Difference in rectal dosimetry between pre-plan and post-implant analysis in transperineal interstitial brachytherapy for prostate cancer.
OBJECTIVE
To investigate differences in rectal dosimetry between pre-plan ultrasonography (US) and post-implant computed tomography (CT).


METHODS
Subjects comprised 49 patients who underwent prostate brachytherapy using (125)I seed implants. Prescribed dose was 145Gy to the periphery of the prostate. Differences in rectal dosimetry between pre-plan US and post-implant CT analysis were evaluated. In addition, patients were divided into two groups according to timing of pre-planning (pre-plan group, n=28; intraoperative pre-plan group, n=21), and differences in rectal dosimetry between groups were assessed.


RESULTS
The average of volume differences between pre-plan and post-implant analysis (pre-plan minus post-implant analysis) for all patients were follows: -0.08 cm(3) in V60 (volume of rectal wall receiving 60% of prescribed dose); -0.05 cm(3) in V70; -0.16 cm(3) in V80; -0.38 cm(3) in V90; -0.40 cm(3) in V100; -0.32 cm(3) in V110; -0.22 cm(3) in V120; -0.15 cm(3) in V130; -0.10 cm(3) in V140; -0.07 cm(3) in V150; and -0.05 cm(3) in V160. Apparent differences between pre-plan US and post-implant CT in rectal dosimetry were small. However, considering the steep curve of the relationship between tolerable volume and dose, a large actual difference should be assumed. No advantage was identified for the intraoperative pre-plan group. Safe volume to avoid proctitis tended to be smaller on ultrasonography than on CT at 1 month.


CONCLUSIONS
The present work shows that direct comparison of CT analysis and pre-plan US is unfavorable due to large differences in these modalities and overestimation of tolerable volume. However, by comprehending the degree of difference, comparison of data from CT analysis with a US pre-plan may be feasible and useful for providing feedback between these modalities.
Ishiyama
Hiromichi
H
Department of Radiology, Kitasato University School of Medicine, Kanagawa, Japan. hishiyam@kitasato-u.ac.jp
Kitano
Masashi
M
Satoh
Takefumi
T
Niibe
Yuzuru
Y
Uemae
Mineko
M
Fujita
Tetsuo
T
Baba
Shiro
S
Hayakawa
Kazushige
K
D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D010502:Perineum; D011349:Proctitis / Q000517:prevention & control; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012007:Rectum / Q000000981:diagnostic imaging / Q000528:radiation effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals