumours were built for experimental validation. All the phantoms were subjected to computed tomography (CT) scans. Then, the CT data were imported into the Remebot software to design the preoperative seed placement plan. After the phantoms were fixed in place, navigation registration of the Remebot was carried out, and the automatic seed placement device was controlled to complete the needle insertion and particle placement operations. After all of the seeds were implanted in the 4 phantoms, postoperative image scanning was performed, and the results were verified via image fusion. Results A total of 120 seeds were implanted in 4 phantoms. The average error of seed placement was (2.51 ± 1.44) mm. Conclusion This study presents an innovative, fully automated radioactive particle implantation system utilizing the Remebot device, which can successfully complete automated localization, needle insertion, and radioactive particle implantation procedures for skull base tumours. The phantom experiments showed the robotic system to be reliable, stable, efficient and safe. However, further research on the needle-soft tissue interaction and deformation mechanism of needle puncture is still needed.

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Multiple direction needle-path planning and inverse dose optimization for robotic low-dose rate brachytherapy

Cited by 3 publications

References 27 publications

Robust stochastic optimization of needle configurations for robotic HDR prostate brachytherapy

Robust stochastic optimization of needle configurations for robotic HDR prostate brachytherapy

Brachytherapy is an effective and safe salvage option for re-irradiation in recurrent glioblastoma (rGBM): A systematic review

Phantom study of a fully automatic radioactive seed placement robot for the treatment of skull base tumours

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