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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants
S A Thompson1, A Y C Fung, M Zaider
1Department of Medical Physics, North Shore-Long Island Jewish Health System, Manhassett, NY 11030, USA.
Physics in Medicine and Biology
|September 12, 2002
Summary
Optimizing permanent prostate implant placement requires proper needle arrangement. The POSTCTR method, placing needles peripherally and centrally as needed, consistently yielded superior results for seed implantation planning.
Area of Science:
- Medical Physics
- Radiation Oncology
- Surgical Planning
Background:
- Intraoperative planning for permanent prostate implants is limited by pre-placement needle imaging.
- Suboptimal needle placement restricts the generation of optimal seed implantation patterns.
- Developing standardized needle layout principles is crucial for treatment efficacy.
Purpose of the Study:
- To establish guiding principles for optimal needle arrangement in permanent prostate brachytherapy.
- To evaluate the impact of different needle configurations on treatment plan quality.
- To identify superior needle placement strategies for improved dose distribution.
Main Methods:
- Utilized ultrasound volumes from 12 patients undergoing 1-125 permanent prostate implants.
- Generated 72 treatment plans using a genetic algorithm-based planning system with varying needle arrangements (POSTCTR, POSTLAT).
- Evaluated plans based on V100 (dose coverage), U135 (urethral sparing), and Conformity Index (CI).
Main Results:
- The POSTCTR method, featuring peripheral and posterior central needle placement, consistently outperformed other arrangements across all prostate sizes.
- POSTLAT, a peripheral and posterior-lateral arrangement, also provided satisfactory outcomes.
- POSTCTR demonstrated superior V100, U135, and CI metrics compared to other tested configurations.
Conclusions:
- Advocating for the POSTCTR and POSTLAT needle arrangement strategies in permanent prostate brachytherapy.
- The POSTCTR method is recommended for its consistently superior performance in optimizing seed placement and dose distribution.
- Improved needle planning principles enhance treatment plan quality and patient outcomes in prostate brachytherapy.
