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Multisource Rotating Shield Brachytherapy Apparatus for Prostate Cancer.

Hossein Dadkhah1, Karolyn M Hopfensperger1, Yusung Kim2

  • 1Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa.

International Journal of Radiation Oncology, Biology, Physics
|August 28, 2017
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Summary

A new rotating shield brachytherapy (RSBT) device precisely positions 153Gd sources for prostate cancer treatment. This innovative apparatus significantly reduces radiation dose to the urethra, sparing healthy tissue.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Biomedical Engineering

Background:

  • Advanced prostate cancer treatment often involves brachytherapy, which delivers radiation directly to the tumor.
  • Conventional high-dose-rate brachytherapy techniques can pose risks of radiation exposure to nearby healthy tissues, particularly the urethra.
  • Minimizing dose to organs at risk is crucial for improving treatment outcomes and reducing side effects.

Purpose of the Study:

  • To introduce a novel multisource rotating shield brachytherapy (RSBT) apparatus.
  • To enable precise simultaneous angular and linear positioning of 153Gd brachytherapy sources within interstitial needles.
  • To develop a technique for treating locally advanced prostate cancer with reduced dose to the urethra compared to conventional methods.

Main Methods:

  • The apparatus utilizes an angular drive mechanism and a translating moving template with helical threading to achieve simultaneous rotation of multiple shielded brachytherapy sources.
  • Source positioning within needles is controlled by a multisource afterloader, acting as an array of belt-driven linear actuators.
  • Key-keyway pairs transmit rotational motion to the catheter-source-shield assembly for precise angular incrementation during treatment.

Main Results:

  • Treatment planning simulations demonstrated a 31% reduction in urethral D0.1cm (minimum dose to the hottest 0.1 cm³ of the urethra) compared to conventional high-dose-rate brachytherapy.
  • The proposed multisource RSBT apparatus, using nineteen 62.4-GBq 153Gd sources, achieved a treatment time of 122 minutes for delivering 20 Gy.
  • Significant sparing of urethral tissue was observed within a 3 mm gradient volume.

Conclusions:

  • The developed RSBT delivery apparatus offers a mechanically feasible method for urethra-sparing brachytherapy.
  • This technique provides a clinically viable approach for treating prostate cancer while minimizing radiation dose to the urethra.
  • The innovation holds promise for improving the safety and efficacy of brachytherapy for prostate cancer patients.