Phase I/II prospective trial of cancer-specific imaging using ultrasound spectrum analysis tissue-type imaging to guide dose-painting prostate brachytherapy

Systematic Review of Focal Prostate Brachytherapy and the Future Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion

“…The number of patients assessed in the manuscripts ranged from 1 to 20 with a mean number of 7 subjects. Two of the six works utilized a focused [ 20 , 21 ] rather than focal strategy [ 16 , 22 – 24 ] ( Table 2 ). The works were evenly divided between salvage treatments [ 16 , 22 , 24 ] and initial treatments [ 20 , 21 , 23 ] with two focused manuscripts being salvage treatments.…”

“…Two of the six works utilized a focused [ 20 , 21 ] rather than focal strategy [ 16 , 22 – 24 ] ( Table 2 ). The works were evenly divided between salvage treatments [ 16 , 22 , 24 ] and initial treatments [ 20 , 21 , 23 ] with two focused manuscripts being salvage treatments. Planning was based on MRI imaging [ 16 ], MRI combined with biopsy data [ 20 , 24 ], prostate biopsy mapping [ 23 ], and MRI combined with both MRS and biopsy data [ 22 ].…”

“…Planning was based on MRI imaging [ 16 ], MRI combined with biopsy data [ 20 , 24 ], prostate biopsy mapping [ 23 ], and MRI combined with both MRS and biopsy data [ 22 ]. Treatment imaging utilized MRI registered TRUS [ 16 , 22 ], MRI [ 20 ], and biopsy mapping with TRUS [ 21 ]. One manuscript utilized intraoperative planning and treatment guidance with tissue-type imaging (TTI) based TRUS that enables delineation of tumor volumes from US spectra [ 23 ].…”

“…All but one clinical work [ 23 ] included in this review published dosimetric data. Both focused works were able to achieve OAR doses typical of a standard whole gland treatment, with increased dose to the GTV [ 20 , 21 ]. Ennis et al provided examples of what the dosimetry would have been had they employed whole gland rather than focused plans [ 21 ].…”

“…Both focused works were able to achieve OAR doses typical of a standard whole gland treatment, with increased dose to the GTV [ 20 , 21 ]. Ennis et al provided examples of what the dosimetry would have been had they employed whole gland rather than focused plans [ 21 ]. The focused plans did slightly increase GTV dose than what would have been accomplished in the whole gland plan.…”