eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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4/2020
vol. 12
 
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abstract:
Original paper

Evaluation of transrectal ultrasound-based dosimetry for brachytherapy of prostate cancer: a single-center experience

Changzhao Yang
1
,
Zhengtong Lv
1
,
Lingxiao Chen
1
,
Jie Wang
2
,
Xiheng Hu
1
,
Harripersaud Chand
1
,
Xi Sun
1
,
Guyu Tang
1
,
Congyi Tang
1
,
Huichuan Jiang
1
,
Yuan Li
1

  1. Department of Urology, Xiangya Hospital, Central South University, Changsha, City, Hunan Province, P. R. China
  2. Department of Radiotherapy, Hunan Cancer Hospital, Changsha City, Hunan Province, P. R. China
J Contemp Brachytherapy 2020; 12, 4: 327–334
DOI: https://doi.org/10.5114/jcb.2020.98111
Online publish date: 2020/08/21
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Purpose
To explore the possibility of intraoperative transrectal ultrasound (TRUS)-based dose verification in trans­perineal brachytherapy (BT) with iodine-125 (125I) seeds for prostate cancer.

Material and methods
Fifteen patients with prostate cancer were treated using BT with 125I seeds. Post-implant TRUS and computed tomography (CT) images were imported into treatment planning system (TPS) for dosimetry. Dosimetry parameters, including minimum dose received by 90% of the volume (D90), percentage of the volume receiving 100% of prescribed dose (V100), and percentage of the volume receiving 200% of prescribed dose (V200) were calculated based on TRUS and CT images, separately. The D90 value of TRUS-based dosimetry was transformed to its expected value. Comparisons of the dosimetric parameters between post-operative verification and preoperative plans were made by paired t-test. One-way ANOVA model was used to assess the differences in preoperative plans. Agreements were evaluated between the preoperative planning and post-operative actual dose parameters using Bland-Altman analysis.

Results
In total, 825 of 125I seeds were implanted successfully in 15 patients. In TRUS-based dosimetry, 674 seeds (81%) were identified clearly in TRUS-based images, and the expected value of D90 parameter showed no significant differences compared with the preoperative planning and CT post-operation results (p > 0.05). In CT-based dosimetry, 810 seeds (98%) were identified clearly in CT-based images, and there was good consistency of D90, V100, and V200 values (p > 0.05). Post-implant CT-based dosimetry indicated that 125I seed implantation had fulfilled the expected plan.

Conclusions
Intraoperative TRUS can be used for dosimetric verification of BT for prostate cancer.

keywords:

prostate cancer, brachytherapy, TRUS, CT, dosimetry, iodine-125

  
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