title: Towards clinical application of RayStretch for heterogeneity corrections in LDR permanent125I prostate brachytherapy.
abstract: RayStretch is a simple algorithm proposed for heterogeneity corrections in low-dose-rate brachytherapy. It is built on top of TG-43 consensus data, and it has been validated with Monte Carlo (MC) simulations. In this study, we take a real clinical prostate implant with 71125I seeds as reference and we apply RayStretch to analyze its performance in worst-case scenarios.
  
  
  
  To do so, we design two cases where large calcifications are located in the prostate lobules. RayStretch resilience under various calcification density values is also explored. Comparisons against MC calculations are performed.
  
  
  
  Dose-volume histogram-related parameters like prostate D90, rectum D2cc, or urethra D10obtained with RayStretch agree within a few percent with the detailed MC results for all cases considered.
  
  
  
  The robustness and compatibility of RayStretch with commercial treatment planning systems indicate its applicability in clinical practice for dosimetric corrections in prostate calcifications. Its use during intraoperative ultrasound planning is foreseen.
authors.affiliation: Target Systemelektronik GmbH, Wuppertal, Germany; Department of Radiation Oncology, Harvard Medical School and Massachusetts General Hospital, Boston, MA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Hueso-González
authors.affiliation: Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED), Instituto de Investigación Sanitaria La Fe (IIS-La Fe)-Universitat de Valencia (UV), Valencia, Spain.
authors.forename: Facundo
authors.initials: F
authors.lastname: Ballester
authors.affiliation: Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED), Instituto de Investigación Sanitaria La Fe (IIS-La Fe)-Universitat de Valencia (UV), Valencia, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Perez-Calatayud
authors.affiliation: UK S-H, Campus Kiel, Klinik für Strahlentherapie (Radioonkologie), Kiel, Germany.
authors.forename: Frank-André
authors.initials: FA
authors.lastname: Siebert
authors.affiliation: Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED), Instituto de Investigación Sanitaria La Fe (IIS-La Fe)-Universitat de Valencia (UV), Valencia, Spain; IFIC (UV-CSIC), Valencia, Spain. Electronic address: javier.vijande@uv.es.
authors.forename: Javier
authors.initials: J
authors.lastname: Vijande
mesh_terms: D000465:Algorithms; D001918:Brachytherapy / Q000379:methods*; D002114:Calcinosis / Q000150:complications; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D058958:Organs at Risk; D011471:Prostatic Neoplasms / Q000150:complications / Q000532:radiotherapy*; D011829:Radiation Dosage; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012007:Rectum; D014521:Urethra
chemical_list: D007457:Iodine Radioisotopes; C000614960:Iodine-125
keywords: Brachytherapy; Calcifications; Dosimetry; Heterogeneities; Low-dose rate; Prostate