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A rapid semi-automated trajectory planning method for non-coplanar interstitial brachytherapy in cervical cancer
Jiuling Shen1, Shaoxing Sun1, Zhiwei Xu2
1Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Radiation Oncology (London, England)
|June 24, 2026
Summary
A new greedy algorithm-based needle trajectory planning (GANTP) framework significantly reduces needle count and planning time for 3D-printing-assisted brachytherapy in cervical cancer. This approach ensures high-risk clinical target volume (HR-CTV) coverage while maintaining organ-at-risk (OAR) sparing.
Area of Science:
- Medical Physics
- Radiation Oncology
- Computational Imaging
Background:
- Precise interstitial needle placement is crucial for effective 3D-printing-assisted brachytherapy in cervical cancer.
- Current methods may lack efficiency and optimal needle configuration.
Purpose of the Study:
- To develop and evaluate a greedy algorithm-based needle trajectory planning (GANTP) framework.
- To ensure collision-free, patient-specific needle configurations for cervical cancer brachytherapy.
- To achieve optimal high-risk clinical target volume (HR-CTV) coverage while adhering to organ-at-risk (OAR) dose constraints.
Main Methods:
- The GANTP framework generates candidate trajectories, employs a parameter-driven greedy selection based on influence radius (δ), coverage threshold (γ), and collision margin (d).
- Evaluated on CT datasets from 20 cervical cancer patients, comparing HR-CTV coverage, OAR doses (D2cc), needle counts, and efficiency against manual planning.
Main Results:
- GANTP achieved clinically acceptable HR-CTV coverage (91.96% ± 1.24%) for all cases, exceeding the 90% threshold.
- No significant difference in OAR sparing (rectum, bladder, sigmoid) compared to manual planning.
- Significantly reduced average needle count (5.40 to 4.25) and planning time (2-3 hours to 8.2 minutes).
Conclusions:
- The GANTP framework offers a semi-automated, efficient method for planning collision-free interstitial brachytherapy.
- This approach shows potential for enhancing precision and efficiency in cervical cancer treatment.
- Future work includes physical validation through phantom experiments.
