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Related Experiment Videos

Progressive transition from pre-planned to intraoperative optimizing seed implant: post implementation analysis.

Hsiang-Chi Kuo1, William Bodner, Ravindra Yaparpalvi

  • 1Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiation Oncology, Montefiore Medical Center, New York, USA.

Journal of Contemporary Brachytherapy
|January 25, 2013
PubMed
Summary

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An intraoperative technique for I-125 prostate seed implantation improved dosimetric accuracy and precision compared to pre-planned methods. This approach enhances prostate cancer treatment outcomes without increasing rectal dose.

Area of Science:

  • Radiation Oncology
  • Medical Physics

Background:

  • Permanent seed implantation using Iodine-125 (I-125) is a common treatment for prostate cancer.
  • Pre-planned techniques rely on pre-implant imaging, which may not fully account for intraoperative anatomical variations.
  • Optimizing seed placement during the procedure can potentially improve treatment accuracy.

Purpose of the Study:

  • To compare the dosimetric outcomes of a pre-planned I-125 seed implantation technique versus a pre-plan based intraoperative technique in prostate cancer patients.
  • To evaluate the impact of intraoperative adjustments on dose coverage and rectal sparing.

Main Methods:

  • Thirty patients undergoing I-125 prostate seed implantation were divided into two groups: pre-planned (Arm A) and intraoperative adjusted (Arm B).
  • Intraoperative ultrasound was used for real-time adjustments in Arm B, with surface registration to account for image set differences in Arm A.
Keywords:
intraoperative planningpre-planprostate cancerseed implant

Related Experiment Videos

  • Dosimetric analysis focused on V(100) (prostate), D(90) (prostate), and V(100) (rectum).

    • Main Results:

    • Pre-implant imaging discrepancies in Arm A led to a 6.4% decrease in V(100) and a 9.3% decrease in D(90).
    • The intraoperative technique in Arm B improved post-implant V(100) by 4.0% and D(90) by 5.7% compared to Arm A.
    • These improvements were achieved without a significant increase in rectal dose (V(100)(rectum)).

    Conclusions:

    • A pre-plan based intraoperative technique for I-125 prostate seed implantation offers enhanced accuracy and precision over traditional pre-planned methods.
    • This technique maintains the cost-effectiveness of seed ordering and procedural efficiency.
    • The intraoperative approach leads to superior dosimetric outcomes for prostate cancer patients.