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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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5/2023
vol. 15
 
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abstract:
Original paper

Analysis of source dwell position during treatment in brachytherapy using CT scout images

Nozomi Nakajima
1, 2
,
Tomonori Isobe
1
,
Yoshinobu Furuyama
3
,
Tetsuya Tomita
4
,
Daisuke Kobayashi
4
,
Yutaro Mori
1
,
Hideyuki Takei
5
,
Yoshiaki Nagai
6
,
Yasuwo Ide
6
,
Keiko Nemoto Murofushi
7
,
Masaru Nakajima
2
,
Yasuo Yoshioka
2

  1. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
  2. Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
  3. Department of Radiation Oncology, Ibaraki Prefectural Central Hospital, Japan
  4. Department of Radiology, University of Tsukuba Hospital, Japan
  5. Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Japan
  6. Faculty of Health Science, Tsukuba International University, Japan
  7. Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan
J Contemp Brachytherapy 2023; 15, 5: 357–364
DOI: https://doi.org/10.5114/jcb.2023.132700
Online publish date: 2023/10/30
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Purpose:
Several cases of inaccurate irradiation in brachytherapy have been reported, occurring similarly to external radiation. Due to a large dose per fraction in brachytherapy, inaccurate irradiation can seriously harm a patient. Although various studies have been conducted, systems that detect inaccurate irradiation in brachytherapy are not as developed as those for external irradiation. This study aimed to construct a system that analyzes the source dwell position during irradiation using computed tomography (CT) scout images. The novelty of the study was that by using CT scout images, high versatility and analysis of absolute coordinates can be achieved.

Material and methods:
A treatment plan was designed with an iridium-192 (192Ir) source delivering radiation at two dwell positions in a tandem applicator. CT scout images were taken during irradiation, and acquired under different imaging conditions and applicator geometries. First, we confirmed whether a source was visible in CT scout images. Then, employing in-house MATLAB program, source dwell coordinates were analyzed using the images. An analysis was considered adequate when the resulting source dwell coordinates agreed with the treatment plan within ±1 mm, in accordance with AAPM TG56 guidelines for source dwell position accuracy.

Results:
The source dwelling was visible in CT scout image, which was enlarged or reduced depending on applicator geometries. The applicator was enlarged by 127% when 130 mm away from the center of CT gantry. The analysis results using our in-house program were considered adequate; although, analysis parameters required adjustments depending on imaging conditions.

Conclusions:
The proposed system can be easily implemented for image-guided brachytherapy and can analyze the absolute coordinates of source dwell position. Therefore, the system could be used for preventing inaccurate irradiation by verifying whether brachytherapy was performed properly.

keywords:

brachytherapy, source position, MATLAB, CT image

  
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