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Improved prostate delineation in prostate HDR brachytherapy with TRUS-CT deformable registration technology: A pilot study with MRI validation.
Yang, Xiaofeng; Rossi, Peter J; Jani, Ashesh B; Mao, Hui; Zhou, Zhengyang; Curran, Walter J; Liu, Tian.
Afiliação
  • Yang X; Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
  • Rossi PJ; Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
  • Jani AB; Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
  • Mao H; Department of Radiology and Imaging Sciences and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
  • Zhou Z; Department of Radiology, Nanjing Drum Tower Hospital, Nanjing, China.
  • Curran WJ; Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
  • Liu T; Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA.
J Appl Clin Med Phys ; 18(1): 202-210, 2017 Jan.
Article em En | MEDLINE | ID: mdl-28291925
Accurate prostate delineation is essential to ensure proper target coverage and normal-tissue sparing in prostate HDR brachytherapy. We have developed a prostate HDR brachytherapy technology that integrates intraoperative TRUS-based prostate contour into HDR treatment planning through TRUS-CT deformable registration (TCDR) to improve prostate contour accuracy. In a perspective study of 16 patients, we investigated the clinical feasibility as well as the performance of this TCDR-based HDR approach. We compared the performance of the TCDR-based approach with the conventional CT-based HDR in terms of prostate contour accuracy using MRI as the gold standard. For all patients, the average Dice prostate volume overlap was 91.1 ± 2.3% between the TCDR-based and the MRI-defined prostate volumes. In a subset of eight patients, inter and intro-observer reliability study was conducted among three experienced physicians (two radiation oncologists and one radiologist) for the TCDR-based HDR approach. Overall, a 10 to 40% improvement in prostate volume accuracy can be achieved with the TCDR-based approach as compared with the conventional CT-based prostate volumes. The TCDR-based prostate volumes match closely to the MRI-defined prostate volumes for all 3 observers (mean volume difference: 0.5 ± 7.2%, 1.8 ± 7.2%, and 3.5 ± 5.1%); while CT-based contours overestimated prostate volumes by 10.9 ± 28.7%, 13.7 ± 20.1%, and 44.7 ± 32.1%. This study has shown that the TCDR-based HDR brachytherapy is clinically feasible and can significantly improve prostate contour accuracy over the conventional CT-based prostate contour. We also demonstrated the reliability of the TCDR-based prostate delineation. This TCDR-based HDR approach has the potential to enable accurate dose planning and delivery, and potentially enhance prostate HDR treatment outcome.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia / Imageamento por Ressonância Magnética / Tomografia Computadorizada por Raios X / Ultrassonografia Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Aged / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia / Imageamento por Ressonância Magnética / Tomografia Computadorizada por Raios X / Ultrassonografia Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Aged / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article