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A practical MRI-based reconstruction method for a new endocavitary and interstitial gynaecological template
Jose Richart1, Antonio Otal1, Silvia Rodriguez1
1Radiotherapy Department, Benidorm Hospital, Benidorm, Alicante.
Journal of Contemporary Brachytherapy
|December 2, 2015
Summary
A new method improves titanium needle reconstruction for the Template Benidorm (TB) applicator using MRI pellets and free needle lengths. This technique enhances accuracy in brachytherapy treatment planning, offering a robust alternative for MRI-compatible implants.
Area of Science:
- Medical Physics
- Radiotherapy
- Medical Imaging
Background:
- Existing perineal templates (MUPIT, Syed) have limitations including intracavitary component deficits and lack of MRI compatibility, necessitating CT scans for planning.
- Titanium needles in brachytherapy are typically reconstructed using MRI artifacts, but surrounding tissue heterogeneities complicate accurate identification.
- The Template Benidorm (TB) is a novel applicator developed to overcome these limitations.
Purpose of the Study:
- To improve the accuracy of titanium needle reconstruction for the Template Benidorm (TB) applicator.
- To develop a simple method for reducing uncertainty in needle tip positioning using MRI.
- To overcome limitations of existing brachytherapy applicators regarding MRI compatibility and treatment planning.
Main Methods:
- Inclusion of three A-vitamin pellets (hyperintense on MRI) to define the central plane.
- Calculation of needle tip coordinates using the free needle length and intersection of needle line with the defined plane.
- Application of the method in both T1-weighted (T1W) and T2-weighted (T2W) MRI sequences.
- Evaluation of inter-observer variation by two medical physicists reconstructing six implants (three T1W, three T2W).
Main Results:
- Observed differences in needle tip positioning were significantly smaller than 1 mm in all cases.
- The method demonstrated robustness and independence from the visibility of artifacts at the needle tip.
- Successful reconstruction was achieved using only T2W sequences.
Conclusions:
- The proposed method offers a robust and accurate approach for titanium needle reconstruction in the Template Benidorm applicator.
- This technique enhances brachytherapy treatment planning by improving needle tip localization accuracy.
- The algorithm facilitates the use of T2W sequences for both contouring and reconstruction, simplifying the workflow.
