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HDR prostate brachytherapy plan robustness and its effect on in-vivo source tracking error thresholds: A
Joel Poder1,2, Dylan Koprivec2, Yashiv Dookie2
1Department of Radiation Oncology, St George Cancer Care Centre, Kogarah, New South Wales, Australia.
Medical Physics
|April 7, 2022
Summary
A single in-vivo source tracking error threshold is not suitable for high dose rate (HDR) prostate brachytherapy (BT) across different departments. Improving plan robustness during optimization can reduce the burden on tracking devices.
Area of Science:
- Medical Physics
- Radiation Oncology
Background:
- High dose rate (HDR) prostate brachytherapy (BT) relies on accurate source placement.
- In-vivo source tracking aims to minimize treatment errors.
- Departmental variations in planning techniques may influence error tolerance.
Purpose of the Study:
- To evaluate the impact of departmental planning on in-vivo source tracking error thresholds in HDR prostate BT.
- To determine if a universal error threshold is applicable for consistent patient anatomy.
Main Methods:
- 16 departments created HDR prostate BT plans using a standardized TRUS dataset.
- Simulated source positioning errors were analyzed for their effect on DVH indices.
- Intervention criteria included prostate V100% < 90%, urethra D0.1cc > 118%, and rectum Dmax > 80%.
Main Results:
- Significant variation in appropriate in-vivo source tracking error thresholds (1-6 mm) was observed among departments.
- Error thresholds were dependent on error direction and DVH endpoints.
- A derived robustness parameter correlated with plan sensitivity to positioning errors.
Conclusions:
- A single in-vivo source tracking error threshold for HDR prostate BT is not universally applicable across departments, even for identical patient anatomy.
- Enhancing HDR prostate BT plan robustness during the optimization phase can potentially alleviate the demands on in-vivo source tracking devices.
