Josh Mason1, Bashar Al-Qaisieh2, Peter Bownes2, Dan Wilson2, David L Buckley3, David Thwaites4, Brendan Carey5, Ann Henry6. 1. Medical Physics, St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust; Division of Medical Physics, University of Leeds. Electronic address: Joshua.Mason@leedsth.nhs.uk. 2. Medical Physics, St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust. 3. Division of Medical Physics, University of Leeds. 4. Division of Medical Physics, University of Leeds; Institute of Medical Physics, School of Physics, University of Sydney, Australia. 5. Radiology, St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust. 6. Clinical Oncology, St James's Institute of Oncology, Leeds Teaching Hospitals NHS Trust.
Abstract
PURPOSE: This study investigates the feasibility of delivering focal boost dose to tumor regions, identified with multi-parametric MRI, in high-dose-rate prostate brachytherapy. METHODS AND MATERIALS: T2-weighted, diffusion-weighted, and dynamic-contrast-enhanced MRI were acquired the day before treatment and analyzed retrospectively for 15 patients. Twelve patients had hormone therapy before the MRI scan. The tumor was delineated on MRI by a radiologist and registered to treatment planning transrectal ultrasound images. A margin based on analysis of delineation and registration uncertainties was applied to create a focal boost planning target volume (F-PTV). Delivered treatment plans were compared with focal boost plans optimized to increase F-PTV dose as much as allowed by urethral and rectal dose constraints. RESULTS: Tumors were delineated in all patients with volumes 0.4-23.0cc. The margin for tumor delineation and image registration uncertainties was estimated to be 4.5 mm. For F-PTV, the focal boost treatment plans increased median D90 from 17.6 to 20.9 Gy and median V150 from 27.3% to 75.9%. CONCLUSIONS: MRI-guided high-dose-rate prostate brachytherapy focal tumor boost is feasible-tumor regions can be identified even after hormone therapy, and focal boost dose can be delivered without violating urethral and rectal dose constraints.
PURPOSE: This study investigates the feasibility of delivering focal boost dose to tumor regions, identified with multi-parametric MRI, in high-dose-rate prostate brachytherapy. METHODS AND MATERIALS: T2-weighted, diffusion-weighted, and dynamic-contrast-enhanced MRI were acquired the day before treatment and analyzed retrospectively for 15 patients. Twelve patients had hormone therapy before the MRI scan. The tumor was delineated on MRI by a radiologist and registered to treatment planning transrectal ultrasound images. A margin based on analysis of delineation and registration uncertainties was applied to create a focal boost planning target volume (F-PTV). Delivered treatment plans were compared with focal boost plans optimized to increase F-PTV dose as much as allowed by urethral and rectal dose constraints. RESULTS:Tumors were delineated in all patients with volumes 0.4-23.0cc. The margin for tumor delineation and image registration uncertainties was estimated to be 4.5 mm. For F-PTV, the focal boost treatment plans increased median D90 from 17.6 to 20.9 Gy and median V150 from 27.3% to 75.9%. CONCLUSIONS: MRI-guided high-dose-rate prostate brachytherapy focal tumor boost is feasible-tumor regions can be identified even after hormone therapy, and focal boost dose can be delivered without violating urethral and rectal dose constraints.
Authors: Martin T King; Nicola J Nasser; Nitin Mathur; Gil'ad N Cohen; Marisa A Kollmeier; Jasper Yuen; Hebert A Vargas; Xin Pei; Yoshiya Yamada; Kristen L Zakian; Marco Zaider; Michael J Zelefsky Journal: Brachytherapy Date: 2016-04-20 Impact factor: 2.362
Authors: Tonghe Wang; Robert H Press; Matt Giles; Ashesh B Jani; Peter Rossi; Yang Lei; Walter J Curran; Pretesh Patel; Tian Liu; Xiaofeng Yang Journal: Br J Radiol Date: 2019-04-09 Impact factor: 3.039
Authors: Kiaran P McGee; Ken-Pin Hwang; Daniel C Sullivan; John Kurhanewicz; Yanle Hu; Jihong Wang; Wen Li; Josef Debbins; Eric Paulson; Jeffrey R Olsen; Chia-Ho Hua; Lizette Warner; Daniel Ma; Eduardo Moros; Neelam Tyagi; Caroline Chung Journal: Med Phys Date: 2021-05-20 Impact factor: 4.071
Authors: Metha Maenhout; Max Peters; Marco van Vulpen; Marinus A Moerland; Richard P Meijer; Maurice A A J van den Bosch; Paul L Nguyen; Steven J Frank; Jochem R N van der Voort van Zyp Journal: Technol Cancer Res Treat Date: 2017-12-05