Sci-Sat AM: Brachy - 10: Adaptation of the CVT algorithm for catheter optimization in high dose rate brachytherapy

In interstitial high dose rate (HDR) brachytherapy, the number and positions of the catheter are usually fixed by the use of a template, without considering tumor size and shape. In this work, we present a simple and fast method to optimize both the number and position of catheters, using a modified version of the Centroidal Voronoi Tessellations (CVT) algorithm.

8 prostate HDR clinical cases were chosen randomly to test our method. The treatment plan was obtained from a research version of IPSA. Clinically relevant dosimetric parameters were computed to evaluate our method and help optimizing the CVT algorithm parameters. Plans were generated with a specified number of catheters ranging from 9 to 18 and compared to the clinical cases with 17 catheters.

The computation time to optimize the positions of a specific number of catheters was 1.5 s. The prostate V100 was better than the clinical case up to 12 catheters. Plans with 9 or less catheters would not be clinically acceptable in terms of prostate V100 and D90. High conformity is achieved whether the number of catheters used. The V75 of the bladder seems slightly higher, but not significant clinically. All other dosimetric indices are as good as the clinical plan.

We have devised a simple, fast and efficient method to optimize the number and position of catheters in HDR brachytherapy. Ultimately, this catheter optimization algorithm could be coupled with a 3D ultrasound system to allow real-time guidance and planning for any interstitial brachytherapy sites.