Multisector prostate dosimetric quality: Analysis of a large community database

Merrick, Gregory S.; Grimm, Peter; Morris, Mallory; Lief, Jonathan H.; Bennett, Abbey; Fiano, Ryan

doi:10.1016/j.brachy.2013.08.003

Cited by 11 publications

(13 citation statements)

References 16 publications

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“…The prostate gland was outlined by a single radiation oncologist (JAK). A good quality prostate implant was defined by V 100 ≥ 80% on day 1 post-implant dosimetry [3, 5, 12]. …”

Section: Methodsmentioning

confidence: 99%

“…A number of reports have described brachytherapy doses to the prostate base, mid gland, and apex using varying definitions [7–12]. In one report, the base was represented by the two superior most CT slices and the apex was designated as the two inferior most CT slices [7].…”

Section: Methodsmentioning

confidence: 99%

“…In other reports the prostate gland was divided supero-inferiorly into two or three equal quadrants [8–10]. In two recent reports, the prostate was divided into three equal quadrants (base, mid gland, apex) along its length, and then each quadrant was divided into four sectors by using perpendicular or oblique dividers for a total of 12 sectors [11, 12]. In another report by D'Amico et al .…”

Section: Methodsmentioning

confidence: 99%

“…The ABS has not proposed any consensus guidelines for prostate multisector dosimetry [5]. While there are several reports of prostate multisector dosimetry data obtained from CT or MRI scans performed at intervals ranging from 14-70 days after PB, there are no reports on multisector dosimetry performed in the immediate post-implant period [7–12]. This study was undertaken to determine the results of prostate multisector dosimetry performed in the immediate post-implant period on day 1 post-implant dosimetry after 125 I PB.…”

Section: Purposementioning

confidence: 99%

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Multisector dosimetry in the immediate post-implant period: significant under dosage of the prostate base

Kirschner¹,

Sathiaseelan²,

Zhang³

et al. 2014

jcb

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PurposeWhile there are several reports of prostate multisector dosimetry data obtained from CT or MRI scans performed at intervals ranging from 14-70 days after prostate brachytherapy (PB), there are no reports on multisector dosimetry performed in the immediate post-implant period. This study was undertaken to determine the results of prostate multisector dosimetry performed in the immediate post-implant period on day 1 post-implant dosimetry after 125I PB.Material and methodsThe day 1 post-implant CT-based V100 and D90 were determined for the prostate base (PGB) and compared to doses to the entire gland (PG), mid-gland (PMG), and apex (PA) in 75 patients who underwent 125I PB to a dose of 144 Gy. Similar multisector dosimetry was also performed on the pre-implant ultrasound volume study scans of these patients.ResultsAll patients had good quality implants. On day 1 post-implant multisector dosimetry there was significant under dosage of the PGB for both V100 and D90. The average magnitude of under dosage of PGB compared to PMG and PA was 17.2% and 22.7% for V100 and 44.6 Gy and 31.7 Gy for D90, respectively. On pre-implant multisector dosimetry there was no statistically significant under dosage of the PGB for V100, but the PGB D90 was significantly lower compared to PMG and PA, however, the average magnitude of under dosage was small at 12.6 Gy and 4.2 Gy, respectively.ConclusionsThis report demonstrates that similar to other reports on more delayed post-implant multisector dosimetry data, there is significant under dosage of the prostate base in the immediate post-implant period based on day 1 post-implant dosimetry. The clinical significance of this under dosage remains to be defined and further studies are warranted.

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“…The prostate gland was outlined by a single radiation oncologist (JAK). A good quality prostate implant was defined by V 100 ≥ 80% on day 1 post-implant dosimetry [3, 5, 12]. …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Purposementioning

confidence: 99%

See 2 more Smart Citations

Multisector dosimetry in the immediate post-implant period: significant under dosage of the prostate base

Kirschner¹,

Sathiaseelan²,

Zhang³

et al. 2014

jcb

View full text Add to dashboard Cite

show abstract

“…At the present time, there is no consensus regarding the extent of periprostatic margins or the dose necessary to sterilize EPE, even among brachytherapy experts [11]. Previously in the Pro-Qura database (Pro-Qura, Seattle, WA, USA), we have documented substantial differences in overall intraprostatic sector dosimetric quality [12]. In the current Pro-Qura evaluation, we evaluate extracapsular dose distributions in patients implanted with permanent prostate brachytherapy.…”

Section: Purposementioning

confidence: 99%

Permanent prostate brachytherapy extracapsular radiation dose distributions: analysis of a multi-institutional database

Merrick

Butler²,

Grimm³

et al. 2013

jcb

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PurposePeriprostatic brachytherapy doses impact biochemical control. In this study, we evaluate extracapsular volumetric dosimetry following permanent prostate brachytherapy in patients entered in a multi-institutional community database.Material and methodsIn the database, 4547 patients underwent brachytherapy (3094 – 125I, 1437 – 103Pd and 16 – 131Cs). Using the originally determined prostate volume, a 5 mm, 3-dimensional peri-prostatic anulus was constructed around the prostate (except for a 2 mm posterior margin), and evaluated in its entirety and in 90° segments. Prostate dosimetric parameters consisted of a V100 and D90 while the annular dosimetry was reported as a V100.ResultsThe intraprostatic V100 and D90 for 103Pd, and 125I were statistically comparable when stratified by isotope and/or monotherapy vs. boost. The overall mean V100 for the periprostatic annulus was 62.8%. The mean V100 at the base (51.6%) was substantially less than the apex (73.5%) and midgland (65.9%). In addition, for all patients, the anterior V100 (45.7%) was less than the lateral (68.8%) and the posterior (75.0%). The geometric V100 annular differences were consistent when evaluated by isotope. Overall, the V100 was higher in the 125I cohort.ConclusionsThe optimal extracapsular brachytherapy dose and radial extent remains unknown, but will prove increasingly important with reductions and/or elimination of supplemental external beam radiation therapy. The large multi-institutional community database demonstrates periprostatic annular doses that are not as robust as those in selected high volume brachytherapy centers, and may be inadequate for optimal biochemical control following monotherapeutic brachytherapy, especially in higher risk patients.

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Sector analysis provides additional spatial information on the permanent prostate brachytherapy learning curve

et al. 2015

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Multisector prostate dosimetric quality: Analysis of a large community database

Cited by 11 publications

References 16 publications

Multisector dosimetry in the immediate post-implant period: significant under dosage of the prostate base

Multisector dosimetry in the immediate post-implant period: significant under dosage of the prostate base

Permanent prostate brachytherapy extracapsular radiation dose distributions: analysis of a multi-institutional database

Sector analysis provides additional spatial information on the permanent prostate brachytherapy learning curve

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