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Integrating automated electromagnetic tracking-based needle reconstruction in the intraoperative high-dose-rate
Ioannis Androulakis1, Jérémy Godart1,2, Miranda E M C Christianen1
1Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
Physics and Imaging in Radiation Oncology
|December 25, 2025
Summary
Manual transrectal ultrasound (TRUS) reconstruction for prostate brachytherapy is inaccurate. This study implemented and validated afterloader-integrated electromagnetic tracking (EMT) for automated implant reconstruction, showing improved accuracy and reproducibility.
Area of Science:
- Medical Physics
- Oncology
- Radiotherapy
Background:
- Manual transrectal ultrasound (TRUS) reconstruction in prostate brachytherapy is prone to errors.
- Automated implant reconstruction using electromagnetic tracking (EMT) offers potential for improved accuracy.
Purpose of the Study:
- To implement and validate afterloader-integrated EMT for automated implant reconstruction in prostate brachytherapy.
Main Methods:
- Developed and tested a workflow for EMT-based implant reconstruction using an afterloader prototype and TRUS.
- Evaluated a novel setup with a single reference sensor for aligning EMT measurements.
- Assessed reproducibility and accuracy through retrospective clinical data from 14 patients and phantom measurements.
Main Results:
- Retrospective analysis showed EMT-based reconstruction significantly impacts dose-volume metrics compared to TRUS-based methods.
- Phantom measurements demonstrated high reproducibility (0.5 mm) and agreement (0.7 mm) with TRUS-based reconstruction using the novel setup.
- The novel workflow achieved automated reconstruction in under 23 seconds per needle.
Conclusions:
- EMT-based reconstruction has a clinically relevant impact on dose-volume metrics, addressing errors in TRUS-based reconstructions.
- The novel workflow and hardware enable highly accurate and automated implant reconstruction in prostate brachytherapy.
