Superior Postimplant Dosimetry Achieved Using Dynamic Intraoperative Dosimetry for Permanent Prostate Brachytherapy
Tanmay Singh1, Junghoon Lee1, Marianna Zahurak2
1Departments of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Practical Radiation Oncology
|March 16, 2021
Summary
Registered ultrasound and fluoroscopy (iRUF) improved prostate brachytherapy outcomes. This technique enhanced prostate dose coverage without increasing rectal or urethral radiation exposure, leading to better treatment success.
Area of Science:
- Oncology
- Medical Physics
- Radiotherapy
Background:
- Low-dose-rate brachytherapy is a key treatment for prostate cancer.
- High-quality postimplant dosimetry is crucial for successful treatment outcomes.
- Registered ultrasound and fluoroscopy (iRUF) offers real-time monitoring for adaptive planning.
Purpose of the Study:
- To compare the clinical postimplant dosimetry of iRUF-guided brachytherapy with standard ultrasound-guided methods.
- To evaluate the dosimetric outcomes of iRUF in prostate cancer treatment.
Main Methods:
- Analysis of postimplant dosimetry in 292 patients treated with Pd-103 (2007-2018).
- Dosimetry assessed on day 0-1 using fused MRI/CT.
- Comparison between 52 patients treated with iRUF and 240 patients treated with standard ultrasound seed tracking.
Main Results:
- iRUF group showed significantly higher prostate dose coverage across all measured parameters.
- No significant increase in radiation dose to the urethra or rectum was observed in the iRUF group.
- These improvements were consistent regardless of treatment year.
Conclusions:
- iRUF intraoperative dosimetry significantly improves postimplant dose coverage for prostate cancer.
- The iRUF technique achieves better dosimetry without compromising safety for surrounding organs like the urethra and rectum.
- iRUF represents an advancement in achieving superior dosimetric outcomes in prostate brachytherapy.
