Systematic reviewReview of intraoperative imaging and planning techniques in permanent seed prostate brachytherapy
Section snippets
Material and methods
The evidence was selected and reviewed initially by one member of the PROBATE Group (AP) and was subsequently reviewed by the other members of the group in a series of meetings for incremental systematization of the information found. Members of the PROBATE Group have disclosed potential conflict of interest information.
A systematic literature search was carried out using the PubMed database. Medical subject headings included ‘brachytherapy’, ‘prostatic neoplasms’, and ‘radiotherapy planning,
Intraoperative pre-planning
In accord with the American Brachytherapy Society (ABS), intraoperative pre-planning refers to the creation of a plan in the operating room (OR) just before the implant procedure, with immediate execution of this plan [14]. Intraoperative pre-planning eliminates the conventional pre-planning patient visit (a few days or weeks prior to the implant) by bringing the planning system into the OR. Because there is no pre-plan on which to base seed ordering, the approximate number of seeds to be
Interactive planning
Following the terminology of the American Brachytherapy Society (ABS), interactive planning refers to an intraoperative stepwise refinement of the treatment plan using computerized dose calculations derived from image-based needle position feedback [14]. In this approach, the process of seed ordering, image acquisition, target definition, and organ contouring is similar to the intraoperative pre-planning method. An optimized treatment plan is then performed in the operating room, the DVH is
Dynamic dose calculation
Dynamic dose calculation represents a paradigm shift in dose prescription and specification and source delivery for permanent seed implantation. It will mirror the image-guided radiation therapy (IGRT) paradigm in EBRT in that an intended prescription dose is adaptively “painted” to a changing 3D target volume. This process of dose-painting may result in alteration of a previously accepted isodose distribution and total implanted activity at any time, until the end of the procedure when a
MRI-based intraoperative planning
Magnetic resonance imaging has an established role in the preoperative assessment of prostate cancer and has been used for biopsy guidance [45], [46], staging [47], [48], [49] and treatment planning for EBRT ([50]) and brachytherapy [51], [52].
The TRUS-based approach for permanent seed implantation has limitations as it is based on needle positions rather than direct seed capture, causes variable deformation of the patient’s anatomy and is affected by reduced image quality due to poor mucosal
Robotics for permanent seed implantation
Robotics is playing an increasing role in urologic surgery since the introduction of the da Vincï system [71]. Robotic assistance in prostate brachytherapy has been an active research field in the recent years. Several robotic system designs have been proposed, including 3DTRUS-based robots [72], [73], [74] and MRI-based robots [75], [53].
There are several advantages to the use of robotic-assisted devices. First, the elimination of the template offers a larger implantation space that can
Conclusion
The two-step TRUS-based transperineal prostate implant technique revolutionized brachytherapy for prostate cancer and has stood the test of time. There is no doubt that in experienced hands with good quality control systems in place it can deliver highly effective treatment for prostate cancer. However imaging technology and planning software continue to evolve and this review has demonstrated that there are now many ways in which interactive planning in the operating room delivering additional
References (84)
- et al.
Additional treatments and reimbursement rates associated with prostate cancer treatment for patients undergoing radical prostatectomy, interstitial brachytherapy, and external beam radiotherapy
Urology
(2000) - et al.
Transperineal 125iodine seed implantation in prostatic cancer guided by transrectal ultrasonography
J Urol
(1983) - et al.
Brachytherapy and organ preservation in the management of carcinoma of the prostate
Semin Radiat Oncol
(1993) - et al.
10-year biochemical (prostate-specific antigen) control of prostate cancer with (125)I brachytherapy
Int J Radiat Oncol Biol Phys
(2001) - et al.
A survey of current clinical practice of permanent prostate brachytherapy in the United States
Int J Radiat Oncol Biol Phys
(1998) - et al.
Intraoperative treatment planning for radioactive seed implant therapy for prostate cancer
Urology
(2000) - et al.
Intraoperative optimized inverse planning for prostate brachytherapy: early experience
Int J Radiat Oncol Biol Phys
(1999) - et al.
Bypassing the learning curve in permanent seed implants using state-of-the-art technology
Int J Radiat Oncol Biol Phys
(2007) - et al.
Intraoperative planning and evaluation of permanent prostate brachytherapy: report of the American Brachytherapy Society
Int J Radiat Oncol Biol Phys
(2001) - et al.
The importance of adequate follow-up in defining treatment success after external beam irradiation for prostate cancer
Int J Radiat Oncol Biol Phys
(1999)
Real-time optimized intraoperative dosimetry for prostate brachytherapy: a pilot study
Int J Radiat Oncol Biol Phys
Dosimetric comparison of pre-planned and or-planned prostate seed brachytherapy
Int J Radiat Oncol Biol Phys
Intraoperative preplanning for transperineal ultrasound-guided permanent prostate brachytherapy
Int J Radiat Oncol Biol Phys
Iodine-125 brachytherapy for localized prostate cancer and urinary morbidity: a prospective comparison of two seed implant methods-preplanning and intraoperative planning
Urology
Prospective outcomes associated with migration from preoperative to intraoperative planned brachytherapy: a single center report
J Urol
Actuarial disease-free survival after prostate cancer brachytherapy using interactive techniques with biplane ultrasound and fluoroscopic guidance
Int J Radiat Oncol Biol Phys
A comparison of permanent prostate brachytherapy techniques: preplan vs. hybrid interactive planning with postimplant analysis
Int J Radiat Oncol Biol Phys
Postimplantation dosimetric analysis of permanent transperineal prostate implantation: improved dose distributions with an intraoperative computer-optimized conformal planning technique
Int J Radiat Oncol Biol Phys
Prostate seed implantation using 3D-computer assisted intraoperative planning vs. a standard look-up nomogram: Improved target conformality with reduction in urethral and rectal wall dose
Int J Radiat Oncol Biol Phys
Is there a role for postimplant dosimetry after real-time dynamic permanent prostate brachytherapy?
Int J Radiat Oncol Biol Phys
A modified technique allowing interactive ultrasound-guided three-dimensional transperineal prostate implantation
Int J Radiat Oncol Biol Phys
Intraoperative dynamic dose optimization in permanent prostate implants
Int J Radiat Oncol Biol Phys
Localization of linked 125I seeds in postimplant TRUS images for prostate brachytherapy dosimetry
Int J Radiat Oncol Biol Phys
Dosimetric comparison of interactive planned and dynamic dose calculated prostate seed brachytherapy
Radiother Oncol
Computing intraoperative dosimetry for prostate brachytherapy using TRUS and fluoroscopy
Acad Radiol
Ultrasonography and fluoroscopic fusion for prostate brachytherapy dosimetry
Int J Radiat Oncol Biol Phys
Intraoperative adaptive brachytherapy of iodine-125 prostate implants guided by C-arm cone-beam computed tomography-based dosimetry
Brachytherapy
Feasibility of transperineal prostate biopsy under interventional magnetic resonance guidance
Urology
The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants
Int J Radiat Oncol Biol Phys
MRI-guided prostate brachytherapy with single needle method – a planning study
Radiother Oncol
Determination of prostate volume by transrectal ultrasound
J Urol
Estimation of prostate cancer volume by transrectal ultrasound imaging
J Urol
Determinations of prostate volume at 3-Tesla using an external phased array coil: comparison to pathologic specimens
Acad Radiol
Open magnetic resonance imaging using titanium–zirconium needles: improved accuracy for interstitial brachytherapy implants?
Int J Radiat Oncol Biol Phys
Real-time magnetic resonance image-guided interstitial brachytherapy in the treatment of select patients with clinically localized prostate cancer
Int J Radiat Oncol Biol Phys
Comparing PSA outcome after radical prostatectomy or magnetic resonance imaging-guided partial prostatic irradiation in select patients with clinically localized adenocarcinoma of the prostate
Urology
Acute urinary retention after magnetic resonance image-guided prostate brachytherapy with and without neoadjuvant external beam radiotherapy
Urology
Identifying the predictors of acute urinary retention following magnetic-resonance-guided prostate brachytherapy
Int J Radiat Oncol Biol Phys
Robotic assistance for ultrasound-guided prostate brachytherapy
Med Image Anal
A new robotic needle insertion method to minimise attendant prostate motion
Radiother Oncol
Towards multidimensional radiotherapy (MD-CRT): biological imaging and biological conformality
Int J Radiat Oncol Biol Phys
Theragnostic imaging for radiation oncology: dose-painting by numbers
Lancet Oncol
Cited by (90)
Clutch & Grasp: Activation gestures and grip styles for device-based interaction in medical spatial augmented reality
2023, International Journal of Human Computer StudiesGEC-ESTRO ACROP prostate brachytherapy guidelines
2022, Radiotherapy and OncologyBrachyView: Reconstruction of seed positions and volume of an LDR prostate brachytherapy patient plan using a baseline subtraction algorithm
2019, Physica MedicaCitation Excerpt :Algorithms have been developed to aid in solving the “hidden seed problem”, however, their performance degrades as the number of hidden seeds increases [13]. Errors as large as 3 mm can occur due to registration errors between the TRUS and fluoroscopy images resulting from artefacts present on TRUS images being mistaken for brachytherapy seeds, introducing dosimetric uncertainty [10]. Clinics have reported hidden seeds that have not been identified by co-registered TRUS and fluoroscopic images ranging between 7% and 45% [10].
Comparative Analysis of Clinical Outcomes and Procedural Costs between the Conventional Two-stage Technique and 4D Brachytherapy for Early Prostate Cancer
2018, Clinical OncologyCitation Excerpt :However, technology and planning software improvements have evolved, allowing real-time interactive planning and dynamic dosimetry to achieve greater accuracy of seed placement. The relative merits and technical details are beyond the scope of this report and can be found in a review by Polo et al. [14]. The 4D technique takes this trend a step further by incorporating preloaded stranded seeds into the real-time interactive approach, providing improvements in work flow and cost saving.