Journal article
Correlation between real-time intraoperative and postoperative dosimetry and its implications on intraoperative planning
Brachytherapy, v 18(3), pp 338-347
May 2019
PMID: 30655047
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of this study was to study the correlation between intraoperative and postimplant dosimetry. We investigated the correlation between prostate (V
) and urethra (D
, D
) dose limits, and whether it is possible to increase prostate D
and V
in intraoperative planning without violating postimplant urethra and rectum dose limits.
Seventy-nine patients who underwent real-time ultrasound-guided prostate implants using intraoperative planning from 2013 to 2017 were analyzed. Forty-one of the 79 implants were
I as monotherapy and the remainder was
Pd as boost to external beam radiation therapy or external beam radiation therapy plus androgen deprivation therapy. Prescriptions followed the guidelines of AAPM TG-137. The urethra was catheterized during intraoperative implantation and postimplant imaging to facilitate the urethra identification. T2-cubed MRI and CT were acquired on the same day and about 1 month after the low-dose-rate procedure, and MRI was later fused with the CT scan for accurate delineation of the prostate and postimplant dosimetry evaluation. An institutionally based peer-review process and document procedure were established based on national recommendations. Correlation of dose parameters: D
, V
, V
of prostate, D
, D
of urethra, and V
of rectum between intraoperative and postimplant plans were evaluated.
D
and V
declined for all implants between intraoperative and postimplant dosimetry. On average, D
declined by 17.5% and 21.7% for
I and
Pb implants, respectively. V
declined for all implants between intraoperative and postimplant dosimetry but less pronounced. Prostate V
and urethra D
and D
also showed different tendency of decline. Of the 79 implants, 60 did not meet the postimplant dosimetry target for prostate (V
≤ 50%), and 46 of the 60 implants met the optimal dosimetry targets for both D
(<125%) and D
(<150%), and the other 14 of the 60 implants failed to meet either the D
or the D
limits. All the implants met the postimplant target dose for rectum: V
≤ 1.3 cc.
Intraoperative implant dosimetry could not accurately predict postimplant dosimetry; however, to avoid underdosage of prostate, intraoperative D
should be close to 120% of prescribed dose and V
needs to be close to 100% of prescribed dose. Prostate V
> 50% does not necessarily indicate the violation of urethra D
and D
dose limits. For most of the implants, target intraoperative D
and V
could be raised without violating urethra D
and D
limits recommended by American Brachytherapy Society in postimplant evaluation.
Metrics
Details
- Title
- Correlation between real-time intraoperative and postoperative dosimetry and its implications on intraoperative planning
- Creators
- Chenyu Yan - UPMC Hillman Cancer CenterM Saiful Huq - UPMC Hillman Cancer CenterDwight E Heron - UPMC Hillman Cancer CenterSushil Beriwal - UPMC Hillman Cancer CenterRaymond B Wynn - UPMC Hillman Cancer Center
- Publication Details
- Brachytherapy, v 18(3), pp 338-347
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000468713100013
- Scopus ID
- 2-s2.0-85059871465
- Other Identifier
- 991021897384804721
UN Sustainable Development Goals (SDGs)
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging