Improved prostate delineation in prostate HDR brachytherapy with TRUS-CT deformable registration technology: A pilot...

Area of Science:

• Medical Physics
• Radiation Oncology
• Medical Imaging

Background:

• Accurate prostate delineation is critical for effective prostate High-Dose-Rate (HDR) brachytherapy, balancing target coverage and normal tissue sparing.
• Conventional CT-based methods often lack precision in defining prostate contours.

Purpose of the Study:

• To develop and evaluate a novel prostate HDR brachytherapy technology integrating intraoperative TRUS-based prostate contour with HDR treatment planning via TRUS-CT deformable registration (TCDR).
• To assess the clinical feasibility and performance of the TCDR-based approach, comparing its prostate contour accuracy against conventional CT-based HDR using MRI as the gold standard.

Main Methods:

• A prospective study involving 16 patients undergoing prostate HDR brachytherapy.
• TRUS-CT deformable registration (TCDR) was employed to integrate intraoperative TRUS-based prostate contours into HDR treatment planning.
• Prostate contour accuracy was evaluated by comparing TCDR-based contours with MRI-defined contours (gold standard) and conventional CT-based contours.

Main Results:

• The TCDR-based approach achieved an average Dice prostate volume overlap of 91.1 ± 2.3% with MRI-defined volumes.
• A 10% to 40% improvement in prostate volume accuracy was observed with the TCDR-based method compared to conventional CT-based volumes.
• Inter- and intra-observer reliability studies confirmed the robustness of the TCDR-based prostate delineation.

Conclusions:

• The TCDR-based HDR brachytherapy approach is clinically feasible and significantly improves prostate contour accuracy over conventional CT-based methods.
• The TCDR-based method demonstrates high reliability and close agreement with MRI-defined prostate volumes.
• This technology holds potential for enhancing dose planning, delivery, and ultimately, prostate HDR treatment outcomes.