Measurement of craniocaudal catheter displacement between fractions in computed tomography-based high dose rate brachytherapy of prostate cancer.
The objective of this work is to measure the cranio-caudal displacement of catheters occurring between consecutive fractions of transrectal ultrasound (TRUS) guided high dose rate (HDR) prostate brachytherapy. Ten consecutive patients were treated with 2 fractions of 9.5 Gy TRUS guided HDR brachytherapy using dental putty for the fixation of catheters. For each patient, a CT scan with 3 mm slice thickness was acquired before each of the two fractions. Two different references were employed to measure the catheter displacement between fractions: the ischial bone as a bony marker (BM) and the center of two gold markers (COGM) implanted in the prostate. The catheter displacement was calculated by multiplying the thickness of CT slice with the difference in number of CT slices between the reference slice and the slice containing the tip of a catheter. The average (range) magnitude of caudal catheter displacement was 2.7 mm (-6.0 to 13.5 mm) for BM method and 5.4 mm (-3.75 to 18.0 mm) for COGM method, respectively. The measurement data obtained from BM and COGM methods verified that both prostate movement and catheter displacement occurred independently between fractions. The most anterior and medial two catheters (catheter position 8 and 12) had the greatest tendency to be displaced in the caudal direction because they were located at the most distant position from the fulcrum, susceptible to the rotation of the dental putty in lateral plane due to the movement of patient legs between fractions. In conclusion, the use of both BM and COGM methods can demonstrate the prostate and catheter movement relative to the BM between fractions. We found a pattern of catheter displacement using our technique. Based on our finding further improvement of our results may be possible by modification of our current technique.
Kim
Yongbok
Y
Department of Radiation Oncology, University of California-San Francisco, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA, 94143-1708.
Hsu
I-Chow J
IJ
Department of Radiation Oncology, University of California-San Francisco, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA, 94143-1708.
Pouliot
Jean
J
Department of Radiation Oncology, University of California-San Francisco, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA, 94143-1708.
D001918:Brachytherapy / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D009038:Motion; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*