Abstract
Imaging the prostate after low-dose rate brachytherapy is a means of assessing the quality of the implant and the calculated dosimetry results can be correlated with the toxicity and eventual clinical outcomes for these patients. Computed tomography (CT) has long been the accepted imaging technique for post-implant dosimetry despite its acknowledged limitations. It is relatively cheap and convenient for the patient although definition of the prostate and structures at risk is limited because of the inherently poor soft tissue resolution of CT in this area. Magnetic resonance imaging (MRI) offers the advantage of superior soft tissue resolution but has limitations with source recognition and is relatively expensive. Transrectal ultrasound (TRUS) has been used to facilitate intraoperative dosimetry and is the basis for the newer real-time implant techniques that have evolved in recent years. TRUS however also has its limitations with source identification. Image fusion incorporating the benefits of different imaging techniques has been developed for post-implant dosimetry and can offer some improvements over CT but at some cost, and this approach is demanding of medical physics resources. Every brachytherapy centre should have an established programme for post-implant dosimetry in place that can help identify problems with technique and facilitate improvements in implant technique over time. This chapter will review the specific contribution and inherent limitations of the various imaging techniques that can be used for post-implant dosimetry.
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References
Al-Qaisieh B, Ash D, Bottomley D et al (2002) Impact of prostate volume evaluation by different observers on CT-based postimplantation dosimetry. Radiother Oncol 62:267–273
Al-Qaisieh B (2003) UK Prosate Brachytherapy Group. Pre- and post-implant dosimetry: an inter-comparison between UK prostate brachytherapy centres. Radiother Oncol 66:181–183
Al-Qaisieh B, Smith D, Brearley E et al (2007) ComprehensiveI-125 multi seed comparison for prostate brachytherapy: dosimetry and visibility analysis. Radiother Oncol 84(2):140–147
Al-Qaisieh B, Witteveen T, Carey B et al (2009) Correlation between pre- and postimplant dosimetry for iodine-125 seed implants for localized prostate cancer. Int J Radiat Oncol Biol Phys 75(2):626–630
Allen Z, Merrick G, Butler W et al (2005) Detailed urethral dosimetry in the evaluation of prostate brachytherapy-related urinary morbidity. Int J Radiat Oncol Biol Phys 62:981–987
Archer P, Puttagunta S, Rhode K et al (2010) An analysis of intraoperative versus post-operative dosimetry with CT, CT/MRI fusion and XMR for the evaluation of permanent prostate brachytherapy implants. Radiother Oncol 96(2):166–171
Crook J, Milosevic M, Catton P et al (2002) Interobserver variation in postimplant computed tomography contouring affects quality of prostate brachytherapy. Brachytherapy 1:66–73
Crook J, Mclean M, Yeung I et al (2004) MRI-CT fusion to assess post brachytherapy prostate volume and the effects of prolonged oedema on dosimetry following transperineal interstitial permanent prostate brachytherapy. Brachytherapy 3:55–60
De Brabandere M, Kirisits C, Peeters R et al (2006) Accuracy of seed reconstruction in prostate postplanning studied with a CT- and MRI-compatible phantom. Radiother Oncol 79(2):190–197
Debois M, Oyen R, Maes F et al (1999) The contribution of magnetic resonance imaging to the three-dimensional treatment planning of localized prostate cancer. Int J Radiat Oncol Biol Phys 45:857–865
Dogan N, Mohideen N, Glasgow G et al (2002) Effect of prostatic oedema on CT-based postimplant dosimetry. Int J Radiat Oncol Biol Phys 53:483–489
Dubois D, Prestidge B, Hotchkiss L et al (1998) Intraobserver and interobserver variability of MR imaging- and CT-derived prostate volumes after transperineal interstitial permanent prostate brachytherapy. Radiology 207:785–789
Fuks Z, Leibel S, Wallner K et al (1991) The effect of local control on metastatic dissemination in carcinoma of the prostate: long-term results in patients treated with 125I implantation. Int J Radiat Oncol Biol Phys 21(3):537–547
Han B, Wallner K (2001) Dosimetric and radiographic correlates to prostate brachytherapy-related rectal complications. Int J Cancer 96(6):372–378
Holupka E, Meskell P, Burdette E et al (2004) An automatic seed finder for brachytherapy CT postplans based on the Hough transform. Med Phys 31(9):2672–2679
Jaffray D, Siewerdsen J, Edmundson et al (2002) Flat-panel cone-beam CT on a mobile isocentric C-arm for image-guided brachytherapy. Proc SPIE 4682:209–217
Kalkner K, Kubicek G, Nillson J et al (2006) Prostate volume determination: differential volume measurements comparing CT and TRUS. Radiother Oncol 81(2):179–183
Leclerc G, Lavallée M, Roy R et al (2006) Prostatic edema in 125I permanent prostate implants: dynamic rectal dosimetry taking volume changes into account. Med Phys 33:574–583
Lee W, Roach M, Michalski J et al (2002) Interobserver variability leads to significant differences in quantifiers of prostate implant adequacy. Int J Radiat Oncol Biol Phys 54:457–461
McLaughlin P, Narayana V, Drake D et al (2002) Comparison of MRI pulse sequences in defining prostate volume after permanent implantation. Int J Radiat Oncol Biol Phys 54:703–711
McLaughlin P, Narayana V, Meirovitz A et al (2005) Vessel-sparing prostate radiotherapy dose limitation to critical erectile vascular structures (internal pudental artery and corpus cavernosum) defined by MRI. Int J Radiat Oncol Biol Phys 61:20–31
Merrick G, Butler W, Dorsey A et al (1999) Rectal dosimetric analysis following prostate brachytherapy. Int J Radiat Oncol Biol Phys 43:1021–1102
Merrick G, Butler W, Wallner K et al (2002) The importance of radiation doses to the penile bulb vs. crura in the development of postbrachytherapy erectile dysfunction. Int J Radiat Oncol Biol Phys 54:1055–1062
McNeely L, Stone N, Presser J et al (2004) Influence of prostate volume on dosimetry results in real-time 125I seed implantation. Int J Radiat Oncol Biol Phys 58:292–299
Moerland M (1998) The effect of oedema on post implant dosimetry of permanent iodine-125 prostate implants: A simulation study. J Brachyther Int 14:225–231
Nag S, Bice W, DeWyngaert K et al (2000) The American Brachytherapy Society recommendations for permanent prostate brachytherapy postimplant dosimetric analysis. Int J Radiat Oncol Biol Phys 46:221–230
Nag S, Ellis R, Merrick G et al (2002) American Brachytherapy Society recommendations for reporting morbidity after prostate brachytherapy. Int J Radiat Oncol Biol Phys 54(2):462–470
Paulo A, Salembwier C, Venselaar J et al (2010) Review of intraoperative imaging and planning techniques in permanent seed prostate brachytherapy. Radiotherapy Oncol 94(1):12–23
Pinkawa M, Asadpour B, Piroth M et al (2009) Rectal dosimetry following prostate brachytherapy with stranded seeds – comparison of transrectal ultrasound intra-operative planning (day 0) and computed tomography-postplanning (day 1 vs. day 30) with special focus on sources placed close to the rectal wall. Radiother Oncol 91(2):207–212
Polo A, Cattani F, Vavassori A et al (2004) MR and CT image fusion for postimplant analysis in permanent prostate seed implants. Int J Radiat Oncol Biol Phys 60:1572–1579
Potters L, Cao Y, Calugaru E et al (2001) A comprehensive review of CT-based dosimetry parameters and biochemical control in patients treated with permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 50:605–661
Potters L, Huang D, Calugaru E et al (2003) Importance of Implant dosimetry for patients undergoing prostate brachytherapy. Urol 62(6):1073–1077
Reed D, Wallner K, Ford E et al (2005) Effect of post-implant edema on prostate brachytherapy treatment margins. Int J Radiat Oncol Biol Phys 63:1469–1473
Remeijer P, Rasch C, Lebesque J et al (1999) A general methodology for three-dimensional analysis of variation in target volume delineation. Med Phys 26:931–994
Roy J, Wallner K, Harrington P et al (1993) CT-based evaluation method for permanent implants: application to prostate. Int J Radiat Oncol Biol Phys 26(1):163–169
Salembier C, Lavagnini P, Nickers P et al (2007) Tumour and target volumes in permanent prostate brachytherapy: a supplement to the ESTRO/EAU/EORTC recommendations on prostate brachytherapy. Radiother Oncol 83:3–10
Siewerdsen J, Moseley D, Burch S et al (2005) Volume CT with a flat-panel detector on a mobile, isocentric C-arm: pre-clinical investigation in guidance of minimally invasive surgery. Med Phys 32:241–254
Smith W, Lewis C, Bauman G et al (2007) Prostate volume contouring: a 3D analysis of segmentation using 3DTRUS, CT, and MR. Int J Radiat Oncol Biol Phys 67(4):1238–1247
Snyder K, Stock R, Hong S et al (2001) Defining the risk of developing Grade 2 proctitis following 125I prostate brachytherapy using a rectal dose–volume histogram analysis. Int J Radiat Oncol Biol Phys 50(2):335–341
Steggerda M, Schneider C, van Herk M et al (2005) The applicability of simultaneous TRUS-CT imaging for the evaluation of prostate seed implants. Med Phys 32:2262–2271
Steggerda M, Luc M, Moonen H et al (2007) The influence of geometrical changes on the dose distribution after I-125 seed implantation of the prostate. Radiother Oncol 83(1):11–17
Su Y, Davis B, Herman M et al (2004) Prostate brachytherapy seed localization by analysis of multiple projections: identifying and addressing the seed overlap problem. Med Phys 31:1277–1287
Su Y, Davis B, Herman M et al (2005) Examination of dosimetry accuracy as a function of seed detection rate in permanent prostate brachytherapy. Med Phys 32(9):3049–3056
Tanaka O, Hayashi S, Matsue M et al (2006a) Comparison of MRI-based and CT/MRI fusion–based postimplant dosimetric analysis of prostate brachytherapy. Int J Radiat Oncol Biol Phys 66:597–602
Tanaka O, Hayashi S, Sakurai K et al (2006b) Importance of the CT/MRI fusion method as a learning tool for CT-based postimplant dosimetry in prostate brachytherapy. Importance of the CT/MRI fusion method as a learning tool for CT-based postimplant dosimetry in prostate brachytherapy dosimetry. Radiother Oncol 81(3):303–308
Taussky D, Austen L, Toi A et al (2005) Sequential evaluation of prostate edema after permanent seed prostate brachytherapy using CT-MRI fusion. Int J Radiat Oncol Biol Phys 62:974–980
Thomas S, Wachowicz K, Fallone B (2009) MRI of prostate brachytherapy seeds at high field: a study in phantom. Med Phys 36(11):5228–5235
Todor D, Cohen G, Amols H et al (2002) Operator-free, film-based 3D seed reconstruction in brachytherapy. Phys Med Biol 47(12):2031–2048
Waterman F, Dicker A (2000) The impact of postimplant oedema on the urethral dose in prostate brachytherapy. Int J Radiat Oncol Biol Phys 47:661–664
Zhang M, Zaider M, Worman M et al (2004) On the question of 3D seed reconstruction in prostate brachytherapy: the determination of x-ray source and film locations. Phys Med Biol 49(19):335–345
Zhanrong G, Wilkins D, Eapen L et al (2007) A study of prostate delineation referenced against a gold standard created from the visible human data. Radiother Oncol 85(2):239–246
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Carey, B.M. (2013). Imaging for Post-implant Dosimetry. In: Kovács, G., Hoskin, P. (eds) Interstitial Prostate Brachytherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36499-0_9
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DOI: https://doi.org/10.1007/978-3-642-36499-0_9
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