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Volume 13, Number 1, 2008

Real-time brachytherapy for prostate cancer – implant analysis

Marta Szlag, Krzysztof Ślosarek, Agata Rembielak, Brygida Białas, Marek Fijałkowski, Joanna Bystrzycka


Background In HDR brachytherapy precision of catheter implantation is crucial for conformal treatment planning as a starting point for better optimization process.
Aim The aim was to investigate differences between virtual and real needle position
and the effect of needle displacement on dosimetric parameters as a function of
prostate volume for better evaluation of “real” implant with respect to fi nal dose
Materials/Methods Thirty treatment plans calculated by Nucletron SWIFT™ were randomly selected. Dosimetric data including V100 for prostate gland and D10 for urethra were analyzed as a function of prostate volume and needle displacement.
Needle displacement was determined by measuring the distance between virtual
and real positions of respective needles in three sectional images: at the base,
apex of the prostate gland and reference image. Dosimetric parameters were determined
for consecutive computer plans: virtual (before implantation), live (after
implantation and renewed optimization). For the purpose of this study a new
parameter, VD (Volume-Dose), was created.
Results VD indicates the quality of “real” dose distribution with respect to “virtual” treatment plan. In order to realize the assumption of virtual plan (VD<1) for a given
prostate volume, mean values of needle displacement r should not exceed racceptable
according to the formula: racceptable(Vp) μ Vp2. For larger glands (above 30cc) fi nal
dose distribution is less dependent on needle displacement than smaller ones.
Conclusions The experiment determined maximum values of needle displacement for a given Vp parameter, allowing one to take advantage of optimization algorithms and
to improve the fi nal dose distribution.

Signature: Rep Pract Oncol Radiother, 2008; 13(1) : 9-14


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