Therapeutic prostate cancer interventions: a systematic review on pubic arch interference and needle positioning
Jette Bloemberg1, Martijn de Vries1, Luigi A M J G van Riel2
1Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Expert Review of Medical Devices
|July 1, 2024
Summary
This study quantifies Pubic Arch Interference (PAI) and needle positioning errors in prostate cancer treatment. Solutions like steerable needles can mitigate these hazards, improving treatment accuracy.
Area of Science:
- Urology
- Medical Physics
- Oncology
Background:
- Needle positioning in prostate cancer treatment faces challenges like Pubic Arch Interference (PAI) and positioning errors.
- Current clinical guidelines for PAI and needle accuracy are unclear, leading to varied institutional compliance.
Approach:
- A systematic literature review was conducted using Embase, Medline ALL, Web of Science, and Cochrane databases.
- Fifty articles were included to analyze PAI and needle displacement errors in prostate brachytherapy.
Key Points:
- Pubic Arch Interference (PAI) varies (0-22.3 mm) based on patient position and measurement method.
- Low-Dose-Rate Brachytherapy showed cranio-caudal misplacement up to 10 mm.
- High-Dose-Rate Brachytherapy exhibited larger cranio-caudal displacements (up to 47 mm) over time.
Conclusions:
- Ambiguous guidelines for prostate volume, needle accuracy, and PAI necessitate standardized protocols.
- Emerging solutions, including steerable needles, show promise in mitigating positioning hazards.
- Improved needle guidance can enhance procedural safety and efficacy in prostate cancer treatment.
