eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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1/2016
vol. 8
 
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abstract:
Original paper

Dosimetry of permanent interstitial prostate brachytherapy for an intraoperative procedure, using O-arm based CT and TRUS

Hiromichi Ishiyama
,
Akane Sekiguchi
,
Takefumi Satoh
,
Hideyasu Tsumura
,
Kouji Takenaka
,
Shogo Kawakami
,
Ken-ichi Tabata
,
Kentaro Kobayashi
,
Masatsugu Iwamura
,
Kazushige Hayakawa

J Contemp Brachytherapy 2016; 8, 1: 7–16
DOI: https://doi.org/10.5114/jcb.2016.57817
Online publish date: 2016/02/09
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Purpose: The aim of this report is dosimetric evaluation for an intraoperative fusion computed tomography (CT) as a superior predictor of 1-month CT based dosimetry in comparison to transrectal ultrasound (TRUS) in permanent interstitial prostate brachytherapy.

Material and methods: Data of 65 patients treated with seed implantation were analyzed. All procedures has been performed with patients in the lithotomy position inside the O-arm system. An end-fine probe is used as a landmark to fuse TRUS and O-arm-based CT images. There was no difference in the patient’s position, probe position, and timing of image acquisition between the two imaging modalities. Dose-volume histogram (DVH) parameters such as the dose to 90% of prostate volume (D90) has been analyzed.

Results: The area under the curve of the receiver operating characteristic tended to be larger on fusion CT than on TRUS for most DVH parameters (71.85% vs. 59.59% for D90; p = 0.07). Significant relationships between fusion CT and 1-month CT were confirmed using Pearson’s correlation coefficients for most DVH parameters (R = 0.48, p < 0.01 for D90), although the relationship between TRUS and 1-month CT was poor. Large dose reduction (35 Gy for D90) was seen from TRUS to fusion CT, especially in patients with high body weight and small prostate volume.

Conclusions: Intraoperative fusion CT appears to have higher predictive power for 1-month CT-based dosimetry than TRUS. A prospective trial using fusion CT-based planning is warranted.
keywords:

brachytherapy, intraoperative CT, low dose rate, O-arm system, prostate cancer

  
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