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Catheters and dose optimization using a modified CVT algorithm and multi-criteria optimization in prostate HDR

Philippe Y Chatigny1,2, Cédric Bélanger1,2, Éric Poulin2

  • 1Département de physique, de génie physique et d'optique, et Centre de recherche sur le cancer, Université Laval, Québec, Québec, Canada.

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|July 27, 2022
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Summary
This summary is machine-generated.

This study developed a new algorithm for optimizing catheter placement and dose in high-dose rate brachytherapy, potentially reducing treatment toxicity and the number of catheters needed for effective prostate cancer treatment.

Keywords:
catheter's optimizationdose optimizationprostate cancerrobustness evaluation

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Computational Biology

Background:

  • Current high-dose rate (HDR) brachytherapy planning relies on planner experience for catheter positioning.
  • Optimizing catheter number and location is crucial for dose coverage and reducing treatment toxicity.
  • Patient-specific algorithms for catheter and dose optimization are needed.

Purpose of the Study:

  • To develop and evaluate patient-specific algorithms for optimizing catheter placement and dwell times in HDR brachytherapy.
  • To investigate the potential for reducing the number of catheters required while maintaining dose coverage and plan robustness.
  • To assess the impact of catheter placement deviations on treatment plan quality.

Main Methods:

  • A modified Centroidal Voronoi tessellation (CVT) algorithm was developed to optimize catheter positions.
  • A graphics processing unit (GPU)-based multi-criteria optimization algorithm (gMCO) was used to optimize dwell times and positions.
  • The algorithms were evaluated on 108 HDR brachytherapy cases for prostate cancer using real-time ultrasound, assessing plan robustness against insertion and reconstruction deviations.

Main Results:

  • The combined CVT and gMCO approach increased the acceptance rate for Radiation Therapy Oncology Group (RTOG) criteria by 37% compared to standard methods.
  • All patients met RTOG criteria with 11 catheters using CVT+gMCO with a 5 mm template, and 10 catheters with freehand placement.
  • Plan acceptance remained high (85%) even with 3 mm deviations when using 11 catheters, with minimal decrease for 13+ catheters.

Conclusions:

  • The developed CVT and gMCO algorithms enable optimization of catheter placement and dwell times for HDR brachytherapy.
  • This approach can reduce the number of catheters needed for effective treatment while improving plan quality and robustness.
  • Increased catheter numbers enhance plan robustness against insertion and reconstruction deviations.