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Sample records for i125 seed brachytherapy

  1. Dosimetric study of I-125 seeds used in prostate brachytherapy

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    Santos, Maira R.; Rosa, Luiz A.R. da, E-mail: mairasantos@ird.gov.br, E-mail: lrosa@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Facure, Alessandro, E-mail: facure@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Cardoso, Simone C., E-mail: simone@if.ufrj.br [Laboratorio de Fisica da Radiacao Gama e X, Instituto de Fisica (IF/UFRJ), Universidade Federal do Rio de Janeiro, RJ (Brazil); Pereira, Pedro P. [Dosimetrika, Rio de Janeiro, RJ (Brazil); Instituto Nacional de Cancer, E-mail: ppereira@dosimetrika.com.br [INCA-MS, Rio de Janeiro, RJ (Brazil); Silva, Ademir X. da, E-mail: ademir@con.ufrj.br [PEN/COPPE/UFRJ, Universidade Federal do Rio de Janeiro, RJ (Brazil)

    2011-07-01

    Among the possibilities for treatment of prostate cancer, radiotherapy is one of the most commonly used procedures. One of the radiation therapy modalities is brachytherapy, where radioactive sources are placed near or in contact with the tumor mass. Prostate Brachytherapy with iodine seed permanent implantation has become increasingly widespread because it is less invasive and offers the possibility of lower doses to organs at risk and therefore less side effects to patients. The planning for this type of treatment includes the acquisition of images and the delineation of the contours of organs at risk. Generally, important factors for dose administration as, for example, the actual composition of tissues and geometry particularities of the seeds used in the treatment are disregarded. In order to assess the impact of such approaches on the outcome of prostate permanent implant treatment, experimental results, performed with TLD detectors in a prostate phantom of solid water (RW3), and the formalism of the protocol compiled by the Task Group No.43 of the American Association of Physicists in Medicine, were compared for two different irradiation geometries. The present results indicate a good agreement between them. These dataset offers the possibility to determine correction factors that may be applied in actual treatment planning. (author)

  2. Comparative dosimetry of prostate brachytherapy with I-125 and Pd-103 seeds via SISCODES/MCNP

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    Trindade, Bruno Machado; Falcao, Patricia Lima, E-mail: bmtrindade@yahoo.com [Nucleo de Radiacoes Ionizantes - Universidade Federal de Minas Gerais (NRI/UFMG), Belo Horizonte, MG (Brazil); Christovao, Marilia Tavares [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Trindade, Daniela de Fatima Maia [Centro Universitario Una, Belo Horizonte, MG (Brazil); Campos, Tarcisio Passos Ribeiro de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2012-09-15

    Objective: The present paper is aimed at presenting a comparative dosimetric study of prostate brachytherapy with I-125 and Pd-103 seeds. Materials and Methods: A protocol for both implants with 148 seeds was simulated on a heterogeneous three-dimensional pelvic phantom by means of the SISCODES/MCNP5 codes. Dose-volume histograms on prostate, rectum and bladder, dose indexes D10, D30, D90, D0.5cc, D2cc and D7cc, and representations of the spatial dose distribution were evaluated. Results: For a D90 index equivalent to the prescription dose, the initial activity of each I-125 seed was calculated as 0.42 mCi and of Pd-103 as 0.94 mCi. The maximum dose on the urethra was 90% and 108% of the prescription dose for I-125 and Pd-103, respectively. The D2cc for I-125 was 30 Gy on the rectum and 127 Gy on the bladder; for Pd-103 was 29 Gy on the rectum and 189 Gy on the bladder. The D10 on the pubic bone was 144 Gy for I-125 and 66 Gy for Pd-103. Conclusion: The results indicate that Pd-103 and I-125 implants could deposit the prescribed dose on the target volume. Among the findings of the present study, there is an excessive radiation exposure of the pelvic bones, particularly with the I-125 protocol. (author)

  3. Refining prostate seed brachytherapy: Comparing high-, intermediate-, and low-activity seeds for I-125 permanent seed prostate brachytherapy.

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    Delouya, Guila; Bahary, Pascal; Carrier, Jean-François; Larouche, Renée-Xavière; Hervieux, Yannick; Béliveau-Nadeau, Dominic; Donath, David; Taussky, Daniel

    2015-01-01

    To analyze the difference in prostate coverage and dose to the rectum in men with prostate carcinoma treated with permanent seed brachytherapy with different seed activities. Forty-nine patients treated with iodine-125 permanent seed prostate brachytherapy with low-activity seeds of 0.30-0.37 mCi were identified. For each of these patients, 2 patients with similar prostate volume (±2 cc) were paired: one treated with intermediate seed activity (0.44-0.46 mCi) and one with high seed activity (0.60-0.66 mCi). The doses to prostate and rectum were compared using CT on Day 30. A total of 147 patients divided into the three seed activity groups were analyzed. Mean prostate volume was 35.7 cc (standard deviation [SD], 11.70). Compared with low-activity seeds, implants with high-activity seeds consisted of an average of 22 seeds and 4.7 needles less. The dose to the prostate (prostate volume receiving 100% of the prescribed dose [V100], prostate volume receiving 150% of the prescribed dose, and minimal dose covering 90% of the prostate volume expressed in Gy) was not higher on Day 30 (p = 0.58-0.97). The mean volume (in cubic centimeters) of rectal wall receiving 100% of the prescribed dose (V100) increased with activity: low activity, 0.34 cc (SD, 0.49), intermediate activity, 0.47 cc (SD, 0.48), and high activity, 0.72 cc (SD, 0.79) (p = 0.009). There was a trend (p = 0.073) toward a higher frequency of clinically unfavorable rectal dosimetry (V100 > 1.3 cc) in patients with high-activity seeds (16.7%) compared with low-activity (6.3%) or intermediate-activity (4.2%) seeds. High-activity seeds do not result in a higher dose to the prostate but in a higher dose to the rectum. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  4. Computational system to create an entry file for replicating I-125 seeds simulating brachytherapy case studies using the MCNPX code

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    Leonardo da Silva Boia

    2014-03-01

    decline for short distances.------------------------------Cite this article as: Boia LS, Junior J, Menezes AF, Silva AX. Computational system to create an entry file for replicating I-125 seeds simulating brachytherapy case studies using the MCNPX code. Int J Cancer Ther Oncol 2014; 2(2:02023.DOI: http://dx.doi.org/10.14319/ijcto.0202.3

  5. An evaluation of the AAPM-TG43 dosimetry protocol for I-125 brachytherapy seed.

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    Mobit, Paul; Badragan, Iulian

    2004-07-21

    The EGSnrc Monte Carlo system has been used to calculate the dose distributions from 125I radioactive seeds (model 6711). The results showed that the agreement between EGSnrc and the American Association of Physicists in Medicine Task Group Report 43 (AAPM-TG43) dosimetry protocol is generally within +/-15% for radial distances less than 1.0 cm in both the transverse axis and longitudinal axis of the source. For radial distances between 1.0 and 2.5 cm the agreement between Monte Carlo simulations and the AAPM-TG43 dosimetry protocol is within +/-20%. In the longitudinal axis of the source the difference between Monte Carlo simulations and the AAPM-TG43 dosimetry is up to 40% for radial distances greater than 2.5 cm. The agreement between the EGSnrc/Monte Carlo simulation and the AAPM-TG43 dosimetry protocol improved significantly when recently published data of the anisotropic function were implemented (Weaver 1998 Med. Phys. 25 2271-8). The difference between Monte Carlo simulations and the AAPM-TG43 dosimetry protocol is not more than +/-10% in the transverse axis of the source up to a radius of 2.5 cm. The EGSnrc Monte Carlo simulation and the AAPM-TG43 with the Weaver anisotropic data were also used to investigate the differences in the dose distribution caused by small differences in the construction of individual seeds (Sloboda and Menon 2000 Med. Phys. 27 1789-99). The results show that a change in length of the silver rod containing the 125I radioactive material of 0.14 mm does not affect the dose distribution significantly in the transverse and longitudinal axes but a change of 0.13 mm in the thickness of the welded end of the encapsulation affected the dose significantly in the longitudinal axis of the source.

  6. Späte Seed-Migration nach LDR-Brachytherapie der Prostata mit I125-Permanentimplantaten

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    Maletzki P

    2015-01-01

    Full Text Available Hintergrund: Nach einer „Lowdose-rate“- (LDR Brachytherapie der Prostata kommt es häufig zu einer Seed-Migration. Trotz mehrerer Arbeiten über eine Seed-Migration in der frühen postoperativen Phase nach Seed-Implantation gibt es bisher nur wenige Daten über eine Seed-Migration mehrere Jahre nach erfolgter Intervention. Unser Ziel war eine Datenerhebung zur Inzidenz, Lokalisation, Symptomatik und therapeutischen Konsequenz einer späten Seed-Migration 3 Jahre nach Seed-Implantation. Methoden: Wir untersuchten retrospektiv 63 unselektionierte Patienten, die mittels transrektaler, Ultraschall-gesteuerter, transperinealer interstitieller LDR-Brachytherapie der Prostata zwischen 2001 und 2010 behandelt wurden. Es wurden hierbei verknüpfte („stranded“ Seeds verwendet. Am ersten Tag nach der Intervention erfolgte eine Symphysenzielaufnahme und 6 Wochen postoperativ eine erneute Symphysenzielaufnahme in Kombination mit einem CT/MRI des Beckens mit Bildfusionstechnik zur dosimetrischen Untersuchung. Die radiologische Spätkontrolle wurde mehr als 3 Jahre postoperativ mittels einer Symphysenzielaufnahme und eines Thorax-Röntgens durchgeführt. Ergebnisse: Mehr als 3 Jahre nach Brachytherapie zeigten 36 der 63 Patienten (57 % einen Seed-Verlust. Die Anzahl fehlender Seeds lag zwischen 1 und 9. Neben einer frühen Seed-Migration zeigte sich eine späte Seed-Migration bei 2 der 36 Patienten (6 % mit Migration in die Lunge, Leber und das kleine Becken. Alle Spätmigrationen waren asymptomatisch und ohne therapeutische Konsequenz. Diskussion: Neben häufig auftretenden Seed-Verlusten scheint eine Seed-Migration mehrere Jahre nach erfolgter Implantation eine seltene Erscheinung zu sein. Langzeitkontrollen mit ergänzenden radiologischen Nachuntersuchungen könnten dennoch hilfreich zur Dokumentation einer relevanten Seed-Migration sein.

  7. I-125 seed dose estimates in heterogeneous phantom

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    Branco, Isabela S.L.; Antunes, Paula C.G.; Cavalieri, Tassio A.; Moura, Eduardo S.; Zeituni, Carlos A.; Yoriyaz, Helio, E-mail: isabela.slbranco@gmail.com [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Brachytherapy plays an important role in the healing process involving tumors in a variety of diseases. Several studies are currently conducted to examine the heterogeneity effects of different tissues and organs in brachytherapy clinical situations and a great effort has been made to incorporate new methodologies to estimate doses with greater accuracy. The objective of this study is to contribute to the assessment of heterogeneous effects on dose due to I-125 brachytherapy source in the presence of different materials with different densities and chemical compositions. The study was performed in heterogeneous phantoms using materials that simulate human tissues. Among these is quoted: breast, fat, muscle, lungs (exhaled and inhaled) and bones with different densities. Monte Carlo simulations for dose calculation in these phantoms were held and subsequently validated. The model 6711 I-125 seed was considered because it is widely used as a brachytherapy permanent implant and the one used in clinics and hospitals in Brazil. Thermoluminescent dosimeters TLD-700 (LiF: Mg, Ti) were simulated for dose assess. Several tissue configurations and positioning of I-125 sources were studied by simulations for future dose measurements. The methodology of this study so far shall be suitable for accurate dosimetric evaluation for different types of brachytherapy treatments, contributing to brachytherapy planning systems complementation allowing a better assessment of the dose actually delivered to the patient. (author)

  8. Occupational exposure in prostate permanent implants with I-125 seeds

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    Fdez Garcia, J.; Luna, V.; Sancho, J. M. g.; Martinez, J.; Galiano, P. S.; Jimenez, I.; Prada, P.; Juan, G.; Vivanco, J.

    2002-07-01

    Prostate brachytherapy is one of the techniques increasing faster in the environment of the radiotherapy and will probably go on increasing in the future. There are two forms in their use; by means of remote afterloading high dose rate (HDR) with Ir-192 radioactive sources or by means of permanent implant by manual/automatic afterloading of low dose rate (LDR) with seeds of I-125 or Pd-103. Iodine-125 has a half life of 59.4 days and it decays by electron capture with emissions of characteristic photons and electrons. The electrons are absorbed by the titanium wall of the I-125 seed. The principal photon emissions are 27.4 and 31.4 keV X-rays and a 35.5 keV gamma ray. Besides 22.1 and 25.2 keV fluorescent X-rays are also emitted resulting from interactions of the iodine-125 photons with the silver rod. The resulting average photon energy is approximately 27.4 keV. (Author)

  9. Monte Carlo dosimetry for I125 and Pd103 eye plaque brachytherapy.

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    Thomson, R M; Taylor, R E P; Rogers, D W O

    2008-12-01

    A Monte Carlo study of dosimetry for eye plaque brachytherapy is performed. BrachyDose, an EGSnrc user code which makes use of Yegin's multi-geometry package, is used to fully model I125 (model 6711) and Pd103 (model 200) brachytherapy seeds and the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). Three-dimensional dose distributions in the eye region are obtained. In general, dose to water is scored; however, the implications of replacing water with eye tissues are explored. The effect of the gold alloy (Modulay) backing is investigated and the dose is found to be sensitive to the elemental composition of the backing. The presence of the silicone polymer (Silastic) seed carrier results in substantial dose decreases relative to water, particularly for Pd103. For a 20mm plaque with a Modulay backing and Silastic insert, fully loaded with 24 seeds, the dose decrease relative to water is of the order of 14% for I125 and 20% for Pd103 at a distance of 1cm from the inner sclera along the plaque's central axis. For the configurations of seeds used in COMS plaques, interseed attenuation is a small effect within the eye region. The introduction of an air interface results in a dose reduction in its vicinity which depends on the plaque's position within the eye and the radionuclide. Introducing bone in the eye's vicinity also causes dose reductions. The dose distributions in the eye for the two different radionuclides are compared and, for the same prescription dose, Pd103 generally offers a lower dose to critical normal structures. BrachyDose is sufficiently fast to allow full Monte Carlo dose calculations for routine clinical treatment planning. © 2008 American Association of Physicists in Medicine.

  10. Factors influencing outcome of I-125 prostate cancer brachytherapy

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    Hinnen, K.A.

    2011-01-01

    Brachytherapy is becoming an increasingly popular prostate cancer treatment, probably due to the specific advantages of the procedure, such as the minimal invasiveness and the lower chance of impotence and incontinence. Nonetheless, because of the long follow-up that is required to obtain prostate

  11. Dosimetry and treatment planning of Occu-Prosta I-125 seeds for intraocular lesions

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    Chaudhari Suresh

    2008-01-01

    Full Text Available Intraocular malignant lesions are frequently encountered in clinical practice. Plaque brachytherapy represents an effective means of treatment for intraocular lesions. Recently Radiopharmaceutical Division, BARC, Mumbai, has indigenously fabricated reasonable-cost I-125 sources. Here we are presenting the preliminary experience of dosimetry of sources, configuration of treatment planning system (TPS and quality assurance (QA for eye plaque therapy with Occu-Prosta I-125 seeds, treated in our hospital, for a patient with ocular lesions. I-125 seeds were calibrated using well-type chamber. BrachyVision TPS was configured with Monte Carlo computed radial dose functions and anisotropy functions for I-125 sources. Dose calculated by TPS at different points in central axis and off axis was compared with manually calculated dose. Eye plaque was fabricated of 17 karat pure gold, locally. The seeds were arranged in an outer ring near the edge of the plaque and in concentric rings throughout the plaque. The sources were manually digitized on the TPS, and dose distribution was calculated in three dimensions. Measured activity using cross-calibrated well-type chamber was within ±10% of the activity specified by the supplier. Difference in TPS-calculated dose and manually calculated dose was within 5%. Treatment time calculated by TPS was in concordance with published data for similar plaque arrangement.

  12. Dosimetric and technical aspects of intraoperative I-125 brachytherapy for stage I non-small cell lung cancer

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    Johnson, Mark [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Colonias, Athanasios [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Parda, David [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Trombetta, Mark [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Gayou, Olivier [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Reitz, Bodo [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States); Miften, Moyed [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 (United States)

    2007-03-07

    Initial treatment outcome data from our institution for stage I non-small cell lung cancer (NSCLC) patients have shown that sublobar resection in combination with iodine-125 (I-125) brachytherapy is associated with recurrence rates of 2.0%, compared to 18.6% with sublobar resection alone. In this work, the technical and dosimetric aspects required to execute this procedure from the radiation oncology perspective as well as an analysis of the dose distributions of patients treated with this technique are presented. In this treatment technique, I-125 seeds in vicryl suture are embedded into vicryl mesh and surgically inserted providing a 2.0 cm margin on each side of the resection staple line. A nomogram is developed to determine the suture spacing in the vicryl mesh, as a function of seed activity in order to deliver 120 Gy at a distance of 0.5 cm above and below the seed array. Post-operative dosimetry consists of a CT-based planning and dose volume analysis. Dose distributions, dose volume histograms and mean dose data for lung are analysed in a group of patients. Dosimetric results show significant lung sparing with only a small volume of lung irradiated for all patients with mean lung dose values ranging from 1.5 Gy to 5.4 Gy. Lung brachytherapy with I-125 at the time of sublobar resection is a highly conformal option of dose delivery for stage I NSCLC patients with compromised physiologic reserve. Patient-related toxicity clinically measured by loss of pulmonary function and radiation-induced pneumonitis have not been linked to this procedure.

  13. Dosimetric and technical aspects of intraoperative I-125 brachytherapy for stage I non-small cell lung cancer

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    Johnson, Mark; Colonias, Athanasios; Parda, David; Trombetta, Mark; Gayou, Olivier; Reitz, Bodo; Miften, Moyed

    2007-03-01

    Initial treatment outcome data from our institution for stage I non-small cell lung cancer (NSCLC) patients have shown that sublobar resection in combination with iodine-125 (I-125) brachytherapy is associated with recurrence rates of 2.0%, compared to 18.6% with sublobar resection alone. In this work, the technical and dosimetric aspects required to execute this procedure from the radiation oncology perspective as well as an analysis of the dose distributions of patients treated with this technique are presented. In this treatment technique, I-125 seeds in vicryl suture are embedded into vicryl mesh and surgically inserted providing a 2.0 cm margin on each side of the resection staple line. A nomogram is developed to determine the suture spacing in the vicryl mesh, as a function of seed activity in order to deliver 120 Gy at a distance of 0.5 cm above and below the seed array. Post-operative dosimetry consists of a CT-based planning and dose volume analysis. Dose distributions, dose volume histograms and mean dose data for lung are analysed in a group of patients. Dosimetric results show significant lung sparing with only a small volume of lung irradiated for all patients with mean lung dose values ranging from 1.5 Gy to 5.4 Gy. Lung brachytherapy with I-125 at the time of sublobar resection is a highly conformal option of dose delivery for stage I NSCLC patients with compromised physiologic reserve. Patient-related toxicity clinically measured by loss of pulmonary function and radiation-induced pneumonitis have not been linked to this procedure.

  14. Transperineal prostate brachytherapy, using I-125 seed with or without adjuvant androgen deprivation, in patients with intermediate-risk prostate cancer: study protocol for a phase III, multicenter, randomized, controlled trial

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    Miyakoda Keiko

    2010-10-01

    Full Text Available Abstract Background The optimal protocol for 125I-transperineal prostatic brachytherapy (TPPB in intermediate-risk prostate cancer (PCa patients remains controversial. Data on the efficacy of combining androgen-deprivation therapy (ADT with 125I-TPPB in this group remain limited and consequently the guidelines of the American Brachytherapy Society (ABS provide no firm recommendations. Methods/Design Seed and Hormone for Intermediate-risk Prostate Cancer (SHIP 0804 is a phase III, multicenter, randomized, controlled study that will investigate the impact of adjuvant ADT following neoadjuvant ADT and 125I-TPPB. Prior to the end of March, 2011, a total of 420 patients with intermediate-risk, localized PCa will be enrolled and randomized to one of two treatment arms. These patients will be recruited from 20 institutions, all of which have broad experience of 125I-TPPB. Pathological slides will be centrally reviewed to confirm patient eligibility. The patients will initially undergo 3-month ADT prior to 125I-TPPB. Those randomly assigned to adjuvant therapy will subsequently undergo 9 months of adjuvant ADT. All participants will be assessed at baseline and at the following intervals: every 3 months for the first 24 months following 125I-TPPB, every 6 months during the 24- to 60-month post-125I-TPPB interval, annually between 60 and 84 months post-125I-TPPB, and on the 10th anniversary of treatment. The primary endpoint is biochemical progression-free survival (BPFS. Secondary endpoints are overall survival (OS, clinical progression-free survival, disease-specific survival, salvage therapy non-adaptive interval, acceptability (assessed using the international prostate symptom score [IPSS], quality of life (QOL evaluation, and adverse events. In the correlative study (SHIP36B, we also evaluate biopsy results at 36 months following treatment to examine the relationship between the results and the eventual recurrence after completion of radiotherapy

  15. Comparative dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for brain tumors

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    Brandao, Samia de Freitas, E-mail: samiabrandao@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Campos, Tarcisio Passos Ribeiro de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2013-06-15

    Objective: comparative analysis of dosimetry in intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT for treatment of brain tumors. Materials and methods: simulations of intracavitary balloon catheter brachytherapy with I-125 and in Cf-252 brachytherapy combined with BNCT were performed with the MCNP5 code, modeling the treatment of a brain tumor on a voxel computational phantom representing a human head. Absorbed dose rates were converted into biologically weighted dose rates. Results: intracavitary balloon catheter brachytherapy with I-125 produced biologically weighted mean dose rates of 3.2E-11, 1.3E-10, 1.9E-11 and 6.9E-13 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively, on the healthy tissue, on the balloon periphery and on the /{sub 1} and /{sub 2} tumor infiltration zones. On the other hand, Cf-252 brachytherapy combined with BNCT produced a biologically weighted mean dose rate of 5.2E-09, 2.3E-07, 8.7E-09 and 2.4E-09 RBE.Gy.h{sup -1}.p{sup -1}.s, respectively on the healthy tissue, on the target tumor and on the /{sub 1} and /{sub 2} infiltration zones. Conclusion: Cf-252 brachytherapy combined with BNCT delivered a selective irradiation to the target tumor and to infiltration zones, while intracavitary balloon catheter brachytherapy with I-125 delivered negligible doses on the tumor infiltration zones. (author)

  16. Sci-Sat AM(2): Brachy-03: Monte Carlo dosimetry for I-125 and Pd-103 eye plaque brachytherapy.

    Science.gov (United States)

    Thomson, R M; Taylor, Rep; Rogers, Dwo

    2008-07-01

    A Monte Carlo study of dosimetry for eye plaque brachytherapy was performed. BrachyDose, an EGSnrc user-code which makes use of Yegin's multi-geometry package, was used to fully model Iodine-125 (model 6711) and Palladium-103 (model 200) brachytherapy seeds and the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). Three-dimensional dose distributions in the eye region were obtained. In general, dose to water was scored, however the implications of replacing water with eye materials was explored. The effect of the gold alloy (Modulay) backing was investigated and the dose was found to be sensitive to the elemental composition of the backing. The presence of the silicon polymer (Silastic) seed carrier resulted in substantial dose decreases relative to water, particularly for Pd-103. For the Modulay backing and Silastic insert combination in a 20 mm plaque, the dose decrease relative to water is of the order of 12% for I-125 and 20% for Pd-103 at a distance of 1 cm from the central seed along the plaque's central axis. For the configurations of seeds used in COMS plaques, interseed attenuation is a small effect within the eye region. The introduction of an air interface results in a dose reduction in its vicinity which depends on the plaque's position within the eye and the source type. The dose distributions in the eye for the two different sources were compared and, for the same prescription dose, Pd-103 generally offers a lower dose to critical normal structures. © 2008 American Association of Physicists in Medicine.

  17. Long term outcome and side effects in patients receiving low-dose I125 brachytherapy: a retrospective analysis

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    Pieter Logghe

    Full Text Available ABSTRACT Objectives: To retrospectively evaluate the disease free survival (DFS, disease specific survival (DSS,overall survival (OS and side effects in patients who received low-dose rate (LDR brachytherapy with I125 stranded seeds. Materials and methods: Between july 2003 and august 2012, 274 patients with organ confined prostate cancer were treated with permanent I125 brachytherapy. The median follow-up, age and pretreatment prostate specific antigen (iPSA was 84 months (12-120, 67 years (50-83 and 7.8 ng/mL (1.14-38, respectively. Median Gleason score was 6 (3-9. 219 patients (80% had stage cT1c, 42 patients (15.3% had stage cT2a, 3 (1.1% had stage cT2b and 3 (1.1% had stage cT2c. The median D90 was 154.3 Gy (102.7-190.2. Results: DSS was 98.5%.OS was 93.5%. 13 patients (4.7% developed systemic disease, 7 patients (2.55% had local progression. In 139 low risk patients, the 5 year biochemical freedom from failure rate (BFFF was 85% and 9 patients (6.4% developed clinical progression. In the intermediate risk group, the 5 year BFFF rate was 70% and 5 patients (7.1% developed clinical progression. Median nPSA in patients with biochemical relapse was 1.58 ng/mL (0.21 – 10.46, median nPSA in patients in remission was 0.51 ng/mL (0.01 – 8.5. Patients attaining a low PSA nadir had a significant higher BFFF (p<0.05. Median D90 in patients with biochemical relapse was 87.2 Gy (51 – 143,1. Patients receiving a high D90 had a significant higher BFFF (p<0.05. Conclusion: In a well selected patient population, LDR brachytherapy offers excellent outcomes. Reaching a low PSA nadir and attaining high D90 values are significant predictors for a higher DFS.

  18. Dosimetry on ocular brachytherapy with I-125 ophthalmologic ROPES and COMS plaques

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    Mourao, Arnaldo P. [Centro Federal de Educacao Tecnoloica de Minas Gerais (CEFET-MG), Belo Horizonte, MG (Brazil). Nucleo de Engenharia Hospitalar], e-mail: aprata@des.cefetmg.br; Campos, Tarcisio P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-graduacao em Ciencias e Tecnicas Nucleares], e-mail: campos@nuclear.ufmg.br

    2009-07-01

    Radiotherapy is an alternative to ocular enucleation. However, the irradiation of ocular region can bring deleterious effects due to the high doses, mainly in the lens, retina and in the bone structures in growth phase. Brachytherapy instead of teletherapy looks for departuring absorbed doses in tumor minimizing doses in the lens and the adjacent tissues of the eyeball (orbital region), avoiding deleterious effects. Thus, a three-dimensional computational voxel model and an analytical model were coupled, including the heterogeneous properties of the globe and the adjacent tissues. The analytical model was applied to define the thin structures of the ocular globe. This computational model is used to simulate orbital irradiation with ROPES and COMS ophthalmologic plaques placed on the sclera surface filled to ten and eight iodine-125 seeds, respectively. Simulations are performed on the MCNP5 code. The computational simulation allows evaluating how the dose rates are spatially distributed in the orbital volume. The results are normalized to 100% at the maximum dose on the tumor base, and by the applied source activity. The external globe structures receive 0.5% of the maximum internal dose. The crystalline lens dosimetry depends on the position and thickness of the tumor and the plaque diameters. On the present case, 12.75% of maximum dose is found on the lens. The maximum dose is found onto the eyeball, in the vitreous. The present model represents an advance in simulating and predicting absorbed dose on ocular brachytherapy, incorporating anthropomorphic and anthropometric features of the real eyeball. (author)

  19. Complementary method of analyzing the quality of the implant I-125 seeds for prostate brachytherapy using ultrasound imaging post-implant; Metodo complementario de analisis de la calidad del implante de semillas de I-125 para braquiterapia de prostata mediante la adquisicion de imagenes ecograficas post-implante

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    Jimenez Dominguez, M.; Carrasco Herrera, M.; Baeza Trujillo, M.; Herrador Cordoba, M.

    2011-07-01

    In this paper we propose a complementary method based on Longitudinal mode ultrasound images acquired the same day of surgery, at the end of the implant. This option will allow us to evaluate the dosimetry end of treatment with the patient in the same position he was planning and to the rectum and bladder just as full. This will permit the identification of bodies and the seeds of interest more easily and will have a reference with which to compare one month later, when the CT images can also detect whether there has been some migration.

  20. The accuracy of single-seed dose superposition for I-125 implants.

    Science.gov (United States)

    Burns, G S; Raeside, D E

    1989-01-01

    The Monte Carlo method was used to study perturbations of single I-125 seed dose distributions created by the presence of one or three neighboring seeds for the case of seeds immersed in a water phantom. Perturbation factors were determined within the geometric shadow of neighboring seeds for two-seed designs, four-seed spacings, and several choices of dose point. The results were compared to dose estimates obtained by the simple superposition of single-seed data for one- and two-plane implants. Some significant differences were found.

  1. Brachytherapy of intra ocular tumors using ′BARC I-125 Ocu-Prosta seeds′: An Indian experience

    Directory of Open Access Journals (Sweden)

    Vikas Khetan

    2014-01-01

    Full Text Available Aim: To report our experience of brachytherapy using ′BARC I-125 Ocu-Prosta seeds′ for the management of intraocular tumors with regard to tumor control, globe preservation visual outcome, and patient survival at Sankara Nethralaya, Chennai, India between September 2003 and May 2011. Materials and Methods: We reviewed records of 35 eyes of 35 patients who underwent ophthalmic brachytherapy between September 2003 and May 2011. Twenty-one cases had choroidal melanoma, nine had childhood retinoblastoma, two had adult-onset retinoblastoma, and there were one case each of vasoproliferative tumor, retinal angioma, and ciliary body melanoma. Brachytherapy was administered using a 15- or 20-mm gold plaque with or without a notch. Brachytherapy was the primary treatment modality in all tumors other than retinoblastoma, wherein brachytherapy was done post chemoreduction for residual tumor. Results: For choroidal melanomas, the mean radiation dose was 68.69 ± 15.07 (range, 47.72-94.2 Gy. The eye salvage rate was 13/20 (65% and tumor control rate was 16/20 (80% at an average follow-up of 24.43 ± 24.75 (range, 1.5-87.98 months. For retinoblastoma, the mean dose was 45.85 ± 3.90 (range, 39.51-50.92 Gy. The eye salvage rate and tumor control rate was 5/6 (83.3% at an average follow-up of 38.36 ± 31.33 (range, 4.14-97.78 months. All eyes with retinoblastoma needed additional focal therapy for tumor control and eye salvage. Conclusion: The results of this retrospective study confirms that the use of ′BARC I-125 Ocu-Prosta seeds′ in episcleral plaques to treat intraocular tumors offers a viable option for the management of intraocular cancers.

  2. Radiotherapy of malignant melanoma of the uvea with I-125 seeds

    Energy Technology Data Exchange (ETDEWEB)

    Heikkonen, J. (Department of Radiotherapy and Oncology, Helsinki University Central Hospital, Helsinki (Finland)); Summanen, P.; Immonen, I.; Tommila, P.; Tarkkanen, A. (Department of Ophthalmology, Helsinki University Central Hospital, Helsinki (Finland)); Toivola, H.; Forss, M. (First and Second Departments of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki (Finland))

    1992-01-01

    Nineteen patients with malignant uveal melanomas were treated with I-125 applicators. There were 10 males and 9 females with a median age of 61 years (range 42-76). The tumour was located in the choroid in 12 eyes and in the choroid and ciliary body in 7 eyes. The size of the tumours was 7-18 mm in maximal basal diameter (median 12), 5-16 mm in minimal basal diameter (median 10), and 5.5-15 mm in thickness (median 8.5). The volume of the tumours was 123-1890 mm[sup 3] (median 540). All tumours were classified as large (T3). For the irradiation, a computer program, which calculates three-dimensional dose distribution of I-125 seeds in gold plaques, was developed. By modifying the seed positions, activity and the orientation, patients can be treated individually. Iodine-125 emits low energy photons, ideal for intracular tumour therapy and tissue. Extra-ocular tissue located behind the applicator can be completely shielded by a 0.5 mm gold layer. The dose of the apex of the tumour ranged from 30 to 120 Gy (median 93). The treatment time ranged from 44 to 600 h (median 235). Preliminary results are good. After a median follow-up of 6 months, the tumour growth has been arrested in all eyes and in 10 eyes the tumour has decreased in size. (au).

  3. Microincisional vitrectomy for retinal detachment in I-125 brachytherapy-treated patients with posterior uveal malignant melanoma

    Directory of Open Access Journals (Sweden)

    Lonngi M

    2013-02-01

    Full Text Available Marcela Lonngi,1 Samuel K Houston,1 Timothy G Murray,1–3 Robert A Sisk,4 Christina L Decatur,1 Milena Cavalcante,1 Arnold M Markoe31Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA; 2Murray Ocular Oncology and Retina, Miami, FL, USA; 3Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA; 4Department of Ophthalmology, Cincinnati Eye Institute, Cincinnati, OH, USAPurpose: To analyze functional and anatomical outcomes following 23/25+ gauge microincisional pars plana vitrectomy surgery (MIVS in patients with radiation-related retinal detachment after successful 125-iodine (I-125 brachytherapy treatment for malignant uveal melanoma.Patients and methods: Retrospective case series of 102 consecutive eyes of 102 patients with history of uveal melanoma treated with I-125 brachytherapy that underwent MIVS at the Bascom Palmer Eye Institute. All cases were evaluated for surgical complications and local tumor control. Extended follow-up included Snellen’s best-corrected visual acuity, intraocular pressure evaluation, quantitative echography, indirect ophthalmoscopy, and fundus imaging with optical coherence tomography/wide-field photography.Results: All patients had radiation-related complications, including retinal detachment (102 eyes, vasculopathy (91 eyes, optic neuropathy (32 eyes, and/or vitreous hemorrhage (8 eyes. Sixty-seven patients had vitreoretinal traction. Average follow-up after MIVS was 19.5 months, and from plaque removal was 57.7 months. Interval from plaque to MIVS was 38.1 months. Initial visual acuity was 20/258, which improved to 20/101 at 1 month, 20/110 at 3 months, 20/116 at 6 months, and 20/113 at 12 months (P < 0.05. No eyes required enucleation. Melanoma-related mortality was 0.9% (1/102. There was no intra- or extraocular tumor dissemination, and no tumor recurrence.Conclusion: MIVS was effective in improving

  4. Novel application of 3D printing in brachytherapy using MED610 3D printed insert for I-125 ROPES eye plaque.

    Science.gov (United States)

    Sim, L

    2016-12-01

    The purpose of this study was to evaluate if MED610 3D printed material can be used as a surrogate for acrylic in the manufacturing of a replacement insert used in an eye plaque brachytherapy applicator. Measurement of the dose distributions from a standard acrylic insert were compared with dose obtained from MED610 3D printed replica using GafChromic(®) EBT3 films. The study used a 15 mm Radiation Oncology Physics and Engineering Services, Australia (ROPES) type eye plaque applicator loaded with I-125 (model 6711) seeds. GafChromic(®) EBT3 films were placed in a solid water phantom and dose distributions were measured three-dimensionally both along and perpendicular to a loaded ROPES eye plaque's central axis (CAX). Each measurement was performed with the stainless steel plaque backing attached to the eye plaque, to assess the variability of the dose distributions between the acrylic and MED 610 insert. Results of dose along the central axis were compared between acrylic and MED610 insert and the results found agreement within 1.5 %. Off-axis profiles were also compared between the acrylic insert and MED610 and were found to agree to within 7 % in the central 15 mm width centred on CAX at depths ranging from z = 2 mm to z = 8 mm in 2 mm increments. The aim of this investigation was to verify the consistency between doses profiles over a range of clinically relevant depths for a 15 mm loaded ROPES plaque using acrylic versus MED610 material. The results show an agreement between experimental measurements given the film uncertainty of 7 %.

  5. Prostate brachytherapy seed migration to the heart seen on cardiovascular computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Shilpa Sachdeva, MD

    2017-03-01

    Full Text Available Brachytherapy consists of placing radioactive sources into or adjacent to tumors, to deliver conformal radiation treatment. The technique is used for treatment of primary malignancies and for salvage in recurrent disease. Permanent prostate brachytherapy seeds are small metal implants containing radioactive sources of I-125, Pd-103, or Cs-131 encased in a titanium shell. They can embolize through the venous system to the lungs or heart and subsequently be detected by cardiovascular computed tomography. Cardiovascular imagers should be aware of the appearance of migrated seeds, as their presence in the chest is generally benign, so that unnecessary worry and testing are avoided. We report a case of a patient who underwent brachytherapy for prostate cancer and developed a therapeutic seeds embolus to the right ventricle.

  6. Preparation and administration of I-125 labeled seeds for localization of nonpalpable breast lesions

    DEFF Research Database (Denmark)

    Langhans, Linnea; Klausen, Thomas Levin; Tvedskov, Tove Holst Filtenborg

    2016-01-01

    for reliable gamma probe identification of the seeds and the levels of exposure to the staff. METHODS: 11 patients received a seed, which was manually placed in an 18 gauge needle with bone wax occluding the tip, and the radiologist introduced it into the breast tissue guided by ultrasound. The seed...

  7. Salvage stereotactic body radiotherapy for locally recurrent non-small cell lung cancer after sublobar resection and I125 vicryl mesh brachytherapy

    Directory of Open Access Journals (Sweden)

    Beant Singh Gill

    2015-05-01

    Full Text Available Purpose: Locally-recurrent non-small cell lung cancer (LR-NSCLC remains challenging treat, particularly in patients having received prior radiotherapy. Heterogeneous populations and varied treatment intent in existing literature result in significant limitations in evaluating efficacy of lung re-irradiation. In order to better establish the impact of re-irradiation in patients with LR-NSCLC following high-dose radiotherapy, we report outcomes for patients treated with prior sublobar resection and brachytherapy that subsequently underwent stereotactic body radiotherapy (SBRT.Methods: A retrospective review of patients initially treated with sublobar resection and I125 vicryl mesh brachytherapy, who later developed LR-NSCLC along the suture line, was performed. Patients received salvage SBRT with curative intent. Dose and fractionation was based on tumor location and size, with a median prescription dose of 48 Gy in 4 fractions (range 20-60 Gy in 1-4 fractions.Results: Thirteen consecutive patients were identified with median follow-up of 2.1 years (range 0.7-5.6 years. Two in-field local failures occurred at 7.5 and 11.1 months, resulting in 2-year local control of 83.9% (95% CI 63.5-100.0%. Two-year disease-free survival and overall survival estimates were 38.5% (95% CI 0.0-65.0% and 65.8% (95% CI, 38.2-93.4%. Four patients (31% remained disease-free at last follow-up. All but one patient who experienced disease recurrence developed isolated or synchronous distant metastases. Only one patient (7.7% developed grade ≥3 toxicity, consisting of grade 3 esophageal stricture following a centrally located recurrence previously treated with radiofrequency ablation.Conclusion: Despite high local radiation doses delivered to lung parenchyma previously with I125 brachytherapy, re-irradiation with SBRT for LR-NSCLC results in excellent local control with limited morbidity, allowing for potential disease cure in a subset of patients.

  8. Hospitalary inventory of prostatic sources of I-125; Inventario hospitalario de fuentes prostaticas de I-125

    Energy Technology Data Exchange (ETDEWEB)

    Barquero Sanz, R.; Anton, D.; Frutos Baraja, J. de.; Castillo Belmonte, A. del; Alonso, D.; Miquel, D. de; Lopez Lara-Martin, F.

    2013-07-01

    In accordance with the current regulations for radioactive facilities of brachytherapy, to carry out treatments of Prostate with I-125, must be a safety study involving evaluate maximum sources activity to use in the implants. In our installation was requested to perform implants permanent interstitial in prostate patients who tend to leaving the hospital in the hours following the intervention. The request which was prepared taking into account the maximum number predictable treatment (two per week), and to determine the activity to request, it was made the removal of seeds surplus by the supplier after each treatment. (Author)

  9. Improving photoacoustic imaging contrast of brachytherapy seeds

    Science.gov (United States)

    Pan, Leo; Baghani, Ali; Rohling, Robert; Abolmaesumi, Purang; Salcudean, Septimiu; Tang, Shuo

    2013-03-01

    Prostate brachytherapy is a form of radiotherapy for treating prostate cancer where the radiation sources are seeds inserted into the prostate. Accurate localization of seeds during prostate brachytherapy is essential to the success of intraoperative treatment planning. The current standard modality used in intraoperative seeds localization is transrectal ultrasound. Transrectal ultrasound, however, suffers in image quality due to several factors such speckle, shadowing, and off-axis seed orientation. Photoacoustic imaging, based on the photoacoustic phenomenon, is an emerging imaging modality. The contrast generating mechanism in photoacoustic imaging is optical absorption that is fundamentally different from conventional B-mode ultrasound which depicts changes in acoustic impedance. A photoacoustic imaging system is developed using a commercial ultrasound system. To improve imaging contrast and depth penetration, absorption enhancing coating is applied to the seeds. In comparison to bare seeds, approximately 18.5 dB increase in signal-to-noise ratio as well as a doubling of imaging depth are achieved. Our results demonstrate that the coating of the seeds can further improve the discernibility of the seeds.

  10. Survival of patients with advanced pancreatic cancer after iodine125 seeds implantation brachytherapy

    Science.gov (United States)

    Han, Quanli; Deng, Muhong; Lv, Yao; Dai, Guanghai

    2017-01-01

    Abstract Background: Brachytherapy with iodine125-labeled seeds (125I-seeds) implantation is increasingly being used to treat tumors because of its positional precision, minimal invasion, least damage to noncancerous tissue due to slow and continuous release of radioactivity and facilitation with modern medical imaging technologies. This study evaluates the survival and pain relief outcomes of the 125I-seeds implantation brachytherapy in advanced pancreatic cancer patients. Methods: Literature search was carried out in multiple electronic databases (Google Scholar, Embase, Medline/PubMed, and Ovid SP) and studies reporting I125 seeds implantation brachytherapy in pancreatic cancer patients with unresectable tumor were selected by following predetermined eligibility criteria. Random effects meta-analysis was performed to achieve inverse variance weighted effect size of the overall survival rate after the intervention. Sensitivity and subgroups analyses were also carried out. Results: Twenty-three studies (824 patients’ data) were included in the meta-analysis. 125I-seeds implantation brachytherapy alone was associated with 8.98 [95% confidence interval (CI): 6.94, 11.03] months (P < 0.00001) overall survival with 1-year survival of 25.7 ± 9.3% (mean ± standard deviation; SD) and 2-year survival was 17.9 ± 8.6% (mean ± SD). In stage IV pancreatic cancer patients, overall survival was 7.13 [95% CI: 4.75, 9.51] months (P < 0.00001). In patients treated with 125I-seeds implantation along with 1 or more therapies, overall survival was 11.75 [95% CI: 9.84, 13.65] months (P < 0.00001) with 1-year survival of 47.4 ± 22.75% (mean ± SD) and 2-year survival was 16.97 ± 3.1% (mean ± SD). 125I-seeds brachytherapy was associated with relief of pain in 79.7 ± 9.9% (mean ± SD) of the patients. Conclusions: Survival of pancreatic cancer patients after 125I-seeds implantation brachytherapy is found to be 9 months

  11. A Monte Carlo study of I-125 prostate brachytherapy with gold nanoparticles: dose enhancement with simultaneous rectal dose sparing via radiation shielding

    Science.gov (United States)

    Brivio, D.; Nguyen, P. L.; Sajo, E.; Ngwa, W.; Zygmanski, P.

    2017-03-01

    We investigate via Monte Carlo simulations a new 125I brachytherapy treatment technique for high-risk prostate cancer patients via injection of Au nanoparticle (AuNP) directly into the prostate. The purpose of using the nanoparticles is to increase the therapeutic index via two synergistic effects: enhanced energy deposition within the prostate and simultaneous shielding of organs at risk from radiation escaping from the prostate. Both uniform and non-uniform concentrations of AuNP are studied. The latter are modeled considering the possibility of AuNP diffusion after the injection using brachy needles. We study two extreme cases of coaxial AuNP concentrations: centered on brachy needles and centered half-way between them. Assuming uniform distribution of 30 mg g‑1 of AuNP within the prostate, we obtain a dose enhancement larger than a factor of 2 to the prostate. Non-uniform concentration of AuNP ranging from 10 mg g‑1 and 66 mg g‑1 were studied. The higher the concentration in a given region of the prostate the greater is the enhancement therein. We obtain the highest dose enhancement when the brachytherapy needles are coincident with AuNP injection needles but, at the same time, the regions in the tail are colder (average dose ratio of 0.7). The best enhancement uniformity is obtained with the seeds in the tail of the AuNP distribution. In both uniform and non-uniform cases the urethra and rectum receive less than 1/3 dose compared to an analog treatment without AuNP. Remarkably, employing AuNP not only significantly increases dose to the target but also decreases dose to the neighboring rectum and even urethra, which is embedded within the prostate. These are mutually interdependent effects as more enhancement leads to more shielding and vice-versa. Caution must be paid since cold spot or hot spots may be created if the AuNP concentration versus seed position is not properly distributed respect to the seed locations.

  12. I-125 ROPES eye plaque dosimetry: validation of a commercial 3D ophthalmic brachytherapy treatment planning system and independent dose calculation software with GafChromic® EBT3 films.

    Science.gov (United States)

    Poder, Joel; Corde, Stéphanie

    2013-12-01

    The purpose of this study was to measure the dose distributions for different Radiation Oncology Physics and Engineering Services, Australia (ROPES) type eye plaques loaded with I-125 (model 6711) seeds using GafChromic(®) EBT3 films, in order to verify the dose distributions in the Plaque Simulator™ (PS) ophthalmic 3D treatment planning system. The brachytherapy module of RADCALC(®) was used to independently check the dose distributions calculated by PS. Correction factors were derived from the measured data to be used in PS to account for the effect of the stainless steel ROPES plaque backing on the 3D dose distribution. Using GafChromic(®) EBT3 films inserted in a specially designed Solid Water™ eye ball phantom, dose distributions were measured three-dimensionally both along and perpendicular to I-125 (model 6711) loaded ROPES eye plaque's central axis (CAX) with 2 mm depth increments. Each measurement was performed in full scatter conditions both with and without the stainless steel plaque backing attached to the eye plaque, to assess its effect on the dose distributions. Results were compared to the dose distributions calculated by Plaque Simulator™ and checked independently with RADCALC(®). The EBT3 film measurements without the stainless steel backing were found to agree with PS and RADCALC(®) to within 2% and 4%, respectively, on the plaque CAX. Also, RADCALC(®) was found to agree with PS to within 2%. The CAX depth doses measured using EBT3 film with the stainless steel backing were observed to result in a 4% decrease relative to when the backing was not present. Within experimental uncertainty, the 4% decrease was found to be constant with depth and independent of plaque size. Using a constant dose correction factor of T = 0.96 in PS, where the calculated dose for the full water scattering medium is reduced by 4% in every voxel in the dose grid, the effect of the plaque backing was accurately modeled in the planning system. Off-axis profiles

  13. I-125 ROPES eye plaque dosimetry: Validation of a commercial 3D ophthalmic brachytherapy treatment planning system and independent dose calculation software with GafChromic{sup ®} EBT3 films

    Energy Technology Data Exchange (ETDEWEB)

    Poder, Joel; Corde, Stéphanie [Department of Radiation Oncology, Prince of Wales Hospital, Randwick, NSW 2031 (Australia)

    2013-12-15

    Purpose: The purpose of this study was to measure the dose distributions for different Radiation Oncology Physics and Engineering Services, Australia (ROPES) type eye plaques loaded with I-125 (model 6711) seeds using GafChromic{sup ®} EBT3 films, in order to verify the dose distributions in the Plaque Simulator™ (PS) ophthalmic 3D treatment planning system. The brachytherapy module of RADCALC{sup ®} was used to independently check the dose distributions calculated by PS. Correction factors were derived from the measured data to be used in PS to account for the effect of the stainless steel ROPES plaque backing on the 3D dose distribution.Methods: Using GafChromic{sup ®} EBT3 films inserted in a specially designed Solid Water™ eye ball phantom, dose distributions were measured three-dimensionally both along and perpendicular to I-125 (model 6711) loaded ROPES eye plaque's central axis (CAX) with 2 mm depth increments. Each measurement was performed in full scatter conditions both with and without the stainless steel plaque backing attached to the eye plaque, to assess its effect on the dose distributions. Results were compared to the dose distributions calculated by Plaque Simulator™ and checked independently with RADCALC{sup ®}.Results: The EBT3 film measurements without the stainless steel backing were found to agree with PS and RADCALC{sup ®} to within 2% and 4%, respectively, on the plaque CAX. Also, RADCALC{sup ®} was found to agree with PS to within 2%. The CAX depth doses measured using EBT3 film with the stainless steel backing were observed to result in a 4% decrease relative to when the backing was not present. Within experimental uncertainty, the 4% decrease was found to be constant with depth and independent of plaque size. Using a constant dose correction factor of T= 0.96 in PS, where the calculated dose for the full water scattering medium is reduced by 4% in every voxel in the dose grid, the effect of the plaque backing was

  14. Epoxy resins used to seal brachytherapy seed

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Natalia Carolina Camargos; Ferraz, Wilmar Barbosa; Reis, Sergio Carneiro dos; Santos, Ana Maria Matildes dos, E-mail: nccf@cdtn.br, E-mail: ferrazw@cdtn.br, E-mail: reissc@cdtn.br, E-mail: amms@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, BH (Brazil)

    2013-07-01

    Prostate cancer treatment with brachytherapy is recommended for patients with cancer at an early stage. In this treatment, small radioactive seeds are implanted directly in the prostate gland. These seeds are composed at least of one radionuclide carrier and an X-ray marker enclosed within a metallic tube usually sealed by laser process. This process is expensive and, furthermore, it can provoke a partial volatilization of the radionuclide and change the isotropy in dose distribution around the seed. In this paper, we present a new sealing process using epoxy resin. Three kinds of resins were utilized and characterized by scanning electron microscopy (SEM), energy dispersive X ray (EDS) and by differential scanning calorimetry (DSC) after immersion in simulated body fluid (SBF) and in sodium iodine solution (NaI). The sealing process showed excellent potential to replace the sealing laser usually employed. (author)

  15. Radioactive seed migration following parotid gland interstitial brachytherapy.

    Science.gov (United States)

    Fan, Yi; Huang, Ming-Wei; Zhao, Yi-Jiao; Gao, Hong; Zhang, Jian-Guo

    2017-09-15

    To evaluate the incidence and associated factors of pulmonary seed migration after parotid brachytherapy using a novel migrated seed detection technique. Patients diagnosed with parotid cancer who underwent permanent parotid brachytherapy from January 2006 to December 2011 were reviewed retrospectively. Head and neck CT scans and chest X-rays were evaluated during routine follow-up. Mimics software and Geomagic Studio software were used for seed reconstruction and migrated seed detection from the original implanted region, respectively. Postimplant dosimetry analysis was performed after seeds migration if the seeds were still in their emitting count. Adverse clinical sequelae from seed embolization to the lung were documented. The radioactive seed implants were identified on chest X-rays in 6 patients. The incidence rate of seed migration in 321 parotid brachytherapy patients was 1.87% (6/321) and that of individual seed migration was 0.04% (6/15218 seeds). All migrated seeds were originally from the retromandibular region. No adverse dosimetric consequences were found in the target region. Pulmonary symptoms were not reported by any patient in this study. In our patient set, migration of radioactive seeds with an initial radioactivity of 0.6-0.7 mCi to the chest following parotid brachytherapy was rare. Late migration of a single seed from the central target region did not affect the dosimetry significantly, and patients did not have severe short-term complications. This study proposed a novel technique to localize the anatomical origin of the migrated seeds during brachytherapy. Our evidence suggested that placement of seeds adjacent to blood vessels was associated with an increased likelihood of seed migration to the lungs. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Radiochromic film calibration for low-energy seed brachytherapy dose measurement

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, Hali, E-mail: hamorris@ualberta.ca; Menon, Geetha; Sloboda, Ron S. [Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta T6G 1Z2, Canada and Department of Oncology, University of Alberta, Edmonton, Alberta T6G 2R3 (Canada)

    2014-07-15

    Purpose: Radiochromic film dosimetry is typically performed for high energy photons and moderate doses characterizing external beam radiotherapy (XRT). The purpose of this study was to investigate the accuracy of previously established film calibration procedures used in XRT when applied to low-energy, seed-based brachytherapy at higher doses, and to determine necessary modifications to achieve similar accuracy in absolute dose measurements. Methods: Gafchromic EBT3 film was used to measure radiation doses upwards of 35 Gy from 75 kVp, 200 kVp, 6 MV, and (∼28 keV) I-125 photon sources. For the latter irradiations a custom phantom was built to hold a single I-125 seed. Film pieces were scanned with an Epson 10000XL flatbed scanner and the resulting 48-bit RGB TIFF images were analyzed using both FilmQA Pro software andMATLAB. Calibration curves relating dose and optical density via a rational functional form for all three color channels at each irradiation energy were determined with and without the inclusion of uncertainties in the measured optical densities and dose values. The accuracy of calibration curve variations obtained using piecewise fitting, a reduced film measurement area for I-125 irradiation, and a reduced number of dose levels was also investigated. The energy dependence of the film lot used was also analyzed by calculating normalized optical density values. Results: Slight differences were found in the resulting calibration curves for the various fitting methods used. The accuracy of the calibration curves was found to improve at low doses and worsen at high doses when including uncertainties in optical densities and doses, which may better represent the variability that could be seen in film optical density measurements. When exposing the films to doses > 8 Gy, two-segment piecewise fitting was found to be necessary to achieve similar accuracies in absolute dose measurements as when using smaller dose ranges. When reducing the film measurement

  17. Distortions induced by radioactive seeds into interstitial brachytherapy dose distributions.

    Science.gov (United States)

    Zhou, Chuanyu; Inanc, Feyzi; Modrick, Joseph M

    2004-12-01

    In a previous article, we presented development and verification of an integral transport equation-based deterministic algorithm for computing three-dimensional brachytherapy dose distributions. Recently, we have included fluorescence radiation physics and parallel computation to the standing algorithms so that we can compute dose distributions for a large set of seeds without resorting to the superposition methods. The introduction of parallel computing capability provided a means to compute the dose distribution for multiple seeds in a simultaneous manner. This provided a way to study strong heterogeneity and shadow effects induced by the presence of multiple seeds in an interstitial brachytherapy implant. This article presents the algorithm for computing fluorescence radiation, algorithm for parallel computing, and display results for an 81-seed implant that has a perfect and imperfect lattice. The dosimetry data for a single model 6711 seeds is presented for verification and heterogeneity factor computations using simultaneous and superposition techniques are presented.

  18. Photoacoustic imaging of prostate brachytherapy seeds in ex vivo prostate

    Science.gov (United States)

    Kuo, Nathanael; Kang, Hyun Jae; DeJournett, Travis; Spicer, James; Boctor, Emad

    2011-03-01

    The localization of brachytherapy seeds in relation to the prostate is a key step in intraoperative treatment planning (ITP) for improving outcomes in prostate cancer patients treated with low dose rate prostate brachytherapy. Transrectal ultrasound (TRUS) has traditionally been the modality of choice to guide the prostate brachytherapy procedure due to its relatively low cost and apparent ease of use. However, TRUS is unable to visualize seeds well, precluding ITP and producing suboptimal results. While other modalities such as X-ray and magnetic resonance imaging have been investigated to localize seeds in relation to the prostate, photoacoustic imaging has become an emerging and promising modality to solve this challenge. Moreover, photoacoustic imaging may be more practical in the clinical setting compared to other methods since it adds little additional equipment to the ultrasound system already adopted in procedure today, reducing cost and simplifying engineering steps. In this paper, we demonstrate the latest efforts of localizing prostate brachytherapy seeds using photoacoustic imaging, including visualization of multiple seeds in actual prostate tissue. Although there are still several challenges to be met before photoacoustic imaging can be used in the operating room, we are pleased to present the current progress in this effort.

  19. Validation of GPUMCD for low-energy brachytherapy seed dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Hissoiny, Sami; Ozell, Benoit; Despres, Philippe; Carrier, Jean-Francois [Ecole polytechnique de Montreal, Departement de genie informatique et genie logiciel, 2500 chemin de Polytechnique, Montreal, QC, H3T 1J4 (Canada); Departement de radio-oncologie, Centre hospitalier universitaire de Quebec (CHUQ), 11 Cote du Palais, Quebec, QC, G1R 2J6 (Canada); Departement de physique, Universite de Montreal, Montreal, QC (Canada) and Departement de radio-oncologie and Centre de recherche du CHUM, Centre hospitalier de l' Universite de Montreal (CHUM), Montreal, QC, H2L 4M1 (Canada)

    2011-07-15

    Purpose: To validate GPUMCD, a new package for fast Monte Carlo dose calculations based on the GPU (graphics processing unit), as a tool for low-energy single seed brachytherapy dosimetry for specific seed models. As the currently accepted method of dose calculation in low-energy brachytherapy computations relies on severe approximations, a Monte Carlo based approach would result in more accurate dose calculations, taking in to consideration the patient anatomy as well as interseed attenuation. The first step is to evaluate the capability of GPUMCD to reproduce low-energy, single source, brachytherapy calculations which could ultimately result in fast and accurate, Monte Carlo based, brachytherapy dose calculations for routine planning. Methods: A mixed geometry engine was integrated to GPUMCD capable of handling parametric as well as voxelized geometries. In order to evaluate GPUMCD for brachytherapy calculations, several dosimetry parameters were computed and compared to values found in the literature. These parameters, defined by the AAPM Task-Group No. 43, are the radial dose function, the 2D anisotropy function, and the dose rate constant. These three parameters were computed for two different brachytherapy sources: the Amersham OncoSeed 6711 and the Imagyn IsoStar IS-12501. Results: GPUMCD was shown to yield dosimetric parameters similar to those found in the literature. It reproduces radial dose functions to within 1.25% for both sources in the 0.5< r <10 cm range. The 2D anisotropy function was found to be within 3% at r = 5 cm and within 4% at r = 1 cm. The dose rate constants obtained were within the range of other values reported in the literature.Conclusion: GPUMCD was shown to be able to reproduce various TG-43 parameters for two different low-energy brachytherapy sources found in the literature. The next step is to test GPUMCD as a fast clinical Monte Carlo brachytherapy dose calculations with multiple seeds and patient geometry, potentially providing

  20. Methodology of quality control for brachytherapy {sup 125}I seeds

    Energy Technology Data Exchange (ETDEWEB)

    Moura, Eduardo S.; Zeituni, Carlos A.; Manzoli, Jose E.; Rostelato, Maria Elisa C.M. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)]. E-mail: esmoura@ipen.br

    2007-07-01

    This paper presents the methodology of quality control of {sup 125}I seeds used for brachytherapy. The {sup 125}I seeds are millimeter titanium capsules widely used in permanent implants of prostate cancer, allowing a high dose within the tumour and a low dose on the surrounding tissues, with very low harm to the other tissues. Besides, with this procedure, the patients have a low impotence rate and a small incidence of urinary incontinence. To meet the medical standards, an efficient quality control is necessary, showing values with the minimum uncertainness possible, concerning the seeds dimensions and their respective activities. The medical needles are used to insert the seeds inside the prostate. The needles used in brachytherapy have an internal diameter of 1.0 mm, so it is necessary {sup 125}I seeds with an external maximum diameter of 0.85 mm. For the seeds and the spacer positioning on the planning sheet, the seeds must have a length between 4.5 and 5.0 mm. The activities must not vary more than 5% in each batch of {sup 125}I seeds. For this methodology, we used two ionization chamber detectors and one caliper. In this paper, the methodology using one control batch with 75 seeds manufactured by GE Health care Ltd is presented. (author)

  1. Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Genebes, Caroline, E-mail: genebes.caroline@claudiusregaud.fr [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France); Filleron, Thomas; Graff, Pierre [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France); Jonca, Frédéric [Department of Urology, Clinique Ambroise Paré, Toulouse (France); Huyghe, Eric; Thoulouzan, Matthieu; Soulie, Michel; Malavaud, Bernard [Department of Urology and Andrology, CHU Rangueil, Toulouse (France); Aziza, Richard; Brun, Thomas; Delannes, Martine; Bachaud, Jean-Marc [Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France)

    2013-11-15

    Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation. Methods and Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008. Dosimetric and biochemical recurrence-free (bNED) survival results were reported and compared for the 2 techniques. Univariate and multivariate analysis researched independent predictors for bNED survival. Results: 419 (73%) and 155 (27%) patients with low-risk and intermediate-risk disease, respectively, were treated (median follow-up time, 69.3 months). The 60-month bNED survival rates were 95.2% and 85.7%, respectively, for patients with low-risk and intermediate-risk disease (P=.04). In univariate analysis, patients treated with automated implantation had worse bNED survival rates than did those treated with conventional implantation (P<.0001). By day 30, patients treated with automated implantation showed lower values of dose delivered to 90% of prostate volume (D90) and volume of prostate receiving 100% of prescribed dose (V100). In multivariate analysis, implantation technique, Gleason score, and V100 on day 30 were independent predictors of recurrence-free status. Grade 3 urethritis and urinary incontinence were observed in 2.6% and 1.6% of the cohort, respectively, with no significant differences between the 2 techniques. No grade 3 proctitis was observed. Conclusion: Satisfactory 60-month bNED survival rates (93.1%) and acceptable toxicity (grade 3 urethritis <3%) were achieved by loose-seed implantation. Automated implantation was associated with worse dosimetric and bNED survival outcomes.

  2. Brachytherapy seed localization using geometric and linear programming techniques.

    Science.gov (United States)

    Singh, Vikas; Mukherjee, Lopamudra; Xu, Jinhui; Hoffmann, Kenneth R; Dinu, Petru M; Podgorsak, Matthew

    2007-09-01

    We propose an optimization algorithm to solve the brachytherapy seed localization problem in prostate brachytherapy. Our algorithm is based on novel geometric approaches to exploit the special structure of the problem and relies on a number of key observations which help us formulate the optimization problem as a minimization integer program (IP). Our IP model precisely defines the feasibility polyhedron for this problem using a polynomial number of half-spaces; the solution to its corresponding linear program is rounded to yield an integral solution to our task of determining correspondences between seeds in multiple projection images. The algorithm is efficient in theory as well as in practice and performs well on simulation data (approximately 98% accuracy) and real X-ray images (approximately 95% accuracy). We present in detail the underlying ideas and an extensive set of performance evaluations based on our implementation.

  3. Radiation pneumonitis caused by a migrated brachytherapy seed lodged in the lung.

    Science.gov (United States)

    Miura, Noriyoshi; Kusuhara, Yoshito; Numata, Kousaku; Shirato, Akitomi; Hashine, Katsuyoshi; Sumiyoshi, Yoshiteru; Kataoka, Masaaki; Takechi, Shinsuke

    2008-09-01

    We report a case of radiation pneumonitis caused by a migrated seed lodged in the lung after prostate brachytherapy. A 71-year-old man underwent transperineal interstitial permanent prostate brachytherapy for localized prostate cancer. On the day after brachytherapy, a routine postimplant chest X-ray revealed migration of one seed to the lower lobe of the left lung. After 1 month, pulmonary opacities were observed in the left lower lobe but not near the seed. He was diagnosed with bacterial pneumonia, and antibiotic therapy was commenced. Two months after brachytherapy, the patient's symptoms, laboratory data and pulmonary opacities improved; however, an abnormal shadow (consolidation) developed around the migrated seed. Lung consolidation disappeared almost completely 12 months after brachytherapy without any medical treatment. The abnormal shadow probably represented radiation pneumonitis. To the best of our knowledge, this is the first report of radiation pneumonitis caused by a migrated brachytherapy seed in the lung.

  4. SU-E-T-123: Anomalous Altitude Effect in Permanent Implant Brachytherapy Seeds

    Energy Technology Data Exchange (ETDEWEB)

    Watt, E; Spencer, DP; Meyer, T [University of Calgary and Tom Baker Cancer Centre, Calgary, AB (Canada)

    2015-06-15

    Purpose: Permanent seed implant brachytherapy procedures require the measurement of the air kerma strength of seeds prior to implant. This is typically accomplished using a well-type ionization chamber. Previous measurements (Griffin et al., 2005; Bohm et al., 2005) of several low-energy seeds using the air-communicating HDR 1000 Plus chamber have demonstrated that the standard temperature-pressure correction factor, P{sub TP}, may overcompensate for air density changes induced by altitude variations by up to 18%. The purpose of this work is to present empirical correction factors for two clinically-used seeds (IsoAid ADVANTAGE™ {sup 103}Pd and Nucletron selectSeed {sup 125}I) for which empirical altitude correction factors do not yet exist in the literature when measured with the HDR 1000 Plus chamber. Methods: An in-house constructed pressure vessel containing the HDR 1000 Plus well chamber and a digital barometer/thermometer was pumped or evacuated, as appropriate, to a variety of pressures from 725 to 1075 mbar. Current measurements, corrected with P{sub TP}, were acquired for each seed at these pressures and normalized to the reading at ‘standard’ pressure (1013.25 mbar). Results: Measurements in this study have shown that utilization of P{sub TP} can overcompensate in the corrected current reading by up to 20% and 17% for the IsoAid Pd-103 and the Nucletron I-125 seed respectively. Compared to literature correction factors for other seed models, the correction factors in this study diverge by up to 2.6% and 3.0% for iodine (with silver) and palladium respectively, indicating the need for seed-specific factors. Conclusion: The use of seed specific altitude correction factors can reduce uncertainty in the determination of air kerma strength. The empirical correction factors determined in this work can be applied in clinical quality assurance measurements of air kerma strength for two previously unpublished seed designs (IsoAid ADVANTAGE™ {sup 103}Pd and

  5. Incidence and prediction of seed migration to the chest after iodine-125 brachytherapy for hepatocellular carcinoma.

    Science.gov (United States)

    Lin, Junqing; Yang, Weizhu; Jiang, Na; Zheng, Qubin; Huang, Jingyao; Huang, Ning; Li, Ang; Jiang, Han

    2017-08-08

    The aims were to determine the incidence of seed migration to the chest and to analyze the predictive factors after iodine-125 brachytherapy for hepatocellular carcinoma. Three hundred ninety-nine patients with hepatocellular carcinoma underwent iodine-125 seed brachytherapy. After seed implantation, chest X-ray radiograph or computerized tomography were undertaken to assess the occurrence and location of seed migration at 3 months after brachytherapy. The incidence of seed migration to the lung and heart was calculated. A statistical analysis of the influences of seed loss to the chest was performed between patients with and without seed migration. A total of 13,977 seeds were implanted in 399 patients. One hundred fifty of the 13,977 (1.07%) seeds migrated to the chest in 81 of the 399 (20.30%) patients. Of all the migrated seeds, 112 (74.67%) migrated to the lungs in 59 (67.82%) patients, and 38 (25.33%) seeds migrated to the heart in 28 (47.46%) patients. No case exhibited clinical symptoms related to the migrated seeds. The number of seeds implanted and the number of seed implantations were significantly associated with seed migration. The occurrence of seed migration to the lungs and heart was evaluated. Furthermore, the number of seeds implanted and the number of seed implantation procedures are significant predictors of seed migration. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  6. Preparation of (103)Pd brachytherapy seeds by electroless plating of (103)Pd onto carbon bars.

    Science.gov (United States)

    Li, Zhong-Yong; Gao, Hui-Bo; Deng, Xue-Song; Zhou, Leng; Zhang, Wen-Hui; Han, Lian-Ge; Jin, Xiao-Hai; Cui, Hai-Ping

    2015-09-01

    A method for preparing (103)Pd brachytherapy seeds is reported. The key of the method was to deposit (103)Pd onto carbon bars by electroless plating so as to prepare source cores. After each carbon bar with (103)Pd was sealed in a titanium capsule, the (103)Pd seeds were fabricated. This paper provides valuable experiences and data for the preparation of (103)Pd brachytherapy seeds.

  7. Localization of brachytherapy seeds in ultrasound by registration to fluoroscopy

    Science.gov (United States)

    Fallavollita, P.; KarimAghaloo, Z.; Burdette, E. C.; Song, D. Y.; Abolmaesumi, P.; Fichtinger, G.

    2010-02-01

    Motivation: In prostate brachytherapy, transrectal ultrasound (TRUS) is used to visualize the anatomy, while implanted seeds can be seen in C-arm fluoroscopy or CT. Intra-operative dosimetry optimization requires localization of the implants in TRUS relative to the anatomy. This could be achieved by registration of TRUS images and the implants reconstructed from fluoroscopy or CT. Methods: TRUS images are filtered, compounded, and registered on the reconstructed implants by using an intensity-based metric based on a 3D point-to-volume registration scheme. A phantom was implanted with 48 seeds, imaged with TRUS and CT/X-ray. Ground-truth registration was established between the two. Seeds were reconstructed from CT/X-ray. Seven TRUS filtering techniques and two image similarity metrics were analyzed as well. Results: For point-to-volume registration, noise reduction combined with beam profile filter and mean squares metrics yielded the best result: an average of 0.38 +/- 0.19 mm seed localization error relative to the ground-truth. In human patient data C-arm fluoroscopy images showed 81 radioactive seeds implanted inside the prostate. A qualitative analysis showed clinically correct agreement between the seeds visible in TRUS and reconstructed from intra-operative fluoroscopy imaging. The measured registration error compared to the manually selected seed locations by the clinician was 2.86 +/- 1.26 mm. Conclusion: Fully automated seed localization in TRUS performed excellently on ground-truth phantom, adequate in clinical data and was time efficient having an average runtime of 90 seconds.

  8. Highly efficient method for production of radioactive silver seed cores for brachytherapy.

    Science.gov (United States)

    Cardoso, Roberta Mansini; de Souza, Carla Daruich; Rostelato, Maria Elisa Chuery Martins; Araki, Koiti

    2017-02-01

    A simple and highly efficient (shorter reaction time and almost no rework) method for production of iodine based radioactive silver seed cores for brachytherapy is described. The method allows almost quantitative deposition of iodine-131 on dozens of silver substrates at once, with even distribution of activity per core and insignificant amounts of liquid and solid radioactive wastes, allowing the fabrication of cheaper radioactive iodine seeds for brachytherapy.

  9. Brachytherapy

    Science.gov (United States)

    ... days. A patient receiving LDR brachytherapy will stay overnight at the hospital. This is so the delivery device can remain in place throughout the treatment period. Pulsed dose-rate (PDR) brachytherapy is delivered in a similar way, ...

  10. Development of irradiation support devices for production of brachytherapy seeds

    Energy Technology Data Exchange (ETDEWEB)

    Mattos, Fabio R.; Rostelato, Maria Elisa C.M.; Zeituni, Carlos A.; Souza, Carla D.; Moura, Joao A.; Peleias Junior, Fernando S.; Karan Junior, Dib; Feher, Anselmo; Oliveira, Tiago B.; Benega, Marcos A.G., E-mail: tiagooliveira298@gmail.com, E-mail: mattos.fr@gmail.com, E-mail: elisaros@ipen.br, E-mail: czeituni@ipen.br, E-mail: carladdsouza@yahoo.com.br, E-mail: jamoura@ipen.br, E-mail: ernandopeleias@gmail.com, E-mail: s, E-mail: dib.karan@usp.br, E-mail: afeher@ipen.br, E-mail: marcosagbenega@gmail.com [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    Ophthalmic tumors treatment with brachytherapy sources has been widely used as a primary or secondary therapy for non-malignant or malignant tumors, for example, choroid melanoma, and retinoblastoma. Ruthenium-106, Iodine-125, Palladium -103, Gold-198 and Iridium-192, are some radionuclides that can be applied for treatment of ocular tumors. These sources are in small sizes (a few millimeters) and different shapes (rods, wires, disks). To ensure high accuracy during treatment, they are positioned in eye applicators, specially designed to fit on the surface of tumor. The Nuclear and Energy Research Institute (IPEN/CNEN) in a partnership with Paulista Medicine School (UNIFESP) created a project that aims to develop a prototype of Iridium-192 seeds for treatment of eye cancer. This seed consists in a core of Ir -Pt alloy (20%-80%) with a length of 3 mm, to be activated in IPEN's IEA-R1 Reactor, and a titanium capsule sealing the core. It was imperative to develop a sustainer device for irradiation. This piece is used to avoid overlapping of one cores and, therefore, avoiding the 'shadow effect' that does not allow full activation of each core due to the high density. (author)

  11. SU-E-T-652: Quantification of Dosimetric Uncertainty of I-125 COMS Eye Plaque

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, C; Ahmad, S; Firestone, B; Johnson, D; Matthiesen, C; De La Fuente Herman, T [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

    2015-06-15

    Purpose: To compare dosimetrically three plan calculation systems (Plato, Varian Brachytherapy, and in-house-made Excel) available for I-125 COMS eye plaque treatment with measurement. Methods: All systems assume homogeneous media and calculations are based on a three-dimensional Cartesian coordinates, Plato and Brachytherapy Planning are based on AAPM TG-43 and the in-house Excel program only on inverse square corrections. Doses at specific depths were measured with EBT3 Gafchromic film from a fully loaded and a partially loaded 16 mm plaque (13 and 8 seeds respectively, I-125, model 6711 GE, Oncura). Measurements took place in a water tank, utilizing solid water blocks and a 3D-printed plaque holder. Taking advantage that gafchromic film has low energy dependence, a dose step wedge was delivered with 6 MV photon beam from a Varian 2100 EX linac for calibration. The gray-scale to dose in cGy was obtained with an Epson Expression 10000 XL scanner in the green channel. Treatment plans were generated for doses of 2200 cGy to a depth of 7 mm, and measurements were taken on a sagittal plane. Results: The calculated dose at the prescription point was 2242, 2344, and 2211 cGy with Excel, Brachyvision and Plato respectively for a fully loaded plaque, for the partially loaded plaque the doses were 2266, 2477, and 2193 cGy respectively. At 5 mm depth the doses for Brachyvision and Plato were comparable (3399 and 3267 cGy respectively), however, the measured dose in film was 3180 cGy which was lower by as much as 6.4% in the fully loaded plaque and 7.6% in the partially loaded plaque. Conclusion: Careful methodology and calibration are essential when measuring doses at specific depth due to the sensitivity and rapid dose fall off of I-125.

  12. A Prospective Quasi-Randomized Comparison of Intraoperatively Built Custom-Linked Seeds Versus Loose Seeds for Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ishiyama, Hiromichi, E-mail: hishiyam@kitasato-u.ac.jp [Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara (Japan); Satoh, Takefumi [Department of Urology, Kitasato University School of Medicine, Sagamihara (Japan); Kawakami, Shogo [Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara (Japan); Tsumura, Hideyasu [Department of Urology, Kitasato University School of Medicine, Sagamihara (Japan); Komori, Shouko [Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara (Japan); Tabata, Ken-ichi [Department of Urology, Kitasato University School of Medicine, Sagamihara (Japan); Sekiguchi, Akane [Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara (Japan); Takahashi, Ryo [Department of Urology, Kitasato University School of Medicine, Sagamihara (Japan); Soda, Itaru; Takenaka, Kouji [Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara (Japan); Iwamura, Masatsugu [Department of Urology, Kitasato University School of Medicine, Sagamihara (Japan); Hayakawa, Kazushige [Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara (Japan)

    2014-09-01

    Purpose: To compare dosimetric parameters, seed migration rates, operation times, and acute toxicities of intraoperatively built custom-linked (IBCL) seeds with those of loose seeds for prostate brachytherapy. Methods and Materials: Participants were 140 patients with low or intermediate prostate cancer prospectively allocated to an IBCL seed group (n=74) or a loose seed group (n=66), using quasirandomization (allocated by week of the month). All patients underwent prostate brachytherapy using an interactive plan technique. Computed tomography and plain radiography were performed the next day and 1 month after brachytherapy. The primary endpoint was detection of a 5% difference in dose to 90% of prostate volume on postimplant computed tomography 1 month after treatment. Seed migration was defined as a seed position >1 cm from the cluster of other seeds on radiography. A seed dropped into the seminal vesicle was also defined as a migrated seed. Results: Dosimetric parameters including the primary endpoint did not differ significantly between groups, but seed migration rate was significantly lower in the IBCL seed group (0%) than in the loose seed group (55%; P<.001). Mean operation time was slightly but significantly longer in the IBCL seed group (57 min) than in the loose seed group (50 min; P<.001). No significant differences in acute toxicities were seen between groups (median follow-up, 9 months). Conclusions: This prospective quasirandomized control trial showed no dosimetric differences between IBCL seed and loose seed groups. However, a strong trend toward decreased postimplant seed migration was shown in the IBCL seed group.

  13. Staff dose of hospitalization in the treatment of patients in ophthalmic brachytherapy with 125 I; Dosis al personal de hospitalizacion en el tratamiento de pacientes de braquiterapia oftalmica con I-125

    Energy Technology Data Exchange (ETDEWEB)

    Terron Leon, J. A.; Gomez Palacios, M.; Moreno Reyes, J. C.; Perales Molina, A.

    2013-07-01

    The objective of this work, therefore, has been the evaluation of the dose levels which nursing staff can receive in care for ophthalmic brachytherapy patients treated with 125 I from measurements made on the same, evaluating, in an experimental way, job security following the PR rules laid down for these treatments. (Author)

  14. Use of brachytherapy with permanent implants of iodine-125 in localized prostate cancer; La curietherapie par implants permanents d'I-125 dans le cancer localise de la prostate

    Energy Technology Data Exchange (ETDEWEB)

    Bladou, F.; Serment, G. [Hopital Salvador, Service d' Urologie, 13 - Marseille (France); Salem, N.; Simonian, M. [Hopital Salvador, Dept. de Radiotherapie, 13 - Marseille (France); Rosello, R.; Ternier, F. [Institut Paoli-Calmettes, Dept. de Radiologie, 13 - Marseille (France)

    2002-07-01

    Approximately 15,000 cases of early stage prostate cancer T1 and T2 are diagnosed every year in France by testing for PSA and performing prostatic biopsies. The treatment of these localized forms is based in most cases on radical prostatectomy or nn external beam radiotherapy. Although the ontological results obtained by these two therapeutic methods are satisfactory and equivalent in the long term, the side effects can be important. For a number of years, trans-perineal brachytherapy using permanent implants of iodine -125 or palladium-103 has proved itself as an alternative therapy with equivalent medium to long-term results. The low urinary, digestive and sexual side effects of prostate brachytherapy are important reasons for the enthusiasm among patients and the medical community for this therapy and the growing number of applications and centres which practice it. In September 1998 we started the prostate brachytherapy programmes- in Marseilles with close collaboration between the department of urology of the Hopital Salvator, and the departments of radiotherapy, medical imaging and medical physics of the Institut Paoli-Calmettes. To date, around 250 patients with localized adenocarcinoma of the prostate have benefited from this alternative therapy in our centre. Preliminary results, with a 3 year-follow-up, are comparable to results published in the literature by pioneer teams. (authors)

  15. Twelve-Month Prostate-Specific Antigen Values and Perineural Invasion as Strong Independent Prognostic Variables of Long-Term Biochemical Outcome After Prostate Seed Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ding, William, E-mail: billyding888@gmail.com [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Lee, John [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Chamberlain, David [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States); Cunningham, James [Carson Urology, Carson City, Nevada (United States); Yang Lixi [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Tay, Jonathan [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States)

    2012-11-15

    Purpose: To determine whether post-treatment prostate-specific antigen (ptPSA) values at 12 months and other clinical parameters predict long-term PSA relapse-free survival (PRFS) following prostate seed brachytherapy. Methods and Materials: Records of 204 hormone-naieve patients with localized adenocarcinoma of the prostate treated at St. Mary's Regional Medical Center in Reno, NV, and at Carson Tahoe Regional Medical Center in Carson City, NV, between 1998 and 2003, using I-125 or Pd-103 seed brachytherapy, were retrospectively analyzed. Treatment planning was done using a preplanned, modified peripheral loading technique. A total of 185 of 204 patients had PSA records at 12 months after implant. Variables included were age, initial pretreatment PSA, Gleason score, T stage, National Comprehensive Cancer Network (NCCN) risk group (RG), perineural invasion (PNI), external beam boost, dose, and ptPSA levels at 12 months with cutpoints at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml. Results: Median follow-up was 80 months, and median age was 69 years. The numbers of patients stratified by NCCN low, intermediate, and high RG were 110:65:10, respectively. Monotherapy and boost prescription doses were 145 Gy and 110 Gy for I-125, and 125 Gy and 100 Gy for Pd-103 seeds, respectively. The median dose (D90) was 95.4% of the prescribed dose. The 5-year PRFS at the 12-months ptPSA levels of {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml were 98.5%, 85.7%, 61.5%, and 22.2%, respectively. The 10-year PRFS at the 12-months ptPSA levels of {<=}1 and 1.01 to 2.00 ng/ml were 90.5% and 85.7%, respectively. In multivariate analysis, both ptPSA and PNI were significant independent predictors of PRFS. Hazard ratios (HR) for ptPSA levels at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml at 12 months were 1, 4.96, 27.57, and 65.10, respectively. PNI had an HR of 6.1 (p = 0.009). Conclusions: Presence of PNI and ptPSA values at 12 months are strong prognostic

  16. Dosimetry consequences of the accuracy at the position of the seeds in a seeds implant of I-125 in prostate; Consecuencias dosimetricas de la exactitud en la posicion de las semilla en un implante de semillas de I-125 en prostata

    Energy Technology Data Exchange (ETDEWEB)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-07-01

    The quality control of equipment used to carry out implants of seeds of low rate in prostate, van destined to watch, the activity of seeds and the calculation of planning both positioning them on the inside of the patient. The objective of this work is, using the Nucletron Spot Pro and SeedSelectron, rating dosimetry possible consequences related to the position of the seeds. (Author)

  17. A comparative study of seed localization and dose calculation on pre- and post-implantation ultrasound and CT images for low-dose-rate prostate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ali, Imad; Algan, Ozer; Thompson, Spencer; Sindhwani, Puneet; Herman, Terence; Cheng, C.-Y.; Ahmad, Salahuddin [Department of Radiation Oncology, University of Oklahoma Health Sciences Center, 825 NE 10th Street, OUPB 1430, Oklahoma City, OK 73104 (United States)], E-mail: iali@ouhsc.edu

    2009-09-21

    This work investigates variation in the volume of the prostate measured at different stages through the prostate brachytherapy procedure for 30 patients treated with I-125 radioactive seeds. The implanted seeds were localized on post-implantation ultrasound (US) images and the effect of prostate enlargement due to edema on dose coverage for 15 patients was studied. The volume of the prostate was measured at four stages as follows: (a) 2-3 weeks prior to implantation using US imaging, (b) then at the start of the intra-operative prostate brachytherapy procedure on the day of the implant, (c) immediately post-implantation using US imaging in the operating room and (d) finally by CT imaging at nearly 4 weeks post-implantation. Comparative prostate volume studies were performed using US imaging stepper and twister modes. For the purpose of this study, the implanted seeds were localized successfully on post-implant ultrasound twister images, retrospectively. The plans using post-implant US imaging were compared with intra-operative plans on US and plans created on CT images. The prostate volume increases about 10 cm{sup 3} on average due to edema induced by needle insertion and seed loading during implantation. The visibility of the implanted seeds on US twister images acquired post-implantation is as good as those on CT images and can be localized and used for dose calculation. The dose coverage represented by parameters such as D90 (dose covering 90% of the volume) and V100 (volume covered by 100% dose) is poorer on plans performed on post-implantation twister US studies than on the intra-operative live plan or the CT scan performed 4 weeks post-operatively. For example, the mean D90 difference on post-implantation US is lower by more than 15% than that on pre-implantation US. The volume enlargement of the prostate due to edema induced by needle insertion and seed placement has a significant effect on the quality of dosimetric coverage in brachytherapy prostate seed

  18. A comparative study of seed localization and dose calculation on pre- and post-implantation ultrasound and CT images for low-dose-rate prostate brachytherapy

    Science.gov (United States)

    Ali, Imad; Algan, Ozer; Thompson, Spencer; Sindhwani, Puneet; Herman, Terence; Cheng, Chih-Yao; Ahmad, Salahuddin

    2009-09-01

    This work investigates variation in the volume of the prostate measured at different stages through the prostate brachytherapy procedure for 30 patients treated with I-125 radioactive seeds. The implanted seeds were localized on post-implantation ultrasound (US) images and the effect of prostate enlargement due to edema on dose coverage for 15 patients was studied. The volume of the prostate was measured at four stages as follows: (a) 2-3 weeks prior to implantation using US imaging, (b) then at the start of the intra-operative prostate brachytherapy procedure on the day of the implant, (c) immediately post-implantation using US imaging in the operating room and (d) finally by CT imaging at nearly 4 weeks post-implantation. Comparative prostate volume studies were performed using US imaging stepper and twister modes. For the purpose of this study, the implanted seeds were localized successfully on post-implant ultrasound twister images, retrospectively. The plans using post-implant US imaging were compared with intra-operative plans on US and plans created on CT images. The prostate volume increases about 10 cm3 on average due to edema induced by needle insertion and seed loading during implantation. The visibility of the implanted seeds on US twister images acquired post-implantation is as good as those on CT images and can be localized and used for dose calculation. The dose coverage represented by parameters such as D90 (dose covering 90% of the volume) and V100 (volume covered by 100% dose) is poorer on plans performed on post-implantation twister US studies than on the intra-operative live plan or the CT scan performed 4 weeks post-operatively. For example, the mean D90 difference on post-implantation US is lower by more than 15% than that on pre-implantation US. The volume enlargement of the prostate due to edema induced by needle insertion and seed placement has a significant effect on the quality of dosimetric coverage in brachytherapy prostate seed

  19. Comparison of implant quality between intraoperatively built custom-linked seeds and loose seeds in permanent prostate brachytherapy using sector analysis.

    Science.gov (United States)

    Katayama, Norihisa; Takemoto, Mitsuhiro; Takamoto, Atsushi; Ihara, Hiroki; Katsui, Kuniaki; Ebara, Shin; Nasu, Yasutomo; Kanazawa, Susumu

    2016-07-01

    We compared the implant quality of intraoperatively built custom-linked (IBCL) seeds with loose seeds in permanent prostate brachytherapy. Between June 2012 and January 2015, 64 consecutive prostate cancer patients underwent brachytherapy with IBCL seeds (n = 32) or loose seeds (n = 32). All the patients were treated with 144 Gy of brachytherapy alone. Brachytherapy was performed using a dynamic dose calculation technique. Computed tomography/magnetic resonance imaging fusion-based dosimetry was performed 1 month after brachytherapy. Post-implant dose-volume histogram (DVH) parameters, prostate sector dosimetry, operation time, seed migration, and toxicities were compared between the IBCL seed group and the loose seed group. A sector analysis tool was used to divide the prostate into six sectors (anterior and posterior sectors at the base, mid-gland, and apex). V100 (95.3% vs 89.7%; P = 0.014) and D90 (169.7 Gy vs 152.6 Gy; P = 0.013) in the anterior base sector were significantly higher in the IBCL seed group than in the loose seed group. The seed migration rate was significantly lower in the IBCL seed group than in the loose seed group (6% vs 66%; P seed was significantly longer in the IBCL seed group than in the loose seed group (1.31 min vs 1.13 min; P = 0.003). Other post-implant DVH parameters and toxicities did not differ significantly between the two groups. Our study showed more dose coverage post-operatively in the anterior base prostate sector and less seed migration in IBCL seed implantation compared with loose seed implantation.

  20. On the feasibility of polyurethane based 3D dosimeters with optical CT for dosimetric verification of low energy photon brachytherapy seeds

    Energy Technology Data Exchange (ETDEWEB)

    Adamson, Justus, E-mail: justus.adamson@duke.edu; Yang, Yun; Juang, Titania; Chisholm, Kelsey; Rankine, Leith; Yin, Fang Fang; Oldham, Mark [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710 (United States); Adamovics, John [Department of Chemistry, Rider University, Lawrenceville, New Jersey 08648 (United States)

    2014-07-15

    Purpose: To investigate the feasibility of and challenges yet to be addressed to measure dose from low energy (effective energy <50 keV) brachytherapy sources (Pd-103, Cs-131, and I-125) using polyurethane based 3D dosimeters with optical CT. Methods: The authors' evaluation used the following sources: models 200 (Pd-103), CS-1 Rev2 (Cs-131), and 6711 (I-125). The authors used the Monte Carlo radiation transport code MCNP5, simulations with the ScanSim optical tomography simulation software, and experimental measurements with PRESAGE{sup ®} dosimeters/optical CT to investigate the following: (1) the water equivalency of conventional (density = 1.065 g/cm{sup 3}) and deformable (density = 1.02 g/cm{sup 3}) formulations of polyurethane dosimeters, (2) the scatter conditions necessary to achieve accurate dosimetry for low energy photon seeds, (3) the change in photon energy spectrum within the dosimeter as a function of distance from the source in order to determine potential energy sensitivity effects, (4) the optimal delivered dose to balance optical transmission (per projection) with signal to noise ratio in the reconstructed dose distribution, and (5) the magnitude and characteristics of artifacts due to the presence of a channel in the dosimeter. Monte Carlo simulations were performed using both conventional and deformable dosimeter formulations. For verification, 2.8 Gy at 1 cm was delivered in 92 h using an I-125 source to a PRESAGE{sup ®} dosimeter with conventional formulation and a central channel with 0.0425 cm radius for source placement. The dose distribution was reconstructed with 0.02 and 0.04 cm{sup 3} voxel size using the Duke midsized optical CT scanner (DMOS). Results: While the conventional formulation overattenuates dose from all three sources compared to water, the current deformable formulation has nearly water equivalent attenuation properties for Cs-131 and I-125, while underattenuating for Pd-103. The energy spectrum of each source is

  1. On the feasibility of polyurethane based 3D dosimeters with optical CT for dosimetric verification of low energy photon brachytherapy seeds.

    Science.gov (United States)

    Adamson, Justus; Yang, Yun; Juang, Titania; Chisholm, Kelsey; Rankine, Leith; Adamovics, John; Yin, Fang Fang; Oldham, Mark

    2014-07-01

    To investigate the feasibility of and challenges yet to be addressed to measure dose from low energy (effective energy brachytherapy sources (Pd-103, Cs-131, and I-125) using polyurethane based 3D dosimeters with optical CT. The authors' evaluation used the following sources: models 200 (Pd-103), CS-1 Rev2 (Cs-131), and 6711 (I-125). The authors used the Monte Carlo radiation transport code MCNP5, simulations with the ScanSim optical tomography simulation software, and experimental measurements with PRESAGE(®) dosimeters/optical CT to investigate the following: (1) the water equivalency of conventional (density = 1.065 g/cm(3)) and deformable (density = 1.02 g/cm(3)) formulations of polyurethane dosimeters, (2) the scatter conditions necessary to achieve accurate dosimetry for low energy photon seeds, (3) the change in photon energy spectrum within the dosimeter as a function of distance from the source in order to determine potential energy sensitivity effects, (4) the optimal delivered dose to balance optical transmission (per projection) with signal to noise ratio in the reconstructed dose distribution, and (5) the magnitude and characteristics of artifacts due to the presence of a channel in the dosimeter. Monte Carlo simulations were performed using both conventional and deformable dosimeter formulations. For verification, 2.8 Gy at 1 cm was delivered in 92 h using an I-125 source to a PRESAGE(®) dosimeter with conventional formulation and a central channel with 0.0425 cm radius for source placement. The dose distribution was reconstructed with 0.02 and 0.04 cm(3) voxel size using the Duke midsized optical CT scanner (DMOS). While the conventional formulation overattenuates dose from all three sources compared to water, the current deformable formulation has nearly water equivalent attenuation properties for Cs-131 and I-125, while underattenuating for Pd-103. The energy spectrum of each source is relatively stable within the first 5 cm especially for I-125

  2. Automatic segmentation of seeds and fluoroscope tracking (FTRAC) fiducial in prostate brachytherapy x-ray images

    Science.gov (United States)

    Kuo, Nathanael; Lee, Junghoon; Deguet, Anton; Song, Danny; Burdette, E. Clif; Prince, Jerry

    2010-02-01

    C-arm X-ray fluoroscopy-based radioactive seed localization for intraoperative dosimetry of prostate brachytherapy is an active area of research. The fluoroscopy tracking (FTRAC) fiducial is an image-based tracking device composed of radio-opaque BBs, lines, and ellipses that provides an effective means for pose estimation so that three-dimensional reconstruction of the implanted seeds from multiple X-ray images can be related to the ultrasound-computed prostate volume. Both the FTRAC features and the brachytherapy seeds must be segmented quickly and accurately during the surgery, but current segmentation algorithms are inhibitory in the operating room (OR). The first reason is that current algorithms require operators to manually select a region of interest (ROI), preventing automatic pipelining from image acquisition to seed reconstruction. Secondly, these algorithms fail often, requiring operators to manually correct the errors. We propose a fast and effective ROI-free automatic FTRAC and seed segmentation algorithm to minimize such human intervention. The proposed algorithm exploits recent image processing tools to make seed reconstruction as easy and convenient as possible. Preliminary results on 162 patient images show this algorithm to be fast, effective, and accurate for all features to be segmented. With near perfect success rates and subpixel differences to manual segmentation, our automatic FTRAC and seed segmentation algorithm shows promising results to save crucial time in the OR while reducing errors.

  3. Real-time electromagnetic seed drop detection for permanent implants brachytherapy: Technology overview and performance assessment.

    Science.gov (United States)

    Racine, E; Hautvast, G; Binnekamp, D; Beaulieu, L

    2016-12-01

    To describe the principles and report on the performance of a novel real-time electromagnetic (EM) seed drop detection technology for permanent implants brachytherapy procedures. A novel EM hollow needle prototype was recently developed by Philips. It possesses standard 3D tracking capability as well as a seed drop detection mechanism, both performed from a single custom built EM sensor. The detection mechanism is based on the magnetic permeability changes in the sensor as the seeds pass through. Drop position estimates are generated by the tracking information at the dropping instants. Three validation experiments were carried out in this study. First, the robustness of the detection mechanism was tested in free air with four different seed types. Detection waveforms were measured and commented. The accuracy of the seed drop position estimates was then evaluated using both 2D and 3D experiments. The procedures consisted of dropping seeds in phantoms, recording the drop position estimates, and finally registering the resulting spatial distributions on reference ones obtained by accurate modalities. Seeds were dropped on a specially designed plastic support adapted to brachytherapy template dimensions for 2D experiments, and true seed positions (reference distribution) were obtained by optical detection. In 3D experiments, seeds were dropped in edible gelatin and reference distributions were obtained by localizing the implants from CT scans of the phantoms. All four seed types were correctly detected by the needle prototype. In total, 250 seeds were dropped on the plastic support, and 96 were dropped in gelatin phantoms. The detection rate was 100% in both cases. The minimum, maximum, and average drop position errors were, respectively, 0.1(+1.6/ - 0.1), 2.9(+1.4/ - 1.5), and 0.9(+1.4/ - 0.7) mm for 2D, and 0.1(+1.0/ - 0.1), 2.1(+1.1/ - 0.8), and 0.6(+1.2/ - 0.5) mm for 3D experiments. The hollow needle prototype combines both EM tracking and automatic seed drop

  4. Radiological response of lanthanum guiding seeds in brachytherapy implants; Resposta radiologica de sementes guia de lantanio em implantes braquiterapicos

    Energy Technology Data Exchange (ETDEWEB)

    Silva, L.S.R.; Machado, E.D.P., E-mail: lais26@globo.com [Centro Federal de Educacao Tecnologica de Minas Gerais, Belo Horizonte, MG (Brazil). Departamento de Engenharia de Materiais; Campos, T.P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Roberto, W.S. [Centro Federal de Educacao Tecnologica de Minas Gerais, Belo Horizonte, MG (Brazil). Departamento de Fisica e Matematica

    2013-08-15

    Ceramic seeds with La-139 incorporated were synthesized to be used as radiological guides in brachytherapy implants. The synthesis was performed based on the sol-gel method. The seeds were subjected to characterization by Scanning Electron Microscopy, X-ray diffraction and Energy-Dispersive X-ray Spectroscopy. Furthermore, the contrast from a radiographic film was evaluated to lanthanum, samarium and holmium seeds. Radiological response on a phantom at different depths with lanthanum seeds and metal seeds was also investigated. Based on the values of contrast, the synthesized lanthanum seeds can be considered efficient as radiological guides when implanted together with pure Ho-165 and Sm-152 seeds. (author)

  5. Demonstration of a forward iterative method to reconstruct brachytherapy seed configurations from x-ray projections

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Martin J; Todor, Dorin A [Department of Radiation Oncology, Virginia Commonwealth University, Richmond VA 23298 (United States)

    2005-06-07

    By monitoring brachytherapy seed placement and determining the actual configuration of the seeds in vivo, one can optimize the treatment plan during the process of implantation. Two or more radiographic images from different viewpoints can in principle allow one to reconstruct the configuration of implanted seeds uniquely. However, the reconstruction problem is complicated by several factors: (1) the seeds can overlap and cluster in the images; (2) the images can have distortion that varies with viewpoint when a C-arm fluoroscope is used; (3) there can be uncertainty in the imaging viewpoints; (4) the angular separation of the imaging viewpoints can be small owing to physical space constraints; (5) there can be inconsistency in the number of seeds detected in the images; and (6) the patient can move while being imaged. We propose and conceptually demonstrate a novel reconstruction method that handles all of these complications and uncertainties in a unified process. The method represents the three-dimensional seed and camera configurations as parametrized models that are adjusted iteratively to conform to the observed radiographic images. The morphed model seed configuration that best reproduces the appearance of the seeds in the radiographs is the best estimate of the actual seed configuration. All of the information needed to establish both the seed configuration and the camera model is derived from the seed images without resort to external calibration fixtures. Furthermore, by comparing overall image content rather than individual seed coordinates, the process avoids the need to establish correspondence between seed identities in the several images. The method has been shown to work robustly in simulation tests that simultaneously allow for unknown individual seed positions, uncertainties in the imaging viewpoints and variable image distortion.

  6. Demonstration of a forward iterative method to reconstruct brachytherapy seed configurations from x-ray projections

    Science.gov (United States)

    Murphy, Martin J.; Todor, Dorin A.

    2005-06-01

    By monitoring brachytherapy seed placement and determining the actual configuration of the seeds in vivo, one can optimize the treatment plan during the process of implantation. Two or more radiographic images from different viewpoints can in principle allow one to reconstruct the configuration of implanted seeds uniquely. However, the reconstruction problem is complicated by several factors: (1) the seeds can overlap and cluster in the images; (2) the images can have distortion that varies with viewpoint when a C-arm fluoroscope is used; (3) there can be uncertainty in the imaging viewpoints; (4) the angular separation of the imaging viewpoints can be small owing to physical space constraints; (5) there can be inconsistency in the number of seeds detected in the images; and (6) the patient can move while being imaged. We propose and conceptually demonstrate a novel reconstruction method that handles all of these complications and uncertainties in a unified process. The method represents the three-dimensional seed and camera configurations as parametrized models that are adjusted iteratively to conform to the observed radiographic images. The morphed model seed configuration that best reproduces the appearance of the seeds in the radiographs is the best estimate of the actual seed configuration. All of the information needed to establish both the seed configuration and the camera model is derived from the seed images without resort to external calibration fixtures. Furthermore, by comparing overall image content rather than individual seed coordinates, the process avoids the need to establish correspondence between seed identities in the several images. The method has been shown to work robustly in simulation tests that simultaneously allow for unknown individual seed positions, uncertainties in the imaging viewpoints and variable image distortion.

  7. Photoacoustic-guided focused ultrasound for accurate visualization of brachytherapy seeds with the photoacoustic needle

    Science.gov (United States)

    Singh, Mithun Kuniyil Ajith; Parameshwarappa, Vinay; Hendriksen, Ellen; Steenbergen, Wiendelt; Manohar, Srirang

    2016-12-01

    An important problem in minimally invasive photoacoustic (PA) imaging of brachytherapy seeds is reflection artifacts caused by the high signal from the optical fiber/needle tip reflecting off the seed. The presence of these artifacts confounds interpretation of images. In this letter, we demonstrate a recently developed concept called photoacoustic-guided focused ultrasound (PAFUSion) for the first time in the context of interstitial illumination PA imaging to identify and remove reflection artifacts. In this method, ultrasound (US) from the transducer is focused on the region of the optical fiber/needle tip identified in a first step using PA imaging. The image developed from the US diverging from the focus zone at the tip region visualizes only the reflections from seeds and other acoustic inhomogeneities, allowing identification of the reflection artifacts of the first step. These artifacts can then be removed from the PA image. Using PAFUSion, we demonstrate reduction of reflection artifacts and thereby improved interstitial PA visualization of brachytherapy seeds in phantom and ex vivo measurements on porcine tissue.

  8. Seed loss in prostate brachytherapy. Operator dependency and impact on dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    El-Bared, Nancy; Sebbag, Natanel; Beliveau-Nadeau, Dominic; Hervieux, Yannick; Larouche, Renee; Taussky, Daniel; Delouya, Guila [Centre hospitalier de l' Universite de Montreal - Hopital Notre-Dame, Departement de Radio-Oncologie, Montreal, QC (Canada)

    2016-05-15

    The aim of our study was to review seed loss and its impact on dosimetry as well as the influence of the treating physician on seed loss and dosimetry in patients treated with prostate brachytherapy using permanent loose {sup 125}I implant. We analyzed 1087 consecutive patients treated by two physicians between July 2005 and April 2015 at a single institution. Pelvic fluoroscopic imaging was done 30 days post implant and a chest X-ray when seed loss was observed. Seed loss occurred in 19.4 % of patients: in 20.0 % of implants done by the most experienced physician and in 17.2 % by the less experienced physician (p = 0.4) and migration to the thorax occurred in 5.9 % (6.9 vs. 2.2 %, p = 0.004). The mean seed loss rate was 0.57 % [standard deviation (SD) 1.39] and the mean rate of seeds in the thorax was 0.14 % (SD 0.65). The most experienced physician had a higher mean number of seeds lost: 0.36 versus 0.25 (p = 0.055), and a higher mean number of seed migration to the thorax: 0.1 versus 0.02 (p < 0.001). When at least one seed was lost, a decrease of 4.2 Gy (p < 0.001) in the D90 and a decrease of 3.5 % (p = 0.002) in the V150 was observed. We found a significant decrease in V150 and D90 with the occurrence of seed loss. Furthermore, we found a difference in seed migration among the physicians demonstrating that seed loss is operator dependant. (orig.) [German] Wir analysierten den Prozentsatz des Seed-Verlusts sowie den Einfluss von Arzterfahrung und Seed-Abgang auf die Dosimetrie bei Patienten, die mit einer Prostata-Brachytherapie mit permanent beweglichen {sup 125}I-Implantaten behandelt wurden. Eingeschlossen in diese Studie wurden alle zwischen Juli 2005 und April 2015 an unserem Krankenhaus von zwei Aerzten konsekutiv behandelten 1087 Patienten. Anhand fluoroskopischer Bilder wurden noch vorhandene Seeds 30 Tage nach dem Eingriff gezaehlt. Bei unvollstaendiger Seed-Anzahl wurde ein Thorax-Roentgenbild angefertigt. In 19% der Patienten ging mindestens ein

  9. Recognition of Radiological Protection of Ward Staff after Brachytherapy for Malignant Tumor with Radioiodine Seeds

    Directory of Open Access Journals (Sweden)

    HU Shu

    2016-02-01

    Full Text Available Through radiation measurement of the patients after brachytherapy with radioiodine seeds for malignant tumor at different distances and shielding condition, the importance, optimization and individualization of the radiological protection are well recognized. The 35 patients were randomly selected in the minimally invasive interventional ward of Peking University Shenzhen Hospital who underwent brachytherapy for malignant tumor with radioiodine seeds. Within 2 hours after the brachytherapy, the radiation of the patients without shielding, with 0.25 mmPb and 0.5 mmPb shielding were detected by an x-γ ray detector at different distances (equivalent dose rate. The results were analysed by SPSS19.0 t test. Annual equivalent dose was calculated by the average close contact time (two hours everyone per day. The average annual equivalent dose of the 35 patients without shielding was below 20 mSv at 0.5 meter, close to the public limit 1 mSv at 2 meters and equivalent to the background at 4 meters. Under 0.25 mmPb shielding, 6 patients’ radiation was still above the pubic limit, although the average radiation of the 35 patients was below the pubic limit; under 0.5 mmPb shielding, all patients’ radiation was nearly equivalent to the background at 0 meter. The results showed that among the time, distance and shielded protection, the individual radiological protection was especially important. The 0.25 mmPb lead cushion was the most commonly used shield. The 0.5 mmPb lead cushion also should be used in case of the large number of radioiodine seeds implantation and/or more superficial implant site, so as to ensure the individualization and optimization in radiological protection.

  10. Measurement uncertainty analysis of low-dose-rate prostate seed brachytherapy: post-implant dosimetry.

    Science.gov (United States)

    Gregory, Kent J; Pattison, John E; Bibbo, Giovanni

    2015-03-01

    The minimal dose covering 90 % of the prostate volume--D 90--is arguably the most important dosimetric parameter in low-dose-rate prostate seed brachytherapy. In this study an analysis of the measurement uncertainties in D 90 from low-dose-rate prostate seed brachytherapy was conducted for two common treatment procedures with two different post-implant dosimetry methods. The analysis was undertaken in order to determine the magnitude of D 90 uncertainty, how the magnitude of the uncertainty varied when D 90 was calculated using different dosimetry methods, and which factors were the major contributors to the uncertainty. The analysis considered the prostate as being homogeneous and tissue equivalent and made use of published data, as well as original data collected specifically for this analysis, and was performed according to the Guide to the expression of uncertainty in measurement (GUM). It was found that when prostate imaging and seed implantation were conducted in two separate sessions using only CT images for post-implant analysis, the expanded uncertainty in D 90 values were about 25 % at the 95 % confidence interval. When prostate imaging and seed implantation were conducted during a single session using CT and ultrasound images for post-implant analysis, the expanded uncertainty in D 90 values were about 33 %. Methods for reducing these uncertainty levels are discussed. It was found that variations in contouring the target tissue made the largest contribution to D 90 uncertainty, while the uncertainty in seed source strength made only a small contribution. It is important that clinicians appreciate the overall magnitude of D 90 uncertainty and understand the factors that affect it so that clinical decisions are soundly based, and resources are appropriately allocated.

  11. Seed displacements after permanent brachytherapy for prostate cancer in dependence on the prostate level

    Energy Technology Data Exchange (ETDEWEB)

    Pinkawa, M.; Gagel, B.; Asadpour, B.; Piroth, M.D.; Klotz, J.; Eble, M.J. [Dept. of Radiotherapy, RWTH Aachen (Germany); Borchers, H.; Jakse, G. [Dept. of Urology, RWTH Aachen (Germany)

    2008-10-15

    Purpose: to evaluate seed displacements after permanent prostate brachytherapy considering different prostate levels. Patients and methods: in 61 patients, postimplant CT scans were performed 1 day and 1 month after an implant with stranded seeds. Seed and prostate surface displacements were determined relative to pelvic bones. Four groups of seed locations were selected: seeds at the base (n = 305; B), at the apex (n = 305; A), close to the urethra (n = 306; U), and close to the rectal wall (n = 204; R). The length of two strands (always containing four seeds) per patient was measured in all CT scans and compared. Results: the largest inferior seed displacements were found at the base: mean 5.3 mm (B), 2.2 mm (A), 2.7 mm (U), 3.3 mm (R; p < 0.001). Posterior displacements predominated both at the base and the central region: mean 2.2 mm (B), 2.0 mm (U), 0.8 mm (A), -0.6 mm (R; p < 0.001). With a decreasing edema between day 1 and 30 (mean prostate volume of 51 cm{sup 3} vs. 41 cm{sup 3}; p < 0.001), a mean caudal prostate base displacement of 3.9 mm was found, whereas the mean inward displacement ranged from 1.2 to 1.6 mm at the remaining borders (lateral, anterior, posterior, apical). The analysis of the strand lengths revealed an implant compression between day 1 and 30 (mean 1.7 mm; p < 0.001). Conclusion: the largest prostate tissue and seed displacements were observed at the prostate base, associated with an implant compression. Predominantly inferior and posterior displacements implicate consequential smaller preplanning margins at the apex and the posterior prostate. (orig.)

  12. Energy deposition model for I-125 photon radiation in water

    Energy Technology Data Exchange (ETDEWEB)

    Fuss, M.C.; Garcia, G. [Instituto de Fisica Fundamental, Consejo Superior de Investigaciones Cientificas (CSIC), Madrid (Spain); Munoz, A.; Oller, J.C. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas (CIEMAT), Madrid (Spain); Blanco, F. [Departamento de Fisica Atomica, Molecular y Nuclear, Universidad Complutense de Madrid (Spain); Limao-Vieira, P. [Laboratorio de Colisoes Atomicas e Moleculares, Departamento de Fisica, CEFITEC, FCT-Universidade Nova de Lisboa, Caparica (Portugal); Williart, A.; Garcia, G. [Departamento de Fisica de los Materiales, Universidad Nacional de Educacion a Distancia, Madrid (Spain); Huerga, C.; Tellez, M. [Hospital Universitario La Paz, Madrid (Spain)

    2010-10-15

    In this study, an electron-tracking Monte Carlo algorithm developed by us is combined with established photon transport models in order to simulate all primary and secondary particle interactions in water for incident photon radiation. As input parameters for secondary electron interactions, electron scattering cross sections by water molecules and experimental energy loss spectra are used. With this simulation, the resulting energy deposition can be modelled at the molecular level, yielding detailed information about localization and type of single collision events. The experimental emission spectrum of I-125 seeds, as used for radiotherapy of different tumours, was used for studying the energy deposition in water when irradiating with this radionuclide. (authors)

  13. SU-E-J-233: Effect of Brachytherapy Seed Artifacts in T2 and Proton Density Maps in MR Images

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, S [Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); University of Toronto, Dept of Radiation Oncology, Toronto, Ontario (Canada); Fatemi-Ardekani, A [Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); Sunnybrook Research Institute, Toronto, Ontario (Canada); Song, W [Sunnybrook Odette Cancer Centre, Toronto, Ontario (Canada); University of Toronto, Dept of Radiation Oncology, Toronto, Ontario (Canada); Sunnybrook Research Institute, Toronto, Ontario (Canada)

    2015-06-15

    Purpose: This study aims at investigating the influence of brachytherapy seeds on T2 and proton density (PD) maps generated from MR images. Proton density maps can be used to extract water content. Since dose absorbed in tissue surrounding low energy brachytherapy seeds are highly influenced by tissue composition, knowing the water content is a first step towards implementing a heterogeneity correction algorithm using MR images. Methods: An LDR brachytherapy (IsoAid Advantage Pd-103) seed was placed in the middle of an agar-based gel phantom and imaged using a 3T Philips MR scanner with a 168-channel head coil. A multiple echo sequence with TE=20, 40, 60, 80, 100 (ms) with large repetition time (TR=6259ms) was used to extract T2 and PD maps. Results: Seed artifacts were considerably reduced on T2 maps compared to PD maps. The variation of PD around the mean was obtained as −97% to 125% (±1%) while for T2 it was recorded as −71% to 24% (±1%). Conclusion: PD maps which are required for heterogeneity corrections are susceptible to artifacts from seeds. Seed artifacts on T2 maps, however, are significantly reduced due to not being sensitive to B0 field variation.

  14. Development of an encapsulation method using plasma arc welding to produce iodine-125 seeds for brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Feher, Anselmo; Calvo, Wilson A.P.; Rostelato, Maria E.C.M.; Zeituni, Carlos A.; Somessari, Samir L.; Costa, Osvaldo L.; Moura, Joao A.; Moura, Eduardo S.; Souza, Carla D.; Rela, Paulo R., E-mail: afeher@ipen.b, E-mail: wapcalvo@ipen.b, E-mail: elisaros@ipen.b, E-mail: somessar@ipen.b, E-mail: olcosta@ipen.b, E-mail: esmoura@ipen.b, E-mail: cdsouza@ipen.b, E-mail: prela@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The prostate cancer, which is the second cause of death by cancer in men, overcome only by lung cancer is public health problem in Brazil. Brachytherapy is among the possible available treatments for prostate cancer, in which small seeds containing Iodine-125 radioisotope are implanted into the prostate gland. The seed consists of a titanium sealed capsule with 0.8 mm external diameter and 4.5 mm length, containing a central silver wire with adsorbed Iodine-125. The Plasma Arc Welding (PAW) is one of the viable techniques for sealing process. The equipment used in this technique is less costly than in other processes, such as, Laser Beam Welding (LBW). The main purpose of this work was the development of an encapsulation method using PAW. The development of this work has presented the following phases: cutting and cleaning titanium tube, determination of the welding parameters, development of a titanium tube holding device for PAW, sealed sources validation according to ISO 2919 - Sealed Radioactive Sources - General Requirements and Classification, and metallographic assays. The developed procedure to seal Iodine-125 seeds using PAW has shown high efficiency, satisfying all the established requirements of ISO 2919. The results obtained in this work will give the possibility to establish a routine production process according to the orientations presented in resolution RDC 17 - Good Manufacturing Practices to Medical Products defined by the ANVISA - National Agency of Sanitary Surveillance. (author)

  15. CT image artifacts from brachytherapy seed implants: a postprocessing 3D adaptive median filter.

    Science.gov (United States)

    Basran, Parminder S; Robertson, Andrew; Wells, Derek

    2011-02-01

    To design a postprocessing 3D adaptive median filter that minimizes streak artifacts and improves soft-tissue contrast in postoperative CT images of brachytherapy seed implantations. The filter works by identifying voxels that are likely streaks and estimating more reflective voxel intensity by using voxel intensities in adjacent CT slices and applying a median filter over voxels not identified as seeds. Median values are computed over a 5 x 5 x 5 mm region of interest (ROI) within the CT volume. An acrylic phantom simulating a clinical seed implant arrangement and containing nonradioactive seeds was created. Low contrast subvolumes of tissuelike material were also embedded in the phantom. Pre- and postprocessed image quality metrics were compared using the standard deviation of ROIs between the seeds, the CT numbers of low contrast ROIs embedded within the phantom, the signal to noise ratio (SNR), and the contrast to noise ratio (CNR) of the low contrast ROIs. The method was demonstrated with a clinical postimplant CT dataset. After the filter was applied, the standard deviation of CT values in streak artifact regions was significantly reduced from 76.5 to 7.2 HU. Within the observable low contrast plugs, the mean of all ROI standard deviations was significantly reduced from 60.5 to 3.9 HU, SNR significantly increased from 2.3 to 22.4, and CNR significantly increased from 0.2 to 4.1 (all P mean CT in the low contrast plugs remained within 5 HU of the original values. An efficient postprocessing filter that does not require access to projection data, which can be applied irrespective of CT scan parameters has been developed, provided the slice thickness and spacing is 3 mm or less.

  16. CT image artifacts from brachytherapy seed implants: A postprocessing 3D adaptive median filter

    Energy Technology Data Exchange (ETDEWEB)

    Basran, Parminder S.; Robertson, Andrew; Wells, Derek [Department of Medical Physics, Vancouver Island Cancer Centre, 2410 Lee Avenue, Victoria, British Columbia V8R 6V5 (Canada) and Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8W 3P6 (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8W 3P6 (Canada); Department of Medical Physics, Vancouver Island Cancer Centre, 2410 Lee Avenue, Victoria, British Columbia V8R 6V5 (Canada) and Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8W 3P6 (Canada)

    2011-02-15

    Purpose: To design a postprocessing 3D adaptive median filter that minimizes streak artifacts and improves soft-tissue contrast in postoperative CT images of brachytherapy seed implantations. Methods: The filter works by identifying voxels that are likely streaks and estimating more reflective voxel intensity by using voxel intensities in adjacent CT slices and applying a median filter over voxels not identified as seeds. Median values are computed over a 5x5x5 mm region of interest (ROI) within the CT volume. An acrylic phantom simulating a clinical seed implant arrangement and containing nonradioactive seeds was created. Low contrast subvolumes of tissuelike material were also embedded in the phantom. Pre- and postprocessed image quality metrics were compared using the standard deviation of ROIs between the seeds, the CT numbers of low contrast ROIs embedded within the phantom, the signal to noise ratio (SNR), and the contrast to noise ratio (CNR) of the low contrast ROIs. The method was demonstrated with a clinical postimplant CT dataset. Results: After the filter was applied, the standard deviation of CT values in streak artifact regions was significantly reduced from 76.5 to 7.2 HU. Within the observable low contrast plugs, the mean of all ROI standard deviations was significantly reduced from 60.5 to 3.9 HU, SNR significantly increased from 2.3 to 22.4, and CNR significantly increased from 0.2 to 4.1 (all P<0.01). The mean CT in the low contrast plugs remained within 5 HU of the original values. Conclusion: An efficient postprocessing filter that does not require access to projection data, which can be applied irrespective of CT scan parameters has been developed, provided the slice thickness and spacing is 3 mm or less.

  17. An open-source genetic algorithm for determining optimal seed distributions for low-dose-rate prostate brachytherapy.

    Science.gov (United States)

    McGeachy, P; Madamesila, J; Beauchamp, A; Khan, R

    2015-01-01

    An open source optimizer that generates seed distributions for low-dose-rate prostate brachytherapy was designed, tested, and validated. The optimizer was a simple genetic algorithm (SGA) that, given a set of prostate and urethra contours, determines the optimal seed distribution in terms of coverage of the prostate with the prescribed dose while avoiding hotspots within the urethra. The algorithm was validated in a retrospective study on 45 previously contoured low-dose-rate prostate brachytherapy patients. Dosimetric indices were evaluated to ensure solutions adhered to clinical standards. The SGA performance was further benchmarked by comparing solutions obtained from a commercial optimizer (inverse planning simulated annealing [IPSA]) with the same cohort of 45 patients. Clinically acceptable target coverage by the prescribed dose (V100) was obtained for both SGA and IPSA, with a mean ± standard deviation of 98 ± 2% and 99.5 ± 0.5%, respectively. For the prostate D90, SGA and IPSA yielded 177 ± 8 Gy and 186 ± 7 Gy, respectively, which were both clinically acceptable. Both algorithms yielded reasonable dose to the rectum, with V100 open source SGA was validated that provides a research tool for the brachytherapy community. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. Prostate brachytherapy postimplant dosimetry: Seed orientation and the impact of dosimetric anisotropy in stranded implants

    Energy Technology Data Exchange (ETDEWEB)

    Chng, Nicholas; Spadinger, Ingrid; Rasoda, Rosey; Morris, W. James; Salcudean, Septimiu [Department of Medical Physics, British Columbia Cancer Agency, Vancouver Cancer Centre, 600 West 10th, Vancouver, British Columbia V5Z 4E6 (Canada); Department of Electrical and Computer Engineering, University of British Columbia, 5500-2332 Main Mall, Vancouver, British Columbia V6T 1Z4 (Canada); Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Cancer Centre, 600 West 10th, Vancouver, British Columbia V5Z 4E6 (Canada); Department of Electrical and Computer Engineering, University of British Columbia, 5500-2332 Main Mall, Vancouver, British Columbia V6T 1Z4 (Canada)

    2012-02-15

    Purpose: In postimplant dosimetry for prostate brachytherapy, dose is commonly calculated using the TG-43 1D formalism, because seed orientations are difficult to determine from CT images, the current standard for the procedure. However, the orientation of stranded seeds soon after implantation is predictable, as these seeds tend to maintain their relative spacing, and orient themselves along the implant trajectory. The aim of this study was to develop a method for determining seed orientations from reconstructed strand trajectories, and to use this information to investigate the dosimetric impact of applying the TG-43 2D formalism to clinical postimplant analysis. Methods: Using in-house software, the preplan to postimplant seed correspondence was determined for a cohort of 30 patients during routine day-0 CT-based postimplant dosimetry. All patients were implanted with stranded-seed trains. Spline curves were fit to each set of seeds composing a strand, with the requirement that the distance along the spline between seeds be equal to the seed spacing within the strand. The orientations of the seeds were estimated by the tangents to the spline at each seed centroid. Dose distributions were then determined using the 1D and 2D TG-43 formalisms. These were compared using the TG-137 recommended dose metrics for the prostate, prostatic urethra, and rectum. Results: Seven hundred and sixty one strands were analyzed in total. Defining the z-axis to be cranial-positive and the x-axis to be left-lateral positive in the CT coordinate system, the average seed had an inclination of 21 deg. {+-} 10 deg. and an azimuth of -81 deg. {+-} 57 deg. These values correspond to the average strand rising anteriorly from apex to base, approximately parallel to the midsagittal plane. Clinically minor but statistically significant differences in dose metrics were noted. Compared to the 2D calculation, the 1D calculation underestimated prostate V100 by 1.1% and D90 by 2.3 Gy, while

  19. MAGNETIC RESONANCE IMAGING COMPATIBLE ROBOTIC SYSTEM FOR FULLY AUTOMATED BRACHYTHERAPY SEED PLACEMENT

    Science.gov (United States)

    Muntener, Michael; Patriciu, Alexandru; Petrisor, Doru; Mazilu, Dumitru; Bagga, Herman; Kavoussi, Louis; Cleary, Kevin; Stoianovici, Dan

    2011-01-01

    Objectives To introduce the development of the first magnetic resonance imaging (MRI)-compatible robotic system capable of automated brachytherapy seed placement. Methods An MRI-compatible robotic system was conceptualized and manufactured. The entire robot was built of nonmagnetic and dielectric materials. The key technology of the system is a unique pneumatic motor that was specifically developed for this application. Various preclinical experiments were performed to test the robot for precision and imager compatibility. Results The robot was fully operational within all closed-bore MRI scanners. Compatibility tests in scanners of up to 7 Tesla field intensity showed no interference of the robot with the imager. Precision tests in tissue mockups yielded a mean seed placement error of 0.72 ± 0.36 mm. Conclusions The robotic system is fully MRI compatible. The new technology allows for automated and highly accurate operation within MRI scanners and does not deteriorate the MRI quality. We believe that this robot may become a useful instrument for image-guided prostate interventions. PMID:17169653

  20. A neutron activation system for Ho, HoZr and Sm brachytherapy seeds for breast radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Wagner L., E-mail: wagner.leite@ifmg.edu.br [Instituto Federal de Minas Gerais (IFMG), Congonhas, MG (Brazil). Departamento de Fisica; Campos, Tarcisio P.R., E-mail: tprcampos@pq.cnpq.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

    2015-07-01

    This paper addresses a device designed for transmuting nuclides by means of neutron capture reactions. The device is composed by a neutron generator based on d-d reactions, a neutron moderator and a reflection system, enclosed by a radiation shield. The project was modeled on the CST electromagnetic code. Afterwards, a nuclear investigation was carried out by MCNP5 code, where the final activities of a large set of 0.5 x 1.8 mm cylindrical, biodegradable and biocompatible, Ho-165 (Ho and HoZr) and Sm-152 breast brachytherapy seeds were evaluated, considering the neutron capture reactions. The accelerator-head equipotential profiles and the optical beam of deuterons with its energy map were presented. The neutronic evaluation allowed estimating a neutron yield of 10{sup 13} n s{sup -1}. From the seed's group, an individual Ho-166 seed reached activity of 100 MBq in 58 h operation time. Moreover, Sm-153 seed reached 120 MBq during a period of 64 h of operation. The system shows to be able to provide the neutron activation of brachytherapy seeds with suitable individual specific activity able for controlling breast tumors. (author)

  1. Brachytherapy seed and applicator localization via iterative forward projection matching algorithm using digital X-ray projections

    Science.gov (United States)

    Pokhrel, Damodar

    Interstitial and intracavitary brachytherapy plays an essential role in management of several malignancies. However, the achievable accuracy of brachytherapy treatment for prostate and cervical cancer is limited due to the lack of intraoperative planning and adaptive replanning. A major problem in implementing TRUS-based intraoperative planning is an inability of TRUS to accurately localize individual seed poses (positions and orientations) relative to the prostate volume during or after the implantation. For the locally advanced cervical cancer patient, manual drawing of the source positions on orthogonal films can not localize the full 3D intracavitary brachytherapy (ICB) applicator geometry. A new iterative forward projection matching (IFPM) algorithm can explicitly localize each individual seed/applicator by iteratively matching computed projections of the post-implant patient with the measured projections. This thesis describes adaptation and implementation of a novel IFPM algorithm that addresses hitherto unsolved problems in localization of brachytherapy seeds and applicators. The prototype implementation of 3-parameter point-seed IFPM algorithm was experimentally validated using a set of a few cone-beam CT (CBCT) projections of both the phantom and post-implant patient's datasets. Geometric uncertainty due to gantry angle inaccuracy was incorporated. After this, IFPM algorithm was extended to 5-parameter elongated line-seed model which automatically reconstructs individual seed orientation as well as position. The accuracy of this algorithm was tested using both the synthetic-measured projections of clinically-realistic Model-6711 125I seed arrangements and measured projections of an in-house precision-machined prostate implant phantom that allows the orientations and locations of up to 100 seeds to be set to known values. The seed reconstruction error for simulation was less than 0.6 mm/3o. For the physical phantom experiments, IFPM absolute accuracy for

  2. Permanent 125I-seed prostate brachytherapy: early prostate specific antigen value as a predictor of PSA bounce occurrence

    Directory of Open Access Journals (Sweden)

    Mazeron Renaud

    2012-03-01

    Full Text Available Abstract Purpose To evaluate predictive factors for PSA bounce after 125I permanent seed prostate brachytherapy and identify criteria that distinguish between benign bounces and biochemical relapses. Materials and methods Men treated with exclusive permanent 125I seed brachytherapy from November 1999, with at least a 36 months follow-up were included. Bounce was defined as an increase ≥ 0.2 ng/ml above the nadir, followed by a spontaneous return to the nadir. Biochemical failure (BF was defined using the criteria of the Phoenix conference: nadir +2 ng/ml. Results 198 men were included. After a median follow-up of 63.9 months, 21 patients experienced a BF, and 35.9% had at least one bounce which occurred after a median period of 17 months after implantation (4-50. Bounce amplitude was 0.6 ng/ml (0.2-5.1, and duration was 13.6 months (4.0-44.9. In 12.5%, bounce magnitude exceeded the threshold defining BF. Age at the time of treatment and high PSA level assessed at 6 weeks were significantly correlated with bounce but not with BF. Bounce patients had a higher BF free survival than the others (100% versus 92%, p = 0,007. In case of PSA increase, PSA doubling time and velocity were not significantly different between bounce and BF patients. Bounces occurred significantly earlier than relapses and than nadir + 0.2 ng/ml in BF patients (17 vs 27.8 months, p Conclusion High PSA value assessed 6 weeks after brachytherapy and young age were significantly associated to a higher risk of bounces but not to BF. Long delays between brachytherapy and PSA increase are more indicative of BF.

  3. WE-A-17A-11: Implanted Brachytherapy Seed Movement Due to Transrectal Ultrasound Probe-Induced Prostate Deformation

    Energy Technology Data Exchange (ETDEWEB)

    Liu, D; Usmani, N; Sloboda, R [Cross Cancer Institute, Edmonton, Alberta (Canada); University of Alberta, Edmonton, Alberta (Canada); Meyer, T; Husain, S; Angyalfi, S [Tom Baker Cancer Centre, Calgary, Alberta (Canada); University of Calgary, Calgary, Alberta (Canada); Kay, I [Canterbury District Health Board, Christchurch (New Zealand)

    2014-06-15

    Purpose: To characterize the movement of implanted brachytherapy seeds due to transrectal ultrasound probe-induced prostate deformation and to estimate the effects on prostate dosimetry. Methods: Implanted probe-in and probe-removed seed distributions were reconstructed for 10 patients using C-arm fluoroscopy imaging. The prostate was delineated on ultrasound and registered to the fluoroscopy seeds using a visible subset of seeds and residual needle tracks. A linear tensor and shearing model correlated the seed movement with position. The seed movement model was used to infer the underlying prostate deformation and to simulate the prostate contour without probe compression. Changes in prostate and surrogate urethra dosimetry were calculated. Results: Seed movement patterns reflecting elastic decompression, lateral shearing, and rectal bending were observed. Elastic decompression was characterized by anterior-posterior expansion and superior-inferior and lateral contractions. For lateral shearing, anterior movement up to 6 mm was observed for extraprostatic seeds in the lateral peripheral region. The average intra-prostatic seed movement was 1.3 mm, and the residual after linear modeling was 0.6 mm. Prostate D90 increased by 4 Gy on average (8 Gy max) and was correlated with elastic decompression. For selected patients, lateral shearing resulted in differential change in D90 of 7 Gy between anterior and posterior quadrants, and increase in whole prostate D90 of 4 Gy. Urethra D10 increased by 4 Gy. Conclusion: Seed movement upon probe removal was characterized. The proposed model captured the linear correlation between seed movement and position. Whole prostate dose coverage increased slightly, due to the small but systematic seed movement associated with elastic decompression. Lateral shearing movement increased dose coverage in the anterior-lateral region, at the expense of the posterior-lateral region. The effect on whole prostate D90 was smaller due to the subset

  4. Intraoperative fluoroscopic dose assessment in prostate brachytherapy patients.

    Science.gov (United States)

    Reed, Daniel R; Wallner, Kent E; Narayanan, Sreeram; Sutlief, Steve G; Ford, Eric C; Cho, Paul S

    2005-09-01

    To evaluate a fluoroscopy-based intraoperative dosimetry system to guide placement of additional sources to underdosed areas, and perform computed tomography (CT) verification. Twenty-six patients with prostate carcinoma treated with either I-125 or Pd-103 brachytherapy at the Puget Sound VA using intraoperative postimplant dosimetry were analyzed. Implants were performed by standard techniques. After completion of the initial planned brachytherapy procedure, the initial fluoroscopic intraoperative dose reconstruction analysis (I-FL) was performed with three fluoroscopic images acquired at 0 (AP), +15, and -15 degrees. Automatic seed identification was performed and the three-dimensional (3D) seed coordinates were computed and imported into VariSeed for dose visualization. Based on a 3D assessment of the isodose patterns additional seeds were implanted, and the final fluoroscopic intraoperative dose reconstruction was performed (FL). A postimplant computed tomography (CT) scan was obtained after the procedure and dosimetric parameters and isodose patterns were analyzed and compared. An average of 4.7 additional seeds were implanted after intraoperative analysis of the dose coverage (I-FL), and a median of 5 seeds. After implantation of additional seeds the mean V100 increased from 89% (I-FL) to 92% (FL) (p sources to supplement inadequately dosed areas within the prostate gland. Additionally, guided implantation of additional source, can significantly improve V100s and D90s, without significantly increasing rectal doses.

  5. Development of computational models for the simulation of isodose curves on dosimetry films generated by iodine-125 brachytherapy seeds

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Adriano M.; Meira-Belo, Luiz C.; Reis, Sergio C.; Grynberg, Suely E., E-mail: amsantos@cdtn.b [Center for Development of Nuclear Technology (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    The interstitial brachytherapy is one modality of radiotherapy in which radioactive sources are placed directly in the region to be treated or close to it. The seeds that are used in the treatment of prostate cancer are generally cylindrical radioactive sources, consisting of a ceramic or metal matrix, which acts as the carrier of the radionuclide and as the X-ray marker, encapsulated in a sealed titanium tube. This study aimed to develop a computational model to reproduce the film-seed geometry, in order to obtain the spatial regions of the isodose curves produced by the seed when it is put over the film surface. The seed modeled in this work was the OncoSeed 6711, a sealed source of iodine-125, which its isodose curves were obtained experimentally in previous work with the use of dosimetric films. For the films modeling, compositions and densities of the two types of dosimetric films were used: Agfa Personal Monitoring photographic film 2/10, manufactured by Agfa-Geavaert; and the model EBT radiochromic film, by International Specialty Products. The film-seed models were coupled to the Monte Carlo code MCNP5. The results obtained by simulations showed to be in good agreement with experimental results performed in a previous work. This indicates that the computational model can be used in future studies for other seeds models. (author)

  6. {sup 125}I seed implant brachytherapy for the treatment of parotid gland cancers in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, L.; Zhang, J.; Song, T.; Zhang, J.; Yu, G.; Zhang, Y. [Peking University School and Hospital of Stomatology, Beijing (China). Dept. of Oral and Maxillofacial Surgery

    2013-05-15

    Background and purpose: There is a lack of optimal treatment strategies for managing salivary gland cancers in children and adolescents. This study is aimed at assessing the effect of {sup 125}I seed implantation for the treatment of parotid cancers in children and adolescents. Patients and methods: A total of 12 patients younger than 16 years with parotid gland malignant tumors underwent {sup 125}I seed implant brachytherapy between October 2003 and November 2008. All patients were assessed after treatment and at the local tumor control appointments. Facial nerve function, maxillofacial development, and radioactive side-effects were assessed. Results: The follow-up period ranged from 41-104 months. One patient with T4b died of pulmonary metastasis. The other patients were alive during the follow-up period. There were no serious radiation-related complications. The treatment did not affect facial nerve function and dentofacial growth in any of the children. Conclusion: For parotid gland cancers in children, {sup 125}I seed implant brachytherapy may be an acceptable treatment without serious complications and with satisfactory short-term effects. (orig.)

  7. Clinical research on the treatment effects of radioactive (125)I seeds interstitial brachytherapy on children with primary orbital rhabdomyosarcoma.

    Science.gov (United States)

    Ge, Xin; Ma, Jianmin; Dai, Haojie; Ren, Ling; Li, Quan; Shi, Jitong

    2014-09-01

    Rhabdomyosarcoma (RMS) is one of the most common primary orbital malignancies. However, orbital RMS is a very rare disease, especially in childhood, and the tumor has a high degree of malignancy and rapid development. The objective of the present study was to investigate the clinical treatment effects of radioactive (125)I seeds interstitial brachytherapy on children with primary orbital RMS, which may provide a new method for treating RMS in clinical applications. Radioactive (125)I seeds were used in the present study. Primary lesions from ten children with orbital RMS, including three male and seven female patients, were selected as the targeted areas. The activity, number and spatial location of the seeds were optimized and simulated by applying computer three-dimensional treatment planning system (TPS) software. The interstitial implantation of the radioactive (125)I seeds was conducted on children under general anesthesia according to the TPS simulation results. Quality verifications of the operation were conducted by orbital computed tomography and X-ray plain film at the early stage after operation, and the children were followed up. The patients were followed up by October 2012 with an average follow-up time of 57 ± 17.43 months and a median follow-up time of 55 months. Nine cases achieved complete remission, and one case achieved partial remission, resulting in a total efficiency and survival rate of 100.0 % (10/10). Most patients recovered after treatment or had no radiotherapy side effect after the operations, though 20.0 % of the patients (2/10) experienced corneal opacity, eyeball movement disorder, or loss of sight. Radioactive (125)I seeds interstitial brachytherapy was an effective treatment for children with primary orbital RMS. Results from this study may provide a new clinical approach for the treatment of child patients with primary orbital RMS.

  8. Urethra-Sparing, Intraoperative, Real-Time Planned, Permanent-Seed Prostate Brachytherapy: Toxicity Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zilli, Thomas [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Taussky, Daniel, E-mail: daniel.taussky.chum@ssss.gouv.qc.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Donath, David; Le, Hoa Phong; Larouche, Renee-Xaviere; Beliveau-Nadeau, Dominique; Hervieux, Yannick; Delouya, Guila [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada)

    2011-11-15

    Purpose: To report the toxicity outcome in patients with localized prostate cancer undergoing {sup 125}I permanent-seed brachytherapy (BT) according to a urethra-sparing, intraoperative (IO), real-time planned conformal technique. Methods and Materials: Data were analyzed on 250 patients treated consecutively for low- or intermediate-risk prostate cancer between 2005 and 2009. The planned goal was urethral V{sub 150} = 0. Acute and late genitourinary (GU), gastrointestinal (GI), and erectile toxicities were scored with the International Prostate Symptom Score (IPSS) questionnaire and Common Terminology Criteria for Adverse Events (version 3.0). Median follow-up time for patients with at least 2 years of follow-up (n = 130) was 34.4 months (range, 24-56.9 months). Results: Mean IO urethra V{sub 150} was 0.018% {+-} 0.08%. Mean prostate D{sub 90} and V{sub 100} on day-30 computed tomography scan were 158.0 {+-} 27.0 Gy and 92.1% {+-} 7.2%, respectively. Mean IPSS peak was 9.5 {+-} 6.3 1 month after BT (mean difference from baseline IPSS, 5.3). No acute GI toxicity was observed in 86.8% of patients. The 3-year probability of Grade {>=}2 late GU toxicity-free survival was 77.4% {+-} 4.0%, with Grade 3 late GU toxicity encountered in only 3 patients. Three-year Grade 1 late GI toxicity-free survival was 86.1% {+-} 3.2%. No patient presented Grade {>=}2 late GI toxicity. Of patients with normal sexual status at baseline, 20.7% manifested Grade {>=}2 erectile dysfunction after BT. On multivariate analysis, elevated baseline IPSS (p = 0.016) and high-activity sources (median 0.61 mCi) (p = 0.033) predicted increased Grade {>=}2 late GU toxicity. Conclusions: Urethra-sparing IO BT results in low acute and late GU toxicity compared with the literature. High seed activity and elevated IPSS at baseline increased long-term GU toxicity.

  9. Obtention of brachytherapy seeds by sealing process using polymer; Obtencao de sementes de braquiterapia pelo processo de selagem com polimero

    Energy Technology Data Exchange (ETDEWEB)

    Lana, Diogo Alberto P.D.; Ferraz, Wilmar B.; Santos, Ana Maria M., E-mail: amms@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Carvalho, Luiz Claudio F.M. Garcia [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2012-08-15

    Brachytherapy is an advanced cancer treatment where radioactive seeds or sources are placed near or directly into the tumor thus reducing the radiation exposure in the surrounding healthy tissues. Several kinds of seeds have been developed in order to obtain a better dose distribution around them and with a lower cost manufacturing. These seeds consist of an encapsulation (titanium or stainless steel tube), a radionuclide carrier, and X-ray marker. The usual sealing process of the seeds is done with laser welding, but this process can promote radionuclide volatilization. In this paper, we present a new sealing process using epoxy resin and characterizations of two epoxy resins. These resins were characterized by Fourier transform infrared spectroscopic (FTIR), ultraviolet-visible spectroscopy (UV-vis) and differential scanning calorimetry (DSC). Interactions of the resins and of the sealed seeds in a simulated body fluid (SBF) were evaluated by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and by a counting gamma-rays. (author)

  10. Study of Dosimetric and Thermal Properties of a Newly Developed Thermo-brachytherapy Seed for Treatment of Solid Tumors

    Science.gov (United States)

    Gautam, Bhoj R.

    Studies on the curative effects of hyperthermia and radiation therapy on treatment of cancer show strong evidence of synergistic enhancement when both radiation and hyperthermia treatment modalities are applied simultaneously. A variety of tissue heating approaches developed to date still fail to overcome essential limitations such as inadequate temperature control, temperature non-uniformity, and prolonged time delay between hyperthermia and radiation treatments. We propose a new self-regulating Thermo-brachytherapy (TB) seed, which serves as a source of both radiation and heat for concurrent administration of brachytherapy and hyperthermia. The proposed seed is based on the BestRTM Iodine-125 seed model 2301, where the tungsten marker core and the air gap are replaced with ferromagnetic material. The ferromagnetic core produces heat when subjected to an alternating electromagnetic (EM) field and effectively shuts off after reaching the Curie temperature (TC) of the ferromagnetic material, thus establishing temperature self-regulation. The seed has a ferromagnetic Ni-Cu alloy core having a Curie transition at a temperature of 52 °C. This study summarizes the design and development of the self regulating ferromagnetic core TB seed for the concurrent hyperthermia and brachytherapy treatments. An experimental study of the magnetic properties of the Ni1-xCu x (0.28≤ x ≤0.3) alloys, and the simulation studies of radiation and thermal distribution properties of the seed have been performed. A preliminary experiment for the ferromagnetic induction heating of Ni-Cu needles has been carried out to ensure the practical feasibility of the induction heating. Radiation dose characterizing parameters (dose rate constant and other TG-43 factors) were calculated using the Monte Carlo method. For the thermal characteristics, we studied a model consisting of single or multiple seeds placed in the central region of a cylindrical phantom using a finite-element analysis method

  11. Clinical application and validation of an iterative forward projection matching algorithm for permanent brachytherapy seed localization from conebeam-CT x-ray projections

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, Damodar; Murphy, Martin J.; Todor, Dorin A.; Weiss, Elisabeth; Williamson, Jeffrey F. [Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)

    2010-09-15

    Purpose: To experimentally validate a new algorithm for reconstructing the 3D positions of implanted brachytherapy seeds from postoperatively acquired 2D conebeam-CT (CBCT) projection images. Methods: The iterative forward projection matching (IFPM) algorithm finds the 3D seed geometry that minimizes the sum of the squared intensity differences between computed projections of an initial estimate of the seed configuration and radiographic projections of the implant. In-house machined phantoms, containing arrays of 12 and 72 seeds, respectively, are used to validate this method. Also, four {sup 103}Pd postimplant patients are scanned using an ACUITY digital simulator. Three to ten x-ray images are selected from the CBCT projection set and processed to create binary seed-only images. To quantify IFPM accuracy, the reconstructed seed positions are forward projected and overlaid on the measured seed images to find the nearest-neighbor distance between measured and computed seed positions for each image pair. Also, the estimated 3D seed coordinates are compared to known seed positions in the phantom and clinically obtained VariSeed planning coordinates for the patient data. Results: For the phantom study, seed localization error is (0.58{+-}0.33) mm. For all four patient cases, the mean registration error is better than 1 mm while compared against the measured seed projections. IFPM converges in 20-28 iterations, with a computation time of about 1.9-2.8 min/iteration on a 1 GHz processor. Conclusions: The IFPM algorithm avoids the need to match corresponding seeds in each projection as required by standard back-projection methods. The authors' results demonstrate {approx}1 mm accuracy in reconstructing the 3D positions of brachytherapy seeds from the measured 2D projections. This algorithm also successfully localizes overlapping clustered and highly migrated seeds in the implant.

  12. Postoperative [{sup 125}I] seed brachytherapy in the treatment of acinic cell carcinoma of the parotid gland. With associated risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Mao, Ming-hui; Zhang, Jian-Guo; Zhang, Jie; Zheng, Lei; Liu, Shu-ming; Huang, Ming-wei; Shi, Yan [Peking Univ. School and Hospital of Stomatology, Beijing (China). Dept. of Oral and Maxillofacial Surgery

    2014-11-15

    This retrospective study was undertaken to analyze data from patients receiving iodine-125 ([{sup 125}I]) seed brachytherapy postoperatively for the treatment of acinic cell carcinoma (ACC) of the parotid gland along with the following risk factors: residual tumor, recurrent tumor, facial nerve invasion, positive resection margins, advanced tumor stage, or tumor spillage. Twenty-nine patients with ACC (17 females, 12 males; age range, 13-73 years; median age, 37.3 years) were included. Median follow-up was 58.2 months (range, 14-122 months). Patients received [{sup 125}I] seed brachytherapy (median actuarial D90, 177 Gy) 3-41 days (median, 14 days) following surgery. Radioactivity was 18.5-33.3 MBq per seed, and the prescription dose was 80-120 Gy. The 3-, 5-, and 10-year rates of local control were 93.1, 88.7, and 88.7 %, respectively; overall survival was 96.6, 92, and 92 %; disease-free survival was 93.1, 88.4, and 88.4 %; and freedom from distant metastasis was 96.6, 91.2, and 91.2 %. Lymph node metastases were absent in all patients, although two patients died with distant metastases. Facial nerve recovery was quick, and no severe radiotherapy-related complications were noted. Recurrence history, local recurrence, and distant metastasis significantly affected overall survival. Postoperative [{sup 125}I] seed brachytherapy is effective in treating ACC and has minor complications. Patients with a history of recurrence showed poor prognosis and were more likely to experience disease recurrence and develop metastases. (orig.) [German] Diese retrospektive Studie wurde durchgefuehrt, um die Daten von Patienten zu analysieren, die postoperativ eine Seed-Brachytherapie mit Iod-125 ([{sup 125}I]) zur Behandlung von Azinuszellkarzinomen der Ohrspeicheldruese mit begleitenden Risikofaktoren, wie Residualtumor, Rezidivtumor, Invasion in den N. facialis, positive (= nicht tumorfreie) Resektionsraender, fortgeschrittenes Tumorstadium oder lokale Verbreitung von Tumorzellen

  13. Evaluation of the new cesium-131 seed for use in low-energy x-ray brachytherapy.

    Science.gov (United States)

    Murphy, Mark K; Piper, R Kim; Greenwood, Lawrence R; Mitch, Michael G; Lamperti, Paul J; Seltzer, Stephen M; Bales, Matt J; Phillips, Mark H

    2004-06-01

    Characterization measurements and calculations were performed on a new medical seed developed by IsoRay Inc. in Richland, Washington, that utilizes the short-lived isotope 131Cs. This model has recently received FDA 510(k) clearance. The objective of this work was to characterize the dosimetric properties of the new seed according to the AAPM Task Group 43 recommendations. Cesium-131 is a low-energy x-ray emitter, with the most prominent peaks in the 29 keV to 34 keV region. The intended application is brachytherapy for treating cancers in prostate, breast, head and neck, lung, and pancreas. The evaluations performed included air-kerma strength, radial dose function, anisotropy in phantom, half-life, energy spectra, and internal activity. The results indicate the CS-1 seeds have a dose-rate constant of 0.915 cGy hr(-1) U(-1) in water, dose penetration characteristics similar to 125I and 103Pd, anisotropy function values on the order of 0.71 at short distances and small angles, and an average anisotropy factor of 0.964. The overall dosimetric characteristics are similar to 125I and 103Pd seeds with the exception of half-life, which is 9.7 days, as compared to 17 days for 103Pd and 60 days for 125I. The shorter half-life may offer significant advantages in biological effectiveness.

  14. Surface coating for prevention of metallic seed migration in tissues.

    Science.gov (United States)

    Lee, Hyunseok; Lee, Won Seok; Park, Jong In; Son, Kwang-Jae; Park, Min; Bang, Young-bong; Choy, Young Bin; Ye, Sung-Joon

    2015-06-01

    In radiotherapy, metallic implants often detach from their deposited sites and migrate to other locations. This undesirable migration could cause inadequate dose coverage for permanent brachytherapy and difficulties in image-guided radiation delivery for patients. To prevent migration of implanted seeds, the authors propose a potential strategy to use a biocompatible and tissue-adhesive material called polydopamine. In this study, nonradioactive dummy seeds that have the same geometry and composition as commercial I-125 seeds were coated in polydopamine. Using scanning electron microscopy and x-ray photoelectron spectroscopy, the surface of the polydopamine-coated and noncoated seeds was characterized. The detachment stress between the two types of seeds and the tissue was measured. The efficacy of polydopamine-coated seed was investigated through in vitro migration tests by tracing the seed location after tissue implantation and shaking for given times. The cytotoxicity of the polydopamine coating was also evaluated. The results of the coating characterization have shown that polydopamine was successfully coated on the surface of the seeds. In the adhesion test, the polydopamine-coated seeds had 2.1-fold greater detachment stress than noncoated seeds. From the in vitro test, it was determined that the polydopamine-coated seed migrated shorter distances than the noncoated seed. This difference was increased with a greater length of time after implantation. The authors suggest that polydopamine coating is an effective technique to prevent migration of implanted seeds, especially for permanent prostate brachytherapy.

  15. Surface coating for prevention of metallic seed migration in tissues

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyunseok; Park, Jong In [Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 151-742 (Korea, Republic of); Lee, Won Seok; Park, Min [Interdisciplinary Program in Bioengineering, Seoul National University College of Engineering, Seoul 151-742 (Korea, Republic of); Son, Kwang-Jae [Hanaro Applications Research, Korea Atomic Energy Research Institute, Daejeon 305-353 (Korea, Republic of); Bang, Young-bong [Advanced Institutes of Convergence Technology, Seoul National University, Suwon 443-270 (Korea, Republic of); Choy, Young Bin, E-mail: ybchoy@snu.ac.kr, E-mail: sye@snu.ac.kr [Interdisciplinary Program in Bioengineering, Seoul National University College of Engineering, Seoul 110-744 (Korea, Republic of); Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 110-744 (Korea, Republic of); Ye, Sung-Joon, E-mail: ybchoy@snu.ac.kr, E-mail: sye@snu.ac.kr [Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 151-742 (Korea, Republic of); Advanced Institutes of Convergence Technology, Seoul National University, Suwon 443-270 (Korea, Republic of); Department of Radiation Oncology, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of)

    2015-06-15

    Purpose: In radiotherapy, metallic implants often detach from their deposited sites and migrate to other locations. This undesirable migration could cause inadequate dose coverage for permanent brachytherapy and difficulties in image-guided radiation delivery for patients. To prevent migration of implanted seeds, the authors propose a potential strategy to use a biocompatible and tissue-adhesive material called polydopamine. Methods: In this study, nonradioactive dummy seeds that have the same geometry and composition as commercial I-125 seeds were coated in polydopamine. Using scanning electron microscopy and x-ray photoelectron spectroscopy, the surface of the polydopamine-coated and noncoated seeds was characterized. The detachment stress between the two types of seeds and the tissue was measured. The efficacy of polydopamine-coated seed was investigated through in vitro migration tests by tracing the seed location after tissue implantation and shaking for given times. The cytotoxicity of the polydopamine coating was also evaluated. Results: The results of the coating characterization have shown that polydopamine was successfully coated on the surface of the seeds. In the adhesion test, the polydopamine-coated seeds had 2.1-fold greater detachment stress than noncoated seeds. From the in vitro test, it was determined that the polydopamine-coated seed migrated shorter distances than the noncoated seed. This difference was increased with a greater length of time after implantation. Conclusions: The authors suggest that polydopamine coating is an effective technique to prevent migration of implanted seeds, especially for permanent prostate brachytherapy.

  16. SU-E-J-215: Towards MR-Only Image Guided Identification of Calcifications and Brachytherapy Seeds: Application to Prostate and Breast LDR Implant Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Elzibak, A; Fatemi-Ardekani, A; Soliman, A; Mashouf, S; Safigholi, H; Ravi, A; Morton, G; Song, WY [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Han, D [Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); University of California, San Diego, La Jolla, CA (United States)

    2015-06-15

    Purpose: To identify and analyze the appearance of calcifications and brachytherapy seeds on magnitude and phase MRI images and to investigate whether they can be distinguished from each other on corrected phase images for application to prostate and breast low dose rate (LDR) implant dosimetry. Methods: An agar-based gel phantom containing two LDR brachytherapy seeds (Advantage Pd-103, IsoAid, 0.8mm diameter, 4.5mm length) and two spherical calcifications (large: 7mm diameter and small: 4mm diameter) was constructed and imaged on a 3T Philips MR scanner using a 16-channel head coil and a susceptibility weighted imaging (SWI) sequence (2mm slices, 320mm FOV, TR/ TE= 26.5/5.3ms, 15 degree flip angle). The phase images were unwrapped and corrected using a 32×32, 2D Hanning high pass filter to remove background phase noise. Appearance of the seeds and calcifications was assessed visually and quantitatively using Osirix (http://www.osirix-viewer.com/). Results: As expected, calcifications and brachytherapy seeds appeared dark (hypointense) relative to the surrounding gel on the magnitude MRI images. The diameter of each seed without the surrounding artifact was measured to be 0.1 cm on the magnitude image, while diameters of 0.79 and 0.37 cm were measured for the larger and smaller calcifications, respectively. On the corrected phase images, the brachytherapy seeds and the calcifications appeared bright (hyperintense). The diameter of the seeds was larger on the phase images (0.17 cm) likely due to the dipole effect. Conclusion: MRI has the best soft tissue contrast for accurate organ delineation leading to most accurate implant dosimetry. This work demonstrated that phase images can potentially be useful in identifying brachytherapy seeds and calcifications in the prostate and breast due to their bright appearance, which helps in their visualization and quantification for accurate dosimetry using MR-only. Future work includes optimizing phase filters to best identify

  17. Combined use of transverse and scout computed tomography scans to localize radioactive seeds in an interstitial brachytherapy implant.

    Science.gov (United States)

    Yue, N; Chen, Z; Bond, J E; Son, Y H; Nath, R

    1999-04-01

    Various techniques have been developed to localize radioactive sources in brachytherapy implants. The most common methods include the orthogonal film method, the stereo-shift film method, and recently, direct localization from a series of contiguous CT transverse images. The major advantage of the CT method is that it provides the seed locations relative to anatomic structures. However, it is often the case that accurate identification and localization of the sources become difficult because of partial source artifacts in more than one transverse cut and other artifacts on CT images. A new algorithm has been developed to combine the advantages of using a pair of orthogonal scout views with the advantages of using a stack of transverse cuts. In the new algorithm, a common reference point is used to correlate CT transverse images and two orthogonal scout CT scans (AP and lateral). The radioactive sources are localized on CT transverse images. At the same time, the sources are displayed automatically on the two CT scout scans. In this way, the individual sources can be clearly distinguished and ambiguities arising from partial source artifacts are resolved immediately. Because of the finite slice thickness of transverse cuts, the longitudinal coordinates are more accurately obtained from the scout views. Therefore, the longitudinal coordinates of seeds localized on the transverse cuts are adjusted so that they match the position of the seeds on scout views. The algorithm has been tested on clinical cases and has proved to be a time saving and accurate method.

  18. Reconstruction of brachytherapy seed positions and orientations from cone-beam CT x-ray projections via a novel iterative forward projection matching method

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, Damodar; Murphy, Martin J.; Todor, Dorin A.; Weiss, Elisabeth; Williamson, Jeffrey F. [Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia 23298 (United States)

    2011-01-15

    Purpose: To generalize and experimentally validate a novel algorithm for reconstructing the 3D pose (position and orientation) of implanted brachytherapy seeds from a set of a few measured 2D cone-beam CT (CBCT) x-ray projections. Methods: The iterative forward projection matching (IFPM) algorithm was generalized to reconstruct the 3D pose, as well as the centroid, of brachytherapy seeds from three to ten measured 2D projections. The gIFPM algorithm finds the set of seed poses that minimizes the sum-of-squared-difference of the pixel-by-pixel intensities between computed and measured autosegmented radiographic projections of the implant. Numerical simulations of clinically realistic brachytherapy seed configurations were performed to demonstrate the proof of principle. An in-house machined brachytherapy phantom, which supports precise specification of seed position and orientation at known values for simulated implant geometries, was used to experimentally validate this algorithm. The phantom was scanned on an ACUITY CBCT digital simulator over a full 660 sinogram projections. Three to ten x-ray images were selected from the full set of CBCT sinogram projections and postprocessed to create binary seed-only images. Results: In the numerical simulations, seed reconstruction position and orientation errors were approximately 0.6 mm and 5 deg., respectively. The physical phantom measurements demonstrated an absolute positional accuracy of (0.78{+-}0.57) mm or less. The {theta} and {phi} angle errors were found to be (5.7{+-}4.9) deg. and (6.0{+-}4.1) deg., respectively, or less when using three projections; with six projections, results were slightly better. The mean registration error was better than 1 mm/6 deg. compared to the measured seed projections. Each test trial converged in 10-20 iterations with computation time of 12-18 min/iteration on a 1 GHz processor. Conclusions: This work describes a novel, accurate, and completely automatic method for reconstructing

  19. WE-A-17A-09: Exploiting Electromagnetic Technologies for Real-Time Seed Drop Position Validation in Permanent Implant Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Racine, E [Departement de Radio-Oncologie et Centre de Recherche du CHU de Quebec, Quebec, QC (Canada); Hautvast, G [Biomedical Systems, Philips Group Innovation, Eindhoven, North Brabant (Netherlands); Binnekamp, D [Integrated Clinical Solutions and Marketing, Philips Healthcare, Best, DA (Netherlands); Beaulieu, L [Centre Hospitalier University de Quebec, Quebec, QC (Canada)

    2014-06-15

    Purpose: To report on preliminary results validating the performance of a specially designed LDR brachytherapy needle prototype possessing both electromagnetic (EM) tracking and seed drop detection abilities. Methods: An EM hollow needle prototype has been designed and constructed in collaboration with research partner Philips Healthcare. The needle possesses conventional 3D tracking capabilities, along with a novel seed drop detection mechanism exploiting local changes of electromagnetic properties generated by the passage of seeds in the needle's embedded sensor coils. These two capabilities are exploited by proprietary engineering and signal processing techniques to generate seed drop position estimates in real-time treatment delivery. The electromagnetic tracking system (EMTS) used for the experiment is the NDI Aurora Planar Field Generator. The experiment consisted of dropping a total of 35 seeds in a prismatic agarose phantom, and comparing the 3D seed drop positions of the EMTS to those obtained by an image analysis of subsequent micro-CT scans. Drop position error computations and statistical analysis were performed after a 3D registration of the two seed distributions. Results: Of the 35 seeds dropped in the phantom, 32 were properly detected by the needle prototype. Absolute drop position errors among the detected seeds ranged from 0.5 to 4.8 mm with mean and standard deviation values of 1.6 and 0.9 mm, respectively. Error measurements also include undesirable and uncontrollable effects such as seed motion upon deposition. The true accuracy performance of the needle prototype is therefore underestimated. Conclusion: This preliminary study demonstrates the potential benefits of EM technologies in detecting the passage of seeds in a hollow needle as a means of generating drop position estimates in real-time treatment delivery. Such tools could therefore represent a potentially interesting addition to existing brachytherapy protocols for rapid dosimetry

  20. Dosimetric study in iodine-125 seeds for brachytherapy application; Dosimetria de fontes de iodo-125 aplicadas em braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Zeituni, Carlos Alberto

    2008-07-01

    The demand for iodine-125 seeds for use in brachytherapy treatments has experienced an increase along recent years in Brazil and all over the world. All iodine-125 seed must have its operational parameters measured and/or calculated every time changes in the production process are carried out. A complete dosimetric measurement is very expensive, and it is recommended that this procedure must be repeated at least once a year. Thus, this work developed a methodology for the entire dosimetric process. This methodology is based on the scarce information available in the literature, once almost all the methodology used in large industrial laboratories is commercial secret. The proposed methodology was tested using seeds of Amersham-Oncura-Ge Healthcare, which is the largest seed manufactory in the world. In this new methodology, an automatic reader was employed in order to reduce the time required in the selection process of the TLD-100 dosimeters used and a postprocessing of the obtained spectra was carried out. A total of 142 dosimeters were used and only 29 have been selected using the new methodology. Measurements were performed using slabs of Solid Water RW1 to simulate measuring in the 'water', using three different experimental apparatus and each measurement was repeated at least three times. The TLD-100 calibration was performed using a Dermopan II - Siemens. The measured values showed a good agreement with the ones available in the literature. Finally, these measured values were compared with calculated ones obtained by a semiempirical simulation program, showing a good agreement and, therefore, demonstrating the validity of the proposed methodology regarding dosimetric calculations. (author)

  1. Iodine-125 orbital brachytherapy with a prosthetic implant in situ

    Energy Technology Data Exchange (ETDEWEB)

    Stannard, Clare [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Radiation Oncology; Maree, Gert; Munro, Roger [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Medical Physics; Lecuona, Karin [Groote Schuur Hospital and Cape Town Univ. (South Africa). Dept. of Ophthalmology; Sauerwein, Wolfgang [Universitaetsklinikum Essen (Germany). Strahlenklinik, NCTeam

    2011-05-15

    Purpose: Brachytherapy is one method of irradiating the orbit after enucleation of an eye with a malignant tumor that has a potential to recur. It consists of 6 trains of I-125 seeds placed around the periphery of the orbit, a shorter central train, and a metal disc, loaded with seeds, placed beneath the eyelids. The presence of a prosthetic orbital implant requires omission of the central train and adjustment of the activity of the seeds in the anterior orbit around the prosthesis. Patients and Methods: This is a retrospective review of the technical modifications and outcome of 12 patients treated in this manner: 6 with retinoblastoma, 5 with malignant melanoma, and 1 with an intraocular rhabdomyosarcoma. The median dose was 35.5 Gy in 73 hours for retinoblastoma and 56 Gy in 141 hours for malignant melanoma. Patients with retinoblastoma and rhabdomyosarcoma also received chemotherapy. Results: The tubes can be placed satisfactorily around the prosthesis. The increased activity in the anterior half of the tubes produced comparable dose distributions. There have been no orbital recurrences, no extrusion of the prosthesis, and cosmesis is good. Conclusion: Insertion of a prosthetic implant at the time of enucleation greatly enhances the subsequent cosmetic appearance. This should be encouraged unless there is frank tumor in the orbit. Orbital brachytherapy without the central train continues to give excellent local control. The short treatment time and good cosmesis are added advantages. The patient is spared the expense and inconvenience of removing and replacing the prosthetic implant. (orig.)

  2. Electroless Sliver-Plating Process in the Preparation of 103Pd-125I Hybrid Brachytherapy Seed Cores

    Directory of Open Access Journals (Sweden)

    LI Zhong-yong1,2;CHEN Bin-da1;Lv Xiao-zhou1;LU Jin-hui1;CUI Hai-ping1,2

    2014-02-01

    Full Text Available Electroless 103Pd plating and electroless Ag plating and chemical 125I depositing were took place on the surface of carbon rods in turn, which was a reliable method for the preparation of 103Pd-125I hybrid brachytherapy seed cores. 103Pd and 125I were deposited on the same substrate effectively through silver coating as a bridge. The process of electroless Ag plating was a novel and important step in the preparation of 103Pd-125I hybrid seed. In this work, the process of electroless Ag plating was studied using 0.5×3.0 mm carbon rods with palladium coating as substrate, silver-ammino complex as precursor, 110mAg as radioactive tracer, and hydrazine as reductant. The optimum conditions were AgNO3 2g/L,Na2EDTA 40 g/L,NH3•H2O 16.25%,H4N2•H2O 5‰,pH=10,t=60 min,and T=35 ℃. Sliver deposited on each carbon rod was uniform, and sliver-coating was white and smooth.

  3. Y-configured metallic stent combined with (125)I seed strands cavity brachytherapy for a patient with type IV Klatskin tumor.

    Science.gov (United States)

    Dechao, Jiao; Han, Xinwei; Yanli, Wang; Zhen, Li

    2016-08-01

    We report a case in an inoperable patient with type IV Klatskin tumor treated by the use of a novel, two piece, Y-configured self-expandable metallic stent (SEMS) combined with two (125)I seed strands via bilateral approach. The placement of the Y-shaped SEMS was successful and resulted in adequate biliary drainage. After 2 months of intraluminal brachytherapy (ILBT), both (125)I seed strands and temporary drainage catheter were removed after patency of the expanded stents was confirmed by the cholangiogram. This technique was feasible and could be considered for the treatment of patients with Bismuth type IV Klatskin tumors.

  4. Y-configured metallic stent combined with 125I seed strands cavity brachytherapy for a patient with type IV Klatskin tumor

    Science.gov (United States)

    Dechao, Jiao; Yanli, Wang; Zhen, Li

    2016-01-01

    We report a case in an inoperable patient with type IV Klatskin tumor treated by the use of a novel, two piece, Y-configured self-expandable metallic stent (SEMS) combined with two 125I seed strands via bilateral approach. The placement of the Y-shaped SEMS was successful and resulted in adequate biliary drainage. After 2 months of intraluminal brachytherapy (ILBT), both 125I seed strands and temporary drainage catheter were removed after patency of the expanded stents was confirmed by the cholangiogram. This technique was feasible and could be considered for the treatment of patients with Bismuth type IV Klatskin tumors. PMID:27648091

  5. The use of gel dosimetry to measure the 3D dose distribution of a 90Sr/90Y intravascular brachytherapy seed.

    Science.gov (United States)

    Massillon-Jl, G; Minniti, R; Mitch, M G; Maryanski, M J; Soares, C G

    2009-03-21

    Absorbed dose distributions in 3D imparted by a single (90)Sr/(90)Y beta particle seed source of the type used for intravascular brachytherapy were investigated. A polymer gel dosimetry medium was used as a dosemeter and phantom, while a special high-resolution laser CT scanner with a spatial resolution of 100 microm in all dimensions was used to quantify the data. We have measured the radial dose function, g(L)(r), observing that g(L)(r) increases to a maximum value and then decreases as the distance from the seed increases. This is in good agreement with previous data obtained with radiochromic film and thermoluminescent dosemeters (TLDs), even if the TLDs underestimate the dose at distances very close to the seed. Contrary to the measurements, g(L)(r) calculated through Monte Carlo simulations and reported previously steadily decreases without a local maximum as a function of the distance from the seed. At distances less than 1.5 mm, differences of more than 20% are observed between the measurements and the Monte Carlo calculations. This difference could be due to a possible underestimation of the energy absorbed into the seed core and encapsulation in the Monte Carlo simulation, as a consequence of the unknown precise chemical composition of the core and its respective density for this seed. The results suggest that g(L)(r) can be measured very close to the seed with a relative uncertainty of about 1% to 2%. The dose distribution is isotropic only at distances greater than or equal to 2 mm from the seed and is almost symmetric, independent of the depth. This study indicates that polymer gel coupled with the special small format laser CT scanner are valid and accurate methods for measuring the dose distribution at distances close to an intravascular brachytherapy seed.

  6. The use of gel dosimetry to measure the 3D dose distribution of a {sup 90}Sr/{sup 90}Y intravascular brachytherapy seed

    Energy Technology Data Exchange (ETDEWEB)

    Massillon-JL, G; Minniti, R; Mitch, M G; Soares, C G [Ionizing Radiation Division, National Institute of Standards and Technology, Gaithersburg, MD 20899 (United States); Maryanski, M J [MGS Research, Inc., Madison, CT 06443 (United States)], E-mail: massillon@fisica.unam.mx

    2009-03-21

    Absorbed dose distributions in 3D imparted by a single {sup 90}Sr/{sup 90}Y beta particle seed source of the type used for intravascular brachytherapy were investigated. A polymer gel dosimetry medium was used as a dosemeter and phantom, while a special high-resolution laser CT scanner with a spatial resolution of 100 {mu}m in all dimensions was used to quantify the data. We have measured the radial dose function, g{sub L}(r), observing that g{sub L}(r) increases to a maximum value and then decreases as the distance from the seed increases. This is in good agreement with previous data obtained with radiochromic film and thermoluminescent dosemeters (TLDs), even if the TLDs underestimate the dose at distances very close to the seed. Contrary to the measurements, g{sub L}(r) calculated through Monte Carlo simulations and reported previously steadily decreases without a local maximum as a function of the distance from the seed. At distances less than 1.5 mm, differences of more than 20% are observed between the measurements and the Monte Carlo calculations. This difference could be due to a possible underestimation of the energy absorbed into the seed core and encapsulation in the Monte Carlo simulation, as a consequence of the unknown precise chemical composition of the core and its respective density for this seed. The results suggest that g{sub L}(r) can be measured very close to the seed with a relative uncertainty of about 1% to 2%. The dose distribution is isotropic only at distances greater than or equal to 2 mm from the seed and is almost symmetric, independent of the depth. This study indicates that polymer gel coupled with the special small format laser CT scanner are valid and accurate methods for measuring the dose distribution at distances close to an intravascular brachytherapy seed.

  7. Computational model of Amersham I-125 source model 6711 and Prosper Pd-103 source model MED3633 using MCNP

    Energy Technology Data Exchange (ETDEWEB)

    Menezes, Artur F.; Reis Junior, Juraci P.; Silva, Ademir X., E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear; Rosa, Luiz A.R. da, E-mail: lrosa@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Facure, Alessandro [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Cardoso, Simone C., E-mail: Simone@if.ufrj.b [Universidade Federal do Rio de Janeiro (IF/UFRJ), RJ (Brazil). Inst. de Fisica. Dept. de Fisica Nuclear

    2011-07-01

    Brachytherapy is used in cancer treatment at shorter distances through the use of small encapsulated source of ionizing radiation. In such treatment, a radiation source is positioned directly into or near the target volume to be treated. In this study the Monte Carlo based MCNP code was used to model and simulate the I-125 Amersham Health source model 6711 and the Pd-103 Prospera source model MED3633 in order to obtain the dosimetric parameter dose rate constant ({Lambda}) . The sources geometries were modeled and implemented in MCNPX code. The dose rate constant is an important parameter prostate LDR brachytherapy's treatments planning. This study was based on American Association of Physicists in Medicine (AAPM) recommendations which were produced by its Task Group 43. The results obtained were 0.941 and 0.65 for the dose rate constants of I-125 and Pd-103 sources, respectively. They present good agreement with the literature values based on different Monte Carlo codes. (author)

  8. The Effect of Scattering from Leg Region on Organ Doses in Prostate Brachytherapy for 103Pd, 125I and 131Cs Seeds

    Directory of Open Access Journals (Sweden)

    Seyed Milad Vahabi

    2016-09-01

    Full Text Available Introduction Dose calculation of tumor and surrounding tissues is essential during prostate brachytherapy. Three radioisotopes, namely, 125I, 103Pd, and 131Cs, are extensively used in this method. In this study, we aimed to calculate the received doses by the prostate and critical organs using the aforementioned radioactive seeds and to investigate the effect of scattering contribution for the legs on dose calculations. Materials and Methods The doses to organs of interest were calculated using MCNPX code and ORNL (Oak Ridge National Laboratory phantom. Results Doses to the prostate as a source of radiation for 125I, 103Pd, and 131Cs were approximately 108.9, 97.7, and 81.5 Gy, respectively. Bladder, sigmoid colon, and testes received higher doses than other organs due to proximity to the prostate. Differences between the doses when tallying with the legs intact and with the legs voided were significant for testes, sigmoid colon contents, and sigmoid colon wall because of their proximity to the prostate. There was also a good consistency between our results and the data published by Montefiore Medical Center and Albert Einstein College of Medicine for the prostate. Conclusion Scattering from leg region had a significant effect on doses to testes, sigmoid colon contents, and sigmoid colon wall in the pelvic region, and prostate and the other organs were unaffected. Brachytherapy treatment plans using 131Cs seeds allow for better sparing of critical tissues, with a comparable number of, or fewer, seeds required, compared to 125I seeds.

  9. [Physical and technical quality assurance and radiation protection in transperineal interstitial permanent prostate brachytherapy with 125-iodine seeds].

    Science.gov (United States)

    Kaulich, Theodor W; Lamprecht, Ulf; Paulsen, Frank; Lorenz, Joachim; Maurer, Uwe; Loeser, Wolfgang; Bichler, Karl-Horst; Nüsslin, Fridtjof; Bamberg, Michael

    2002-12-01

    Early stage prostate cancer can be treated successfully by interstitial brachytherapy with 125-iodine seeds. A quality-assurance programme is presented that was designed for this purpose for internal clinical use. Furthermore the requirements of the new German Ordinance Governing Radiation Protection (StrlSchV) that came into force on August 1, 2001, are taken into account. For the 125-iodine monotherapy of the prostate we used RAPID STRANDS (Amersham Health, Braunschweig, Germany). According to the guidelines of the new Ordinance Governing Radiation Protection, the determination of the body dose of the staff is made to rely on the new measurement quantities H(p) (10) and H(p) (0.07). The nominal air kerma rate of the seeds is measured with a calibrated well-chamber of the type HDR 1000 Plus and an electrometer of the type MAX 4000 (Standard Imaging Inc., USA). The ultrasound images of the prostate are produced by an ultrasound device of the type Falcon 2101 (B-K Medical, Denmark). For treatment planning the programme VariSeed (Varian, Darmstadt, Germany) was employed. Correct loading of the needles is controlled by autoradiography before implantation. After the implantation radiation-protection measurements in the operating room are carried out. As regards the personnel, for the depth personal dose equivalent Hp(10) and relating to two applications each, measurement values between 0 microSv and 14 microSv resulted. The control of the radiation exposure of the hands revealed superficial personal dose values H(p) (0.07) of up to 1 mSv. The nominal air kerma rates of the RAPID STRANDS were all lying within the 95% confidence interval guaranteed by the producer. The autoradiographs documented -- except for one case -- the correct loading of the needles. The interstitial transperineal prostate implantation of the 125-iodine seeds succeeded as planned with all patients. Until now no contamination of the operating room was detected by the radiation

  10. Feasibility of vibro-acoustography with a quasi-2D ultrasound array transducer for detection and localizing of permanent prostate brachytherapy seeds: A pilot ex vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Mehrmohammadi, Mohammad; Kinnick, Randall R.; Fatemi, Mostafa, E-mail: fatemi.mostafa@mayo.edu [Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota 55905 (United States); Alizad, Azra [Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota 55905 and Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905 (United States); Davis, Brian J. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905 (United States)

    2014-09-15

    Purpose: Effective permanent prostate brachytherapy (PPB) requires precise placement of radioactive seeds in and around the prostate. The impetus for this research is to examine a new ultrasound-based imaging modality, vibro-acoustography (VA), which may serve to provide a high rate of PPB seed detection while also effecting enhanced prostate imaging. The authors investigate the ability of VA, implemented on a clinical ultrasound (US) scanner and equipped with a quasi-2D (Q2D) array US transducer, to detect and localize PPB seeds in excised prostate specimens. Methods: Nonradioactive brachytherapy seeds were implanted into four excised cadaver prostates. A clinical US scanner equipped with a Q2D array US transducer was customized to acquire both US and C-scan VA images at various depths. The VA images were then used to detect and localize the implanted seeds in prostate tissue. To validate the VA results, computed tomography (CT) images of the same tissue samples were obtained to serve as the reference by which to evaluate the performance of VA in PPB seed detection. Results: The results indicate that VA is capable of accurately identifying the presence and distribution of PPB seeds with a high imaging contrast. Moreover, a large ratio of the PPB seeds implanted into prostate tissue samples could be detected through acquired VA images. Using CT-based seed identification as the standard, VA was capable of detecting 74%–92% of the implanted seeds. Additionally, the angular independency of VA in detecting PPB seeds was demonstrated through a well-controlled phantom experiment. Conclusions: Q2DVA detected a substantial portion of the seeds by using a 2D array US transducer in excised prostate tissue specimens. While VA has inherent advantages associated with conventional US imaging, it has the additional advantage of permitting detection of PPB seeds independent of their orientation. These results suggest the potential of VA as a method for PPB imaging that

  11. An analysis of brachytherapy with computed tomography-guided permanent implantation of Iodine-125 seeds for recurrent nonkeratin nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Shen X

    2015-05-01

    Full Text Available Xinying Shen,1,2 Yong Li,2 Yanfang Zhang,2 Jian Kong,2 Yanhao Li1 1Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 2Department of Interventional Radiology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, People’s Republic of China Background: 125I seed implantation is a new method in treatment of nasopharyngeal carcinoma (NPC, and it is worthwhile to evaluate its feasibility. In this study, we performed brachytherapy with computed tomography (CT-guided permanent implantation of 125I seeds in the treatment of patients with the recurrence of NPC.Methods: A total 30 patients (20 male and ten female at the median age of 55 (range 25–80 years were diagnosed with recurrent nonkeratin NPC, with a total 38 lesions and a short disease-free interval (median ~11 months after primary radiotherapy alone or combined with chemotherapy. Patients received CT scan, starting from 2 months after the treatment. Follow-up was conducted for ~2–38 months to observe the local control rate and overall survival rate. We also analyzed the possible correlation between survival periods and the status of recurrent tumors.Results: The local control rates at 6, 12, 24, 30, and 36 months after the procedure of 125I seed implantation were 86.8%, 73.7%, 26.3%, 15.8%, and 5.3%, respectively. The overall 1-, 2-, and 3-year survival rates were 80.0% (24/30, 30.0% (9/30, and 6.7% (2/30, respectively, with a median survival period of 18 months (17.6±8.6 months. Interestingly, the survival periods of the patients who had primary radiotherapy with or without chemotherapy were 15.8±7.9 and 24.3±7.9 months, respectively. Kaplan–Meier survival analysis demonstrated that χ2 (log rank was 7.555, with very significant difference (P<0.01. The survival periods of patients in tumor stages I, II, III, and IV were 25.4±8.7, 19.8±9.4, 16.1±4.5, and 12.8±7.8 months, respectively, with

  12. Acute urinary morbidity following I-125 interstitial implantation of the prostate gland.

    Science.gov (United States)

    Desai, J; Stock, R G; Stone, N N; Iannuzzi, C; DeWyngaert, J K

    1998-01-01

    The objective of this paper was to evaluate the acute urinary morbidity associated with I-125 interstitial implantation of the prostate gland. From 1991-1995, 117 patients underwent ultrasound (U/S)-guided implantation of the prostate gland. Median dose to 90% of the gland (d90) was 14.68 Gy (range = 1.65-21.75 Gy). The patients' urinary symptoms were recorded pre-implantation and at regular intervals after implantation using the International Prostate Symptom Score (IPSS), a self-assessment questionnaire in which patients scored 7 symptoms: incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia. Median follow-up was 12 months. The natural history of implant-related urinary symptoms was assessed in this manner. In addition, dosimetric factors including U/S prostate volume, total activity, activity per seed, dose volume histogram (DVH) values for dose to gland, and dose area histogram (DAH) values for dose to urethra and bladder were examined for correlation to the severity of each symptom as well as to total IPSS (sum of the individual symptom scores). Total IPSS peaked at 1 month post-implant and gradually returned to approximately baseline at 24 months. Total IPSS directly correlated with total activity and DVH for the prostate. Total IPSS, however, did not correlate with bladder or urethral DAH. With the exception of frequency, individual symptoms did not correlate with dose to gland, bladder, or urethra. Frequency scores did, however, correlate not only with dose to prostate gland but also dose to urethra. The acute urinary side effects of I-125 prostate implantation are transient and peak at 1 month post-implant. The severity of the urinary irritative symptoms developed are closely related to total dose to the gland. Urethral dose appears to affect frequency most significantly. Urinary symptoms, therefore, may be a limiting factor when considering dose escalation with I-125.

  13. Treatment of portal vein tumor thrombus using ~(125)Iodine seed implantation brachytherapy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    We reported two cases of liver metastasis with portal vein tumor thrombus that developed after liver transplantation for hepato cellular carcinoma (HCC). Both the patients were women aged 43 and 55 years, who had liver metastasis and portal vein tumor thrombus formation after liver transplantations for HCC. For the treatment of portal vein tumor thrombus, 125I seeds were implanted into the hepatic tissue under the guidance of preoperative computed tomography (CT) images with a total radiation dose of 130 Gy...

  14. Synthesis and biodistribution studies of (I-125)-iodoergoline derivatives

    Energy Technology Data Exchange (ETDEWEB)

    Mikhail, E.A.; Basmadjian, G.P.; Gilliland, D.L.; Leonard, J.C.; Magarian, R.A.; Rieger, J.A.

    1985-05-01

    The relatively high uptake in rat and dog brains of (Se-75)-Selenopergolide reported earlier, has prompted the synthesis of four new ergoline analogs that can be labeled with I-123. The radioactive iodoergoline derivatives Ia and II were synthesized in a radiochemical yield of 80% and 30% respectively, by refluxing the corresponding 8..beta..-mesyl derivatives with (I-125)-NaI in absolute ethanol. Their chromatographic purification yielded no-carrier added compounds. Ib and Ic were synthesized in a radiochemical yield of 75% and 40% respectively, by refluxing the 8..beta..-(o-iodobenzoyl)- and the 8..beta..-(p-iodobenzenesulfonyl)-lysergol derivatives with (I-125)-NaI. Chromatographic purification yielded compounds with specific activities of --0.3 mCi/mg. Biodistribution studies performed in mature male rats after injection of 2-7 ..mu..Ci of the compounds, showed high uptake of Ia, Ib and II in the brain and adrenals up to 30 min. This data is in agreement with previously studied Se-75 labeled closely related derivatives. Compound II showed, at maximum uptake time, the highest target/non-target ratios. Complete chemical, radiochemical synthesis, and structure biodistribution relationships are presented to support the hypothesis that radiolabeled ergolines could potentially be used as dopamine receptor site mapping agents.

  15. Effect of improved TLD dosimetry on the determination of dose rate constants for {sup 125}I and {sup 103}Pd brachytherapy seeds

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, M., E-mail: manuel.rodriguez@rmp.uhn.ca [Carleton Laboratory for Radiotherapy Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada and Princess Margaret Hospital, Toronto, Ontario M5G 2M9 (Canada); Rogers, D. W. O. [Carleton Laboratory for Radiotherapy Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada)

    2014-11-01

    Purpose: To more accurately account for the relative intrinsic energy dependence and relative absorbed-dose energy dependence of TLDs when used to measure dose rate constants (DRCs) for {sup 125}I and {sup 103}Pd brachytherapy seeds, to thereby establish revised “measured values” for all seeds and compare the revised values with Monte Carlo and consensus values. Methods: The relative absorbed-dose energy dependence, f{sup rel}, for TLDs and the phantom correction, P{sub phant}, are calculated for {sup 125}I and {sup 103}Pd seeds using the EGSnrc BrachyDose and DOSXYZnrc codes. The original energy dependence and phantom corrections applied to DRC measurements are replaced by calculated (f{sup rel}){sup −1} and P{sub phant} values for 24 different seed models. By comparing the modified measured DRCs to the MC values, an appropriate relative intrinsic energy dependence, k{sub bq}{sup rel}, is determined. The new P{sub phant} values and relative absorbed-dose sensitivities, S{sub AD}{sup rel}, calculated as the product of (f{sup rel}){sup −1} and (k{sub bq}{sup rel}){sup −1}, are used to individually revise the measured DRCs for comparison with Monte Carlo calculated values and TG-43U1 or TG-43U1S1 consensus values. Results: In general, f{sup rel} is sensitive to the energy spectra and models of the brachytherapy seeds. Values may vary up to 8.4% among {sup 125}I and {sup 103}Pd seed models and common TLD shapes. P{sub phant} values depend primarily on the isotope used. Deduced (k{sub bq}{sup rel}){sup −1} values are 1.074 ± 0.015 and 1.084 ± 0.026 for {sup 125}I and {sup 103}Pd seeds, respectively. For (1 mm){sup 3} chips, this implies an overall absorbed-dose sensitivity relative to {sup 60}Co or 6 MV calibrations of 1.51 ± 1% and 1.47 ± 2% for {sup 125}I and {sup 103}Pd seeds, respectively, as opposed to the widely used value of 1.41. Values of P{sub phant} calculated here have much lower statistical uncertainties than literature values, but

  16. Reproducibility study of TLD-100 dosimeters for {sup 122}I seeds used in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zeituni, Carlos A. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Universidade Presbiteriana Mackenzie, Sao Paulo, SP (Brazil); E-mail: czeituni@ipen.br; Moura, Eduardo S. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Faculdade Oswaldo Cruz, Sao Paulo, SP (Brazil); Manzoli, Jose E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Universidade Sao Judas Tadeu, Sao Paulo, SP (Brazil); Terremoto, Luis A.A.; Rostelato, Maria Elisa C.M. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2007-07-01

    In order to provide the dosimetry for {sup 125}I seed production in Brazil, Harshaw thermoluminescent dosimeters (TLD-100) will be used. Even if measurements with TLD-100 of the same batch of fabrication are performed, the precision of the response will not be the same. As a consequence, they must be measured one by one. This paper presents the calculation methodology for selection procedure to TLD-100 dosimeter used, embracing 143 TLD-100 dosimeters prepared by Harshaw Company on December 19th, 2005. These dosimeters are LiF type with a micro-cube (1 mm x 1 mm x 1 mm) shape. The annealing procedure used for these dosimeters consists of annealing the TLD dosimeters at 400 deg C for 65 minutes using a PC controlled annealing oven. This procedure is followed by an oven-typical cooling down profile to about 100 deg C for 127 minutes. The pre-readout thermal stabilization was used and it consists of an annealing at 100 deg C for 15 minutes. Irradiations were performed using 36 {sup 125}I seeds with activity of 0,623 mCi (23,05 MBq) on October 20th, 2006 for approximately 150 minutes, to guarantee a minimum of 5 Gy absorbed dose in each dosimeter. Different evanescence times have been used. These complete procedures were carried out four times in order to compare the data and minimize the systematic error. (author)

  17. Comparing the RTOG/EORTC and LENT-SOMA scoring systems for the evaluation of late skin toxicity after (125)I seed brachytherapy for parotid gland cancer.

    Science.gov (United States)

    Mao, Ming-Hui; Feng, Zhien; Li, Hua; Qin, Li-Zheng; Li, Jian-Hua; Huang, Xin; Xing, Ru-Dong; Zhang, Jie; Zhang, Jian-Guo; Han, Zheng-Xue

    The Radiation Therapy Oncology Group (RTOG) and Late Effects Normal Tissue Task Force-Subjective, Objective, Management and Analytic (LENT-SOMA) scoring systems were compared for grading late skin effects after iodine-125 seed brachytherapy in parotid gland cancer patients. A total of 109 patients diagnosed with parotid gland carcinoma were treated postoperatively with iodine-125 seed brachytherapy at a dose of 100-120 Gy. After 6-24 months of followup, telangiectasia, skin pigmentation, atrophy, fibrosis, and ulceration were scored according to both RTOG and LENT-SOMA scale criteria. The strength of correlation between the scores and the interobserver variability were calculated. Of 109 patients, 22.9% had telangiectasia; 78.9%, pigmentation; 28.4%, fibrosis; 4.6%, edema; 0.9%, ulceration; 37.6%, retraction and/or atrophy; 22.9%, sensation change; and 11%, scaliness and/or roughness. Compared with RTOG, LENT-SOMA criteria resulted in the upgrading of pigmentation in 17% of cases, the downgrading of all instances of telangiectasia and the downgrading of one instance of Grade 4 ulceration to Grade 3. Between the two scales, fibrosis and atrophy correlated well (Spearman ρ, 0.992, 0.986). An additional 229 side effects were observed using LENT-SOMA criteria. The LENT-SOMA scale was more accurate than the RTOG scale for the evaluation of late skin and subcutaneous toxicity. The downgrading of telangiectasia and upgrading of pigmentation with the LENT-SOMA scale reflected the patients' conditions better than the scores obtained with the RTOG scale. The assessment of fibrosis and atrophy correlated well between the two scales. The use of the sum of the individual scores of the LENT-SOMA is therefore advocated. The addition of decreased sweating and the removal of the alopecia (scalp) metric should be considered to standardize the reporting of late radiation morbidity. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. The role of brachytherapy in radiation and isotopes centre of Khartoum (RICK)

    CERN Document Server

    Ali, A M

    2000-01-01

    As there are many efforts devoted in order to manage the cancer, here the researcher handle one of these efforts that play a major part in treating the cancer internationally, it is a brachytherapy system. Brachytherapy was carried out mostly with radium sources, but recently some artificial sources are incorporated in this mode of treatment such as Cs-137, Ir-192, Au-198, P-32, Sr-90 and I-125. The research cover history of brachytherapy and radioactive sources used in, techniques of implementation, radiation protection and methods of brachytherapy dose calculation, as well as brachytherapy in radiation and isotopes centre in Khartoum.

  19. MRI/TRUS data fusion for prostate brachytherapy. Preliminary results

    CERN Document Server

    Reynier, Christophe; Fourneret, Philippe; Dusserre, André; Gay-Jeune, Cécile; Descotes, Jean-Luc; Bolla, Michel; Giraud, Jean-Yves

    2008-01-01

    Prostate brachytherapy involves implanting radioactive seeds (I125 for instance) permanently in the gland for the treatment of localized prostate cancers, e.g., cT1c-T2a N0 M0 with good prognostic factors. Treatment planning and seed implanting are most often based on the intensive use of transrectal ultrasound (TRUS) imaging. This is not easy because prostate visualization is difficult in this imaging modality particularly as regards the apex of the gland and from an intra- and interobserver variability standpoint. Radioactive seeds are implanted inside open interventional MR machines in some centers. Since MRI was shown to be sensitive and specific for prostate imaging whilst open MR is prohibitive for most centers and makes surgical procedures very complex, this work suggests bringing the MR virtually in the operating room with MRI/TRUS data fusion. This involves providing the physician with bi-modality images (TRUS plus MRI) intended to improve treatment planning from the data registration stage. The pape...

  20. Standardization of I-125. Sum-Peak Coincidence Counting

    Energy Technology Data Exchange (ETDEWEB)

    Grau Carles, A.; Grau Malonda, A.

    2011-07-01

    I-125 is a nuclide which presents difficulties for standardization. The sum-peak method is one of the procedures used to standardize this radionuclide. Initially NaI (Tl)detectors and then the semiconductor detectors with higher resolution have been used.This paper describes the different methods based on the sum-peak procedure and the different expressions used to calculate the activity are deduced. We describe a general procedure for obtaining all of the above equations and many more. We analyze the influence of uncertainties in the used parameters in the uncertainty of the activity. We give a complete example of the transmission of uncertainty and the effects of correlations in the uncertainty of the activity of the sample. High-resolution spectra show an unresolved doublet of 62.0 keV and 62.8 keV. The paper presents two approaches to solve this problem. One is based on the calculation of area ratio and the sum of peak areas obtained from atomic and nuclear data, in the other we modify the equations so that the sum of the peak areas doublet, rather than its components, is present. (Author) 19 refs.

  1. Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, S.A. [Department of Medical Physics, North Shore-Long Island Jewish Health System, Manhassett, NY (United States); Fung, A.Y.C.; Zaider, M. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2002-08-21

    One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results. (author)

  2. NOTE: Optimal needle arrangement for intraoperative planning in permanent I-125 prostate implants

    Science.gov (United States)

    Thompson, S. A.; Fung, A. Y. C.; Zaider, M.

    2002-08-01

    One limitation of intraoperative planning of permanent prostate implants is that needles must already be in the gland before planning images are acquired. Improperly placed needles often restrict the capability of generating optimal seed placement. We developed guiding principles for the proper layout of needles within the treatment volume. The Memorial Sloan-Kettering Cancer Center planning system employs a genetic algorithm to find the optimal seed implantation pattern consistent with pre-assigned constraints (needle geometry, uniformity, conformity and the avoidance of high doses to urethra and rectum). Ultrasound volumes for twelve patients with I-125 implants were used to generate six plans per patient (total 72 plans) with different needle arrangements. The plans were evaluated in terms of V100 (percentage prostate volume receiving at least the prescription dose), U135 (percentage urethra volume receiving at least 135% of prescription dose), and CI (conformity index, the ratio of treatment volume to prescription dose volume.) The method termed POSTCTR, in which needles were placed on the periphery of the largest ultrasound slice and posterior central needles were placed as needed, consistently gave superior results for all prostate sizes. Another arrangement, labelled POSTLAT, where the needles were placed peripherally with additional needles in the posterior lateral lobes, also gave satisfactory results. We advocate two needle arrangements, POSTCTR and POSTLAT, with the former giving better results.

  3. Calibration of film radiochromic EBT2 for sources of I-125 encapsulated; Calibracion de pelicula radiocromica EBT2 para fuentes de I-125 encapsulado

    Energy Technology Data Exchange (ETDEWEB)

    Huerga Cabrerizo, C.; Luquero Llopis, N.; Torre Hernandez, I. de la; Ferrer Garcia, C.; Corredoira silva, E.; Serrada Hierro, A.

    2013-07-01

    This paper determines the calibration curve in absolute dose for sources of I-125 encapsulated to estimate its uncertainty. In order to assess energy dependence is compared with the obtained for an accelerator of 6MV calibration curve. (Author)

  4. SU-E-T-397: Include Organ Deformation Into Dose Calculation of Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shao, Y; Shen, D; Chen, R; Wang, A; Lian, J [University of North Carolina, Chapel Hill, NC (United States)

    2014-06-01

    Purpose: Prostate brachytherapy is an important curative treatment for patients with localized prostate cancer. In brachytherapy, rectal balloon is generally needed to adjust for unfavorable prostate position for seed placement. However, rectal balloon causes prostate deformation, which is not accounted for in dosimetric planning. Therefore, it is possible that brachytherapy dosimetry deviates significantly from initial plan when prostate returns to its non-deformed state (after procedure). The goal of this study is to develop a method to include prostate deformation into the treatment planning of brachytherapy dosimetry. Methods: We prospectively collected ultrasound images of prostate pre- and post- rectal balloon inflation from thirty five consecutive patients undergoing I-125 brachytherapy. Based on the cylinder coordinate systems, we learned the initial coordinate transformation parameters between the manual segmentations of both deformed and non-deformed prostates of each patient in training set. With the nearest-neighbor interpolation, we searched the best transformation between two coordinate systems to maximum the mutual information of deformed and non-deformed images. We then mapped the implanted seeds of five selected patients from the deformed prostate into non-deformed prostate. The seed position is marked on original pre-inflation US image and it is imported into VariSeed software for dose calculation. Results: The accuracy of image registration is 87.5% as quantified by Dice Index. The prostate coverage V100% dropped from 96.5±0.5% of prostate deformed plan to 91.9±2.6% (p<0.05) of non-deformed plan. The rectum V100% decreased from 0.44±0.26 cc to 0.10±0.18 cc (p<0.05). The dosimetry of the urethra showed mild change but not significant: V150% changed from 0.05±0.10 cc to 0.14±0.15 cc (p>0.05) and D1% changed from 212.9±37.3 Gy to 248.4±42.8 Gy (p>0.05). Conclusion: We have developed a deformable image registration method that allows

  5. Measurement of the absorbed dose distribution near an 192Ir intravascular brachytherapy seed using a high-spatial-resolution gel dosimetry system

    Science.gov (United States)

    Massillon-JL, G.; Minniti, R.; Mitch, M. G.; Soares, C. G.

    2012-06-01

    The absorbed dose distribution at sub-millimeter distances from the Best single 192Ir intravascular brachytherapy seed was measured using a high-spatial-resolution gel dosimetry system. Two gel phantoms from the same batch were used; one for the seed irradiation and one for calibration. Since the response of this gel is energy independent for photons between 20 and 1250 keV, the gel was calibrated using a narrowly collimated 60Co gamma-ray beam (cross-sectional area ˜1 cm2). A small format laser computed tomography scanner was used to acquire the data. The measurements were carried out with a spatial resolution of 100 µm in all dimensions. The seed was calibrated at NIST in terms of air-kerma strength. The absorbed dose rate as well as the radial dose function, gL(r), was measured for radial distances between 0.6 and 12.6 mm from the seed center. The dose rate constant was measured, yielding a value of Λ = (1.122 ± 0.032) cGy h-1 U-1, which agrees with published data within the measurement uncertainty. For distances between 0.6 and 1.5 mm, gL(r) decreases from a maximum value of 1.06 down to 1.00; between 1.5 and 6.7 mm, an enhancement is clearly observed with a maximum value around 1.24 and beyond 6.7 mm, gL(r) has an approximately constant value around 1.0, which suggests that this seed can be considered as a point source only at distances larger than 6.7 mm. This latter observation agrees with data for the same seed reported previously using Gafchromic film MD-55-2. Additionally, published Monte Carlo (MC) calculations have predicted the observed behavior of the radial dose function resulting from the absorbed dose contributions of beta particles and electrons emitted by the 192Ir seed. Nonetheless, in the enhancement region, MC underestimates the dose by approximately 20%. This work suggests that beta particles and electrons emitted from the seed make a significant contribution to the total absorbed dose delivered at distances near the seed center (less

  6. The incidence of radioepidermitis and the dose-response relationship in parotid gland cancer patients treated with 125I seed brachytherapy. Incidence of radioepidermitis and the dose-response relationship

    Energy Technology Data Exchange (ETDEWEB)

    Mao, Ming-Hui; Zheng, Lei; Gao, Hong; Zhang, Jie; Liu, Shu-ming; Huang, Ming-wei; Shi, Yan [Peking University School and Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, Beijing (China); Zhang, Jian-Guo [Peking University School and Hospital of Stomatology, Department of Oral and Maxillofacial Surgery, Beijing (China); Fujian Provincial Hospital, Fujian (China)

    2014-09-09

    We studied the incidence and dose-response relationship of radioepidermitis in parotid gland carcinoma patients treated with [{sup 125}I] seed brachytherapy in the hopes of designing an optimized pre-implant treatment plan that would reduce the incidence and severity of radioepidermitis in patients receiving this therapy. Between January 2007 and May 2010, 100 parotid gland cancer patients were treated postoperatively with [{sup 125}I] seed brachytherapy. The matched peripheral dose (MPD) was 80-140 Gy, and [{sup 125}I] seed activity was 0.7-0.8 mCi. The mean dose delivered to the skin was calculated in the post-implant CT on day 0 following implantation. Grades of acute and late dermatitis were evaluated at 2, 6, 12, and 18 months post-implantation. Most patients experienced grade 0-2 acute and late skin side effects (86 and 97 %, respectively), though a small subset developed severe complications. Most grade 1-3 effects resolved within 6 months of implantation, though some grade 1-3 effects and all grade 4 effects remained unchanged throughout the 18-month follow-up period. Grade 3 and 4 effects were most prominent (75 and 25 %, respectively) with doses of 110-140 Gy; doses higher than 140 Gy produced only grade 4 effects. [{sup 125}I] seed brachytherapy produced acceptable levels of acute and late radioepidermitis with a good clinical outcome. A mean dose under 100 Gy delivered to the skin was safe, though doses of 110-140 Gy should be given with caution and extra monitoring; doses greater than 140 Gy are dangerous and likely to produce grade 4-5 effects. (orig.) [German] Wir untersuchten die Inzidenz und die Dosis-Wirkung-Beziehung bei Patienten mit Ohrspeicheldruesenkrebs, die mit [{sup 125}I]-Seed-Brachytherapie behandelt wurden, in der Hoffnung, eine optimierte praeimplantologische Behandlung zu entwickeln, welche die Inzidenz und Schwere der Radioepidermitis bei Patienten, die diese Therapie erhalten haben, reduziert. Zwischen Januar 2007 und Mai 2010

  7. Radiation exposure to operating room staff during prostate brachytherapy using iodine-125 seeds; Exposition radiologique de l'equipe operatoire au cours de curietherapies de prostate par implants permanents d'iode-125

    Energy Technology Data Exchange (ETDEWEB)

    Gagna, G.; Amabile, J.C.; Laroche, P. [Service de protection radiologique des armees (SPRA), 1 bis rue du Lieutenant Raoul Batany, 92141 Clamart Cedex (France); Gauron, C. [Institut national de recherche et de securite (INRS), Departement Etudes et Assistance Medicales, 30 rue Olivier Noyer, 75680 Paris Cedex 14 (France)

    2011-04-15

    The French defense radiation protection service (SPRA) and the French national institute for research and safety (INRS) conducted a joint study to assess the radiation exposure to operating room staff during prostate brachytherapy using iodine-125 seeds at the Val-de-Grace military hospital. The purpose of the study was the assessment of the effective doses, the equivalent doses to the extremities and lens received by a novice team, the different ambient dose equivalent rates measurements and the delineation of areas. After six brachy-therapies, all the recorded doses with whole-body InLight{sup R} OSL and nanoDot{sup R} dosimeters remained below the detection limit for the whole staff. The dose rate measured at the end of implantation by an AT1123{sup R} survey meter is about 170 {mu}Sv/h at the perineum of the patient. The controlled area limit is estimated to be about 20 cm from the patient perineum. From these results, the authors propose recommendations for the categorization of workers, the delineation of areas and the dose monitoring procedures. This study demonstrates that real-time ultrasound-guided trans-perineal prostate brachytherapy delivers low dose to the operators because of the radioactive source characteristics and the instrumentation providing an effective radiation protection for the surgical team. (authors)

  8. Brachytherapy with Iodine-125 seeds in initial prostate cancer treatment: preliminary results and complications; Braquiterapia com sementes de Iodo-125 no tratamento do cancer inicial de prostata: resultados e complicacoes preliminares

    Energy Technology Data Exchange (ETDEWEB)

    Penna, Antonio Belmiro R. Campbell [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Programa de Pos-graduacao em Radiologia]. E-mail: info@radiobot.com.br; Bernabe, Antonio Jose S. [Sociedade Brasileira de Urologia, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    2005-07-01

    Low-dose rate brachytherapy as monotherapy is a treatment option for early stage prostate cancer. It consists of the permanent implantation of Iodine-125 seeds in the gland of patients with PSA{<=} 10ng/ml, Gleason {<=} 6 and clinical stage from T1 until T2b. The 68 patients enrolled in this study were treated by the technique developed at the Northwest Pacific Hospital, Seattle, USA. Sixty four patients treated with low-dose rate brachytherapy were followed for 4-48 months (median = 32 months). The treatment results were based on the periodic evaluation of the total PSA values and it was found that, after this time, 55% of patients had total PSA equal or below 1ng/ml. Post-implant morbidities were evaluated, showing that 89% presented negligible or low grade side effects. Low-dose rate brachytherapy is an appealing option for the treatment of early stage prostate cancer because of its successful local control and low morbidity. (author)

  9. Prostate cancer brachytherapy; Braquiterapia de cancer de prostata

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Carlos Eduardo Vita; Silva, Joao L. F. [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Centro de Oncologia. Dep. de Radioterapia; Srougi, Miguel; Nesrallah, Adriano [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina (EPM). Disciplina de Urologia]. E-mail: cevitabr@mandic.com.br

    1999-07-01

    The transperineal brachytherapy with {sup 125}I/Pd{sup 103} seed implantation guided by transurethral ultrasound must be presented as therapeutical option of low urinary morbidity in patients with localized prostate cancer. The combined clinical staging - including Gleason and initial PSA - must be encouraged, for definition of a group of low risk and indication of exclusive brachytherapy. Random prospective studies are necessary in order to define the best role of brachytherapy, surgery and external beam radiation therapy.

  10. Prospective trial comparing intraoperative flexible, rigid, and no cystoscopy after ultrasound-guided transperineal permanent seed prostate brachytherapy

    Directory of Open Access Journals (Sweden)

    John Sylvester

    2016-06-01

    Conclusion: There was no significant difference in dysuria in the first four urinations post-PB between patients in the rigid, flexible, and no cystoscopy groups. Larger blood clots that may have been difficult to void, seeds in the bladder and/or urethra, and other abnormalities were found in 7% of patients who had cystoscopy. This may suggest that cystoscopy may be worthwhile post-PB. The incidence of AUR was not significantly different between the three cohorts.

  11. Statistical differences and systematic effect on measurement procedure in thermoluminescent dosimetry of the Iodine-125 brachytherapy seed

    Energy Technology Data Exchange (ETDEWEB)

    Zeituni, Carlos A.; Moura, Eduardo S.; Rostelato, Maria Elisa C.M.; Manzoli, Jose E.; Moura, Joao Augusto; Feher, Anselmo, E-mail: czeituni@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP) Sao Paulo, SP (Brazil); Karam, Dib [Universidade de Sao Paulo (USP Leste), Sao Paulo, SP (Brazil). Escola de Artes, Ciencias e Humanidades

    2009-07-01

    In order to provide the dosimetry for Iodine-125 seed production in Brazil, Harshaw thermoluminescent dosimeters (TLD-100) will be used. Even if measurements with TLD-100 of the same batch of fabrication are performed, the response will not be the same. As a consequence, they must be measured one by one. These dosimeters are LiF type with a micro-cube (1 mm x 1 mm x 1 mm) shape. Irradiations were performed using Iodine-125 seeds to guarantee the same absorbed dose of 5 Gy in each dosimeter. It has been used a Solid Water Phantom with three concentrically circle with 20 mm, 50 mm and 70 mm diameters. The angle of positions used was 0 deg, 30 deg, 60 deg and 90 deg. Of course there are 2 positions in 0 deg and 90 deg and 4 positions in 30 deg and 60 deg. These complete procedures were carried out five times in order to compare the data and minimize the systematic error. The iodine-125 seed used in the experiment was take off in each measure and put again turning his position 180 deg to guarantee the systematic error was minimized. This paper presents also a little discussion about the statistical difference in the measurement and the calculation procedure to determine the systematic error in these measurements. (author)

  12. Brachytherapy volume visualization

    Science.gov (United States)

    Persons, Timothy M.; Webber, Richard L.; Hemler, Paul F.; Bettermann, Wolfram; Bourland, J. Daniel

    2000-04-01

    Conventional localization schemes for brachytherapy seed implants using biplane or stereoscopic projection radio- graphs can suffer form scaling distortions and poor visibility of implanted seeds, resulting in compromised source tracking and dosimetric inaccuracies. This paper proposes an alternative method for improving the visualization and thus, localization, of radiotherapy implants by synthesizing, form as few as two radiographic projections, a 3D image free of divergence artifacts. The result produces more accurate seed localization leading to improved dosimetric accuracy. Two alternative approaches are compared. The first uses orthogonal merging. The second employs the technique of tuned-aperture computed tomography (TACT), whereby 3D reconstruction is performed by shifting and adding of well-sampled projections relative to a fiducial reference system. Phantom results using nonlinear visualization methods demonstrate the applicability of localizing individual seeds for both approaches. Geometric errors are eliminated by a calibration scheme derived from the fiducial pattern that is imaged concurrently with the subject. Both merging and TACT approaches enhance seed localization by improving visualization of the seed distribution over biplanar radiographs. Unlike current methods, both alternatives demonstrate continuos one-to-one source tracking in 3D, although elimination of scaling artifacts requires more than two projections when using the merging method.

  13. 1{sup 25I} brachytherapy seeds implantation for inoperable low-grade leiomyosarcoma of inferior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yuliang; Wang, Yongzheng; Liu, Bin; Li, Zheng; Wang, Wujie [The Second Hospital of Shandong Univ., Jinan (China)

    2013-04-15

    A 60-year-old female presented with abdominal pain and tenderness of five-day duration. Contrast enhanced CT showed a mass of 9 x 6 x 5.5 cm in size with almost complete obliteration of the inferior vena cava and massive extension to the extravascular space. CT-guided biopsy demonstrated a low-grade leiomyosarcoma. The patient underwent 1{sup 25I}odine seeds implantation in two sessions, and another balloon cavoplasty. Abdominal pain and tenderness gradually improved and the patient continues to remain as disease free state for three years after the procedures.

  14. Calibration of the Accuscan II In Vivo System for I-125 Thyroid Counting

    Energy Technology Data Exchange (ETDEWEB)

    Ovard R. Perry; David L. Georgeson

    2011-07-01

    This report describes the March 2011 calibration of the Accuscan II HpGe In Vivo system for I-125 thyroid counting. The source used for the calibration was a DOE manufactured Am-241/Eu-152 source contained in a 22 ml vial BEA Am-241/Eu-152 RMC II-1 with energies from 26 keV to 344 keV. The center of the detector housing was positioned 64 inches from the vault floor. This position places the approximate center line of the detector housing at the center line of the source in the phantom thyroid tube. The energy and efficiency calibration were performed using an RMC II phantom (Appendix J). Performance testing was conducted using source BEA Am-241/Eu-152 RMC II-1 and Validation testing was performed using an I-125 source in a 30 ml vial (I-125 BEA Thyroid 002) and an ANSI N44.3 phantom (Appendix I). This report includes an overview introduction and records for the energy/FWHM and efficiency calibration including performance verification and validation counting. The Accuscan II system was successfully calibrated for counting the thyroid for I-125 and verified in accordance with ANSI/HPS N13.30-1996 criteria.

  15. Reevaluation of the AAPM TG-43 brachytherapy dosimetry parameters for an 125I seed, and the influence of eye plaque design on dose distributions and dose-volume histograms

    Science.gov (United States)

    Aryal, Prakash

    The TG-43 dosimetry parameters of the Advantage(TM) 125I model IAI-125A brachytherapy seed were studied. An investigation using modern MCNP radiation transport code with updated cross-section libraries was performed. Twelve different simulation conditions were studied for a single seed by varying the coating thickness, mass density, photon energy spectrum and cross-section library. The dose rate was found to be 6.3% lower at 1 cm in comparison to published results. New TG-43 dosimetry parameters are proposed. The dose distribution for a brachytherapy eye plaque, model EP917, was investigated, including the effects of collimation from high-Z slots. Dose distributions for 26 slot designs were determined using Monte Carlo methods and compared between the published literature, a clinical treatment planning system, and physical measurements. The dosimetric effect of the composition and mass density of the gold backing was shown to be less than 3%. Slot depth, width, and length changed the central axis (CAX) dose distributions by < 1% per 0.1 mm in design variation. Seed shifts in the slot towards the eye and shifts of the 125I-laden silver rod within the seed had the greatest impact on the CAX dose distribution, changing it by 14%, 9%, 4.3%, and 2.7% at 1, 2, 5, and 10 mm, respectively, from the inner scleral surface. The measured, full plaque slot geometry delivered 2.4% +/- 1.1% higher dose along the plaque's CAX than the geometry provided by the manufacturer and 2.2%+/-2.3% higher than Plaque Simulator(TM) (PS) treatment planning software (version 5.7.6). The D10 for the simulated tumor, inner sclera, and outer sclera for the measured slot plaque to manufacturer provided slot design was 9%, 10%, and 19% higher, respectively. In comparison to the measured plaque design, a theoretical plaque having narrow and deep slots delivered 30%, 37%, and 62% lower D 10 doses to the tumor, inner sclera, and outer sclera, respectively. CAX doses at --1, 0, 1, and 2 mm were also

  16. Interstitial hyperthermia in combination with brachytherapy.

    Science.gov (United States)

    Coughlin, C T; Douple, E B; Strohbehn, J W; Eaton, W L; Trembly, B S; Wong, T Z

    1983-07-01

    Flexible coaxial cables were modified to serve as microwave antennas operating at a frequency of 915 MHz. These antennas were inserted into nylon afterloading tubes that had been implanted in tumors using conventional interstitial implantation techniques for iridium-192 seed brachytherapy. The tumor volume was heated to 42-45 degrees C within 15 minutes and heating was continued for a total of 1 hour per treatment. Immediately following a conventional brachytherapy dose and removal of the iridium seeds the tumors were heated again in a second treatment. This interstitial technique for delivering local hyperthermia should be compatible with most brachytherapy methods. The technique has proved so far to be practical and without complications. Temperature distributions obtained in tissue phantoms and a patient are described.

  17. [Intraoperative and post-implant dosimetry in patients treated with permanent prostate implant brachytherapy].

    Science.gov (United States)

    Herein, András; Ágoston, Péter; Szabó, Zoltán; Jorgo, Kliton; Markgruber, Balázs; Pesznyák, Csilla; Polgár, Csaba; Major, Tibor

    2015-06-01

    The purpose of our work was to compare intraoperative and four-week post-implant dosimetry for loose and stranded seed implants for permanent prostate implant brachytherapy. In our institute low-dose-rate (LDR) prostate brachytherapy is performed with encapsulated I-125 isotopes (seeds) using transrectal ultrasound guidance and metal needles. The SPOT PRO 3.1 (Elekta, Sweden) system is used for treatment planning. In this study the first 79 patients were treated with loose seed (LS) technique, the consecutive patients were treated with stranded seed (SS) technique. During intraoperative planning the dose constraints were the same for both techniques. All LSs were placed inside the prostate capsule, while with SS a 2 mm margin around the prostate was allowed for seed positioning. The prescribed dose for the prostate was 145 Gy. This study investigated prostate dose coverage in 30-30 randomly selected patients with LS and SS. Four weeks after the implantation native CT and MRI were done and CT/MRI image fusion was performed. The target was contoured on MRI and the plan was prepared on CT data. To assess the treatment plan dose-volume histograms were used. For the target coverage V100, V90, D90, D100, for the dose inhomogeneity V150, V200, and the dose-homogeneity index (DHI), for dose conformality the conformal index (COIN) were calculated. Intraoperative and postimplant plans were compared. The mean V100 values decreased at four-week plan for SS (97% vs. 84%) and for LS (96% vs. 80%) technique, as well. Decrease was observed for all parameters except for the DHI value. The DHI increased for SS (0.38 vs. 0.41) and for LS (0.38 vs. 0.47) technique, as well. The COIN decreased for both techniques at four-week plan (SS: 0.63 vs. 0.57; LS: 0.67 vs. 0.50). All differences were significant except for the DHI value at SS technique. The percentage changes were not significant, except the COIN value. The dose coverage of the target decreased significantly at four-week plans

  18. Brachytherapy applications and techniques

    CERN Document Server

    Devlin, Phillip M

    2015-01-01

    Written by the foremost experts in the field, this volume is a comprehensive text and practical reference on contemporary brachytherapy. The book provides detailed, site-specific information on applications and techniques of brachytherapy in the head and neck, central nervous system, breast, thorax, gastrointestinal tract, and genitourinary tract, as well as on gynecologic brachytherapy, low dose rate and high dose rate sarcoma brachytherapy, vascular brachytherapy, and pediatric applications. The book thoroughly describes and compares the four major techniques used in brachytherapy-intraca

  19. History of dose specification in Brachytherapy: From Threshold Erythema Dose to Computational Dosimetry

    Science.gov (United States)

    Williamson, Jeffrey F.

    2006-09-01

    This paper briefly reviews the evolution of brachytherapy dosimetry from 1900 to the present. Dosimetric practices in brachytherapy fall into three distinct eras: During the era of biological dosimetry (1900-1938), radium pioneers could only specify Ra-226 and Rn-222 implants in terms of the mass of radium encapsulated within the implanted sources. Due to the high energy of its emitted gamma rays and the long range of its secondary electrons in air, free-air chambers could not be used to quantify the output of Ra-226 sources in terms of exposure. Biological dosimetry, most prominently the threshold erythema dose, gained currency as a means of intercomparing radium treatments with exposure-calibrated orthovoltage x-ray units. The classical dosimetry era (1940-1980) began with successful exposure standardization of Ra-226 sources by Bragg-Gray cavity chambers. Classical dose-computation algorithms, based upon 1-D buildup factor measurements and point-source superposition computational algorithms, were able to accommodate artificial radionuclides such as Co-60, Ir-192, and Cs-137. The quantitative dosimetry era (1980- ) arose in response to the increasing utilization of low energy K-capture radionuclides such as I-125 and Pd-103 for which classical approaches could not be expected to estimate accurate correct doses. This led to intensive development of both experimental (largely TLD-100 dosimetry) and Monte Carlo dosimetry techniques along with more accurate air-kerma strength standards. As a result of extensive benchmarking and intercomparison of these different methods, single-seed low-energy radionuclide dose distributions are now known with a total uncertainty of 3%-5%.

  20. [Prostate brachytherapy: oncological and functional results after 400 cases].

    Science.gov (United States)

    Gastaldi, Emilio; Chiono, Luciano; Gallo, Fabrizio; Giberti, Claudio

    2014-01-01

    Brachytherapy (BT) with real-time technique for the treatment of low and medium risk prostate cancer (CaP) has been a well known practice for over 25 years in the USA and for over 
15 years in Italy. However, it is an uncommon procedure, because of problems related to the organization and cooperation among urologists, radiotherapists and physics, to the competition of alternative therapies, to dogmatic and educational beliefs, and to the poor knowledge of this technique.
 Between May1999 and July 2013, 400 patients with low and medium risk CaP underwent I 125 BT using a "real-time" approach. The seeds implantation was performed using a Mick applicator in the first 190 patients and the "QuickLink" technique in the last 210 cases. Oncologic results were reported for the first 250 cases with a mean follow-up of 10 years, while functional outcomes and complications were assessed in 350 patients with a minimum follow-up of 1 year.
 A good quality implantation was assessed in 90% of the patients (D90>145 Gy). A biochemical failure was assessed, based on Phoenix criteria, in 12 patients (4.8%). Out of these patients, 
10 underwent prostate biopsy (the other 2 patients showed a systemic disease). The biopsy showed a CaP in 6/10 patients who underwent retropubic radical prostatectomy (4 patients) and external radiotherapy (2 patients) respectively. The remaining 4/10 patients with negative biopsy were treated with total androgen blockade (3 patients) and watchful waiting (1 patient) respectively. Functional results showed an incidence of postoperative irritative disorders in 70% of the patients during the first six months and a good recovery of erectile function in 78.8% and 68.2% of the patients after one and five years from BT respectively.
 Brachytherapy is a good alternative to radical prostatectomy in the low and medium risk prostatic cancers with excellent oncologic and functional results.

  1. Clinical and dosimetric analysis of 469 prostate cancer patients treated in France in 2005 by permanent implant brachytherapy using the Iodine 125 seeds IsoSeed Bebig: report to the French Economic committee of health products (C.E.P.S.); Analyse clinique et dosimetrique de 469 patients traites en France en 2005 par implantation prostatique de grains d'iode 125 IsoSeed Bebig: rapport pour le Comite economique des produits de sante (CEPS)

    Energy Technology Data Exchange (ETDEWEB)

    Cosset, J.M.; Gomme, S.; Henni, M.; Rosenwald, J.C.; Pontvert, B.; Asselain, D.; Chauveinca, L. [Institut Curie, 75 - Paris (France); Chauveinca, L. [Clinique Hartmann, 92 - Neuilly-sur-Seine (France); Peiffert, D. [Centre Alexis-Vautrin, 54 - Nancy (France); Guerif, S. [CHU de Poitiers, 86 - Poitiers (France); Labib, A. [Centre Rene-Huguenin, 92 - Saint-Cloud (France); Hannoun-Levi, J.M. [Centre Antoine-Lacassagne, 06 - Nice (France); Martin, P. [Polyclinique de Bourgogne, 59 - Lille (France); Quetin, G. [Centre Paul-Strauss, 67 - Strasbourg (France); Nguyen, T.D. [Centre Jean-Godinot, 51 - Reims (France); Flam, T. [Hopital Cochin, 75 - Paris (France); Thiounn, N. [Hopital Necker, 75 - Paris (France); Housset, M. [Hopital Europeen Georges-Pompidou, 75 - Paris (France)

    2007-06-15

    A French decree of February 3. 2005, allowed the Iodine 125 seeds from several companies to be reimbursed after a permanent implantation brachytherapy for a prostate cancer. Within this frame, the French 'Comite economique des produits de sante' (C.E.P.S.; Economic committee for health products) made mandatory the annual writing and publication of a follow-up study with three main aims; make sure that the seeds were used for prostate cancer patients with criteria corresponding to the national recommendations, analyze the quality of the dosimetric data, and report all side effects, complications and possible accidents. We therefore report here a clinical and dosimetric analysis of 469 patient cases treated in France in nine centers in 2005 with the Iodine 125 IsoSeed Bebig. This analysis shows that: 1) The national recommendations for selecting patients for exclusive prostate brachytherapy have been taken into account in 97% of the cases; 2) The dosimetric quality criteria totally fulfilled the recommendations in a large majority of cases; the intra-operative D90 was found to be superior to 145 Gy in 98% of the patients, and the intra-operative V100 was superior to 95% in 96% of the cases; 3) The early toxicity (mainly urinary) was found to be at the lower range of what is reported in the literature, with in particular a retention rate of 2.4%. (autho0008.

  2. Retention of albumin labelled with I-125 in the bio mineral hydroxyapatite; Retencion de albumina marcada con I-125 en el biomineral hidroxiapatita

    Energy Technology Data Exchange (ETDEWEB)

    Badillo A, V.E.; Bugarin C, A. [UAZ, Cipres 10, Fracc. La Penuela, 98068 Zacatecas (Mexico); Monroy G, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2003-07-01

    The demands of materials for the health in the entire world, especially of the odontological and traumatological sectors make every time to be but studied the hydroxyapatite (HAP) and their biocompatibility with the alive beings. The hydroxyapatite is considered as one of the inorganic exchangers by excellence, for what the fixation of ions and molecules have been widely studied and at the moment it is one of the materials of greater acceptance like implant. The surface of the material of implant is in intimate contact with the live tissue and its biocompatibility is determined in great measure by those surface properties of the bio material, which have a direct effect in the cellular response of the material. After administering the implant, the proteins are immediately adsorbed in the surface of the bio mineral. Specifically, the proteins of the blood are considered as key pieces to determine the acceptance of implants in alive beings. The adsorption of proteins it depends on the physicochemical properties of the material as well as of the environment composition. The surface properties of the HAP are relevant in the adsorption mechanisms of the proteins. In this work, it is reported the adsorption of the labelled with I-125 albumin protein and in function of two important physicochemical parameters: the pH value of the of the solution and the chemical nature of the solution; to see the influence of this last, its were studied three electrolytes NaF, NaCl and NaH{sub 2}PO{sub 4}. The existence of the active sites of hydroxyapatite surface, it is key piece in the interpretation of the fixation of the albumin protein in function also of their acid-base properties. (Author)

  3. An ultrahigh resolution SPECT system for I-125 mouse brain imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Meng, L.J. [Department of Nuclear, Plasma and Radiological Engineering, University of Illinois, Urbana-Champaign (United States)], E-mail: ljmeng@umich.edu; Fu, G. [Department of Nuclear, Plasma and Radiological Engineering, University of Illinois, Urbana-Champaign (United States); Roy, E.J.; Suppe, B. [Department of Pathology, University of Illinois, Urbana-Champaign (United States); Chen, C.T. [Department of Radiology, University of Chicago (United States)

    2009-03-01

    This paper presents some initial experimental results obtained with a dual-head prototype single photon emission microscope system (SPEM) that is dedicated to mouse brain studies using I-125 labeled radiotracers. In particular, this system will be used for in vivo tacking of radiolabeled T cells in mouse brain. This system is based on the use of the intensified electron multiplying charge-coupled device (I-EMCCD) camera that offers the combination of an excellent intrinsic spatial resolution, a good signal-to-noise ratio, a large active area and a reasonable detection efficiency over an energy range between 27-140 keV. In this study, the dual-head SPEM system was evaluated using both resolution phantoms and a mouse with locally injected T cells labeled with I-125. It was demonstrated that for a relatively concentrated source object, the current dual-head SPEM system is capable of visualizing the tiny amount of radioactivity ({approx}12 nCi) carried by a very small number (<1000) of T cells. The current SPEM system design allows four or six camera heads to be installed in a stationary system configuration that offers a doubled or tripled sensitivity at a spatial resolution similar to that obtained with the dual-head system. This development would provide a powerful tool for in vivo and non-invasive tracking of radiolabeled T cells in mouse brain and potentially for other rodent brain imaging studies.

  4. An ultrahigh resolution SPECT system for I-125 mouse brain imaging studies

    Science.gov (United States)

    Meng, L. J.; Fu, G.; Roy, E. J.; Suppe, B.; Chen, C. T.

    2009-03-01

    This paper presents some initial experimental results obtained with a dual-head prototype single photon emission microscope system (SPEM) that is dedicated to mouse brain studies using I-125 labeled radiotracers. In particular, this system will be used for in vivo tacking of radiolabeled T cells in mouse brain. This system is based on the use of the intensified electron multiplying charge-coupled device (I-EMCCD) camera that offers the combination of an excellent intrinsic spatial resolution, a good signal-to-noise ratio, a large active area and a reasonable detection efficiency over an energy range between 27-140 keV. In this study, the dual-head SPEM system was evaluated using both resolution phantoms and a mouse with locally injected T cells labeled with I-125. It was demonstrated that for a relatively concentrated source object, the current dual-head SPEM system is capable of visualizing the tiny amount of radioactivity (˜12 nCi) carried by a very small number (<1000) of T cells. The current SPEM system design allows four or six camera heads to be installed in a stationary system configuration that offers a doubled or tripled sensitivity at a spatial resolution similar to that obtained with the dual-head system. This development would provide a powerful tool for in vivo and non-invasive tracking of radiolabeled T cells in mouse brain and potentially for other rodent brain imaging studies.

  5. Dosimetric results in implant and post-implant and low rate in brachytherapy prostate cancer with loose seeds and attached; Resultados dosimetricos en el implante y post-impante en braquiterapia de baja tasa en cancer de prostata con semillas sueltas y unidas

    Energy Technology Data Exchange (ETDEWEB)

    Juan-Senabre, X. J.; Albert Antequera, M.; Lopez-Tarjuelo, J.; Santos Serra, A.; Perez-Mestre, M.; Sanchez Iglesias, A. L.; Conde Moreno, A. J.; Gonzalez Vidal, V.; Beltran Persiva, J.; Muelas Soria, R.; Ferrer Albiach, C.

    2015-07-01

    The objective is determine differences dosimetry statistics on the dosimetry of the implant and post-implant in brachytherapy of low rate with implants permanent in prostate using seed of 125-I loose and attached Both in lives and in the post-prostatic plans dosimetric coverage is good and restrictions in urethra and rectum for both groups of patients are met. Not migrating with joined is evident, as well as better dosimetric homogeneity. (Author)

  6. Dosimetric analysis of 123I, 125I and 131I in thyroid follicle models

    Science.gov (United States)

    2014-01-01

    Background Radioiodine is routinely used or proposed for diagnostic and therapeutic purposes: 123I, 125I and 131I for diagnostics and 125I and 131I for therapy. When radioiodine-labelled pharmaceuticals are administered to the body, radioiodide might be released into the circulation and taken up by the thyroid gland, which may then be an organ at risk. The aim of this study was to compare dosimetric properties for 123I, 125I and 131I in previously developed thyroid models for man, rat and mouse. Methods Dosimetric calculations were performed using the Monte Carlo code MCNPX 2.6.0 and nuclear decay data from ICRP 107. Only the non-radiative transitions in the decays were considered. The S value was determined for the cell nuclei in species-specific thyroid follicle models for mouse, rat and man for different spatial distributions of radioiodine. Results For the species-specific single follicle models with radioiodine homogeneously within the follicle lumen, the highest S value came from 131I, with the largest contribution from the β particles. When radioiodine was homogeneously distributed within the follicle cells or the follicle cell nucleus, the highest contribution originated from 125I, about two times higher than 123I, with the largest contribution from the Auger electrons. The mean absorbed dose calculated for our human thyroid multiple follicle model, assuming homogenous distribution of for 123I, 125I, or 131I within the follicle lumens and follicle cells, was 9%, 18% and 4% higher, respectively, compared with the mean absorbed dose according to Medical Internal Radiation Dose (MIRD) formalism and nuclear decay data. When radioiodine was homogeneously distributed in the follicle lumens, our calculations gave up to 90% lower mean absorbed dose for 125I compared to MIRD (20% lower for 123I, and 2% lower for 131I). Conclusions This study clearly demonstrates the importance of using more detailed dosimetric methods and models than MIRD formalism for radioiodine

  7. 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.

    Science.gov (United States)

    Pinkawa, Michael; Asadpour, Branka; Piroth, Marc D; Gagel, Bernd; Klotz, Jens; Fischedick, Karin; Borchers, Holger; Jakse, Gerhard; Eble, Michael J

    2009-05-01

    The aim of the study was to compare intra-operative and postplanning at different intervals with special focus on sources placed close to the rectal wall. In 61 consecutive patients, CT scans were performed on day 1 and day 30 after an I-125 implant with stranded seeds. The number of sources Sources close to the rectum on day 1 (n=204) have been the most apical in a strand in 98.5% (n=201). By comparing day 1 and day 30 data, significant inferior source displacements (mean 3.6 mm; p=0.02) relative to pelvic bones and a decreasing distance to the rectal wall (mean 1.2 mm; psources initially > or =3 mm to the rectum. In contrast to an almost parallel arrangement of the needle track and the rectal wall in TRUS, strands and rectal wall converged towards the apex in the postplanning CT scans (mean >30 degrees). Posterior preplanning margins around the prostate should be particularly limited at the level of the prostate apex.

  8. The role of brachytherapy in the definitive management of prostate cancer; Place de la curietherapie dans le traitement du cancer prostatique localise

    Energy Technology Data Exchange (ETDEWEB)

    Crook, J. [British Columbia Cancer Agency, Center for the Southern Interior, 399, Royal Avenue, Kelowna, British Columbia, V1Y 5L33 (Canada)

    2011-06-15

    Over the past two decades, brachytherapy has played an ever expanding role in the definitive radiotherapy of prostate cancer. Brachytherapy surpasses external beam radiotherapy in its ability to deliver intense intra-prostatic dose escalation. Although initially low dose rate permanent seed brachytherapy was favored for favorable risk prostate cancers, and high dose rate temporary brachytherapy for intermediate and advanced disease, both types of brachytherapy now have a place across all the risk groups of localized prostate cancer. This article will review indications and patient selection, planning and technical aspects, toxicity and efficacy for both low and high dose rate prostate brachytherapy. (author)

  9. Monte Carlo calculation of dosimetric parameters of a {sup 125}I brachytherapy seed encapsulation with biocompatible polymer and a ceramic matrix as radiographic marker

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Lucas P.; Santos, Adriano M.; Grynberg, Suely E., E-mail: lpr@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Lab. de Dosimetria e Simulacao Computacional; Facure, Alessandro, E-mail: facure@cnen.gov.b [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    For prostate cancer treatments, there is an increasing interest in the permanent radioactive seeds implant technique. Currently, in Brazil, the seeds are imported at high prices, which prohibit their use in public hospitals. One of the seed models that have been developed at CDTN has a ceramic matrix as a radioisotope carrier and a radiographic marker; the seed is encapsulated with biocompatible polymer. In this work, Monte Carlo simulations were performed in order to assess the dose distributions generated by the prototype seed model. The obtained data was assessed as described in the TG-43U1 report by the AAPM. The dosimetric parameters dose rate constant, {Lambda}, radial dose function, g{sub L}(r), and anisotropy function, F(r,{theta}), were derived from simulations using the MCNP5 code. The function g(r) shows that the seed has a lower decrease in dose rate on its transverse axis when compared to the 6711 model (one of the most used seeds in permanent prostate implants). F(r,{theta}) shows that CDTN's seed anisotropy curves are smoother than the 6711 model curves for {theta}{<=}20 deg and 0.25{<=}r{<=}1 cm. As well, the {Lambda} value is 15% lower than the {Lambda} value of 6711. The results show that CDTN's seed model can deposit a more isotropic dose. Because of the model's characteristics, the seeds can be impregnated with iodine of lower specific activity which would help reducing costs. (author)

  10. Advancements in brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Ménard, Cynthia; Polgar, Csaba

    2017-01-01

    Brachytherapy is a radiotherapy modality associated with a highly focal dose distribution. Brachytherapy treats the cancer tissue from the inside, and the radiation does not travel through healthy tissue to reach the target as with external beam radiotherapy techniques. The nature of brachytherap...... in terms of controlling dose and demonstrating excellent clinical outcome. Interests in focal, hypofractionated and adaptive treatments are increasing, and brachytherapy has significant potential to develop further in these directions with current and new treatment indications....

  11. Sexual Function and the Use of Medical Devices or Drugs to Optimize Potency After Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Whaley, J. Taylor; Levy, Lawrence B. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Swanson, David A. [Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Pugh, Thomas J. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Kudchadker, Rajat J.; Bruno, Teresa L. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Frank, Steven J., E-mail: sjfrank@mdnaderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2012-04-01

    Purpose: Prospective evaluation of sexual outcomes after prostate brachytherapy with iodine-125 seeds as monotherapy at a tertiary cancer care center. Methods and Materials: Subjects were 129 men with prostate cancer with I-125 seed implants (prescribed dose, 145 Gy) without supplemental hormonal or external beam radiation therapy. Sexual function, potency, and bother were prospectively assessed at baseline and at 1, 4, 8, and 12 months using validated quality-of-life self-assessment surveys. Postimplant dosimetry values, including dose to 10% of the penile bulb (D10), D20, D33, D50, D75, D90, and penile volume receiving 100% of the prescribed dose (V100) were calculated. Results: At baseline, 56% of patients recorded having optimal erections; at 1 year, 62% of patients with baseline erectile function maintained optimal potency, 58% of whom with medically prescribed sexual aids or drugs. Variables associated with pretreatment-to-posttreatment decline in potency were time after implant (p = 0.04) and age (p = 0.01). Decline in urinary function may have been related to decline in potency. At 1 year, 69% of potent patients younger than 70 years maintained optimal potency, whereas 31% of patients older than 70 maintained optimal potency (p = 0.02). Diabetes was related to a decline in potency (p = 0.05), but neither smoking nor hypertension were. For patients with optimal potency at baseline, mean sexual bother scores had declined significantly at 1 year (p < 0.01). Sexual potency, sexual function, and sexual bother scores failed to correlate with any dosimetric variable tested. Conclusions: Erections firm enough for intercourse can be achieved at 1 year after treatment, but most men will require medical aids to optimize potency. Although younger men were better able to maintain erections firm enough for intercourse than older men, there was no correlation between potency, sexual function, or sexual bother and penile bulb dosimetry.

  12. Methods for prostate stabilization during transperineal LDR brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Podder, Tarun; Yu Yan [Department of Radiation Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107 (United States); Sherman, Jason [Department of Medical Physics, University of Buffalo, Buffalo, NY 14260 (United States); Rubens, Deborah; Strang, John [Departments of Imaging Science and Surgery, University of Rochester, Rochester, NY 14642 (United States); Messing, Edward [Departments of Urology and Surgery, University of Rochester, Rochester, NY 14642 (United States); Ng, Wan-Sing [School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798 (Singapore)

    2008-03-21

    In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and

  13. The initial experience of ~(125)I seeds brachytherapy for patients with oral carcinoma%~(125)I放射性粒子近距离放射治疗口腔癌的初步临床应用

    Institute of Scientific and Technical Information of China (English)

    于香红; 高飞; 李振家; 窦卫涛; 韩旭健; 武乐斌

    2009-01-01

    Objective To evaluate the efficacy of ~(125)I radioactive seeds implantation and ~(125)I plaque brachytherapy for oral carcinoma. Methods Eighteen patients with oral carcinoma confirmed by cytology or histopathology were included in this study, Twelve patients with tongue cancer and six patients with gingival carcinoma, there were 20 ulcerative lesions and 10 metastatic cervical lymph nodes. The mean diameter is (2.3±0.7)cm and(2.8±1.7)cm respectively. The patients were treated with both interstitial implantation of ~(125)I seeds and ~(125)I plaque brachytherapy or with ~(125)I plaque brachytherapy only according to patient's individual conditions.The metastatic cervical lymph nodes were treated with CT-guided interstitial implantation of ~(125)I seeds.The sizes of ulcerative lesions and lymph nodes were observed at 1,3,6 months following treatment,and statistical analysis of the sizes of ulcerative lesions were evaluated by paired t-test.Results After 1,3,6 months follow-up,The mean diameters of ulcerative lesions were(2.1±0.6)cm(t=3.559,P<0.01),(1.7±0.5)cm(t=7.609,P<0.01),(0.7±0.6)cm(t=11.508,P<0.01),the cervical lymph nodes showed reduced size. Furthermore, PET-CT images showed a significant decrease in the metabolic activity of treated tumor. After six months, the focus of infection were healing in 8 patients, the cervical lymph nodes of one patient relapsed after ~(125)I implantation again. Patients were followed for 7 to 28 months, all patients were still alive. Conclusion Interstitial ~(125)I radioactive seeds implantation and ~(125)I plaque brachytherapy provide an effective, safe treatment for oral cancer.%目的 探讨放射性~(125)I粒子组织间置入及粒子敷贴治疗口腔癌的操作方法和临床效果.方法 18例口腔癌患者,均经脱落细胞学或组织病理学证实,其中舌癌12例、牙龈癌6例,溃疡灶20个,平均直径(2.3±0.7)cm,颈部转移淋巴结10个,平均直径(2.8±1.7)cm.根据病变情况采用~(125)I

  14. A novel curvilinear approach for prostate seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Podder, Tarun K.; Dicker, Adam P.; Hutapea, Parsaoran; Darvish, Kurosh; Yu Yan [Department of Radiation Oncology, Leo Jenkins Cancer Center, Brody School of Medicine, East Carolina University, Greenville, North Carolina 27834 (United States); Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States); Department of Mechanical Engineering, Temple University, Philadelphia, Pennsylvania 19122 (United States); Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States)

    2012-04-15

    Purpose: A new technique called ''curvilinear approach'' for prostate seed implantation has been proposed. The purpose of this study is to evaluate the dosimetric benefit of curvilinear distribution of seeds for low-dose-rate (LDR) prostate brachytherapy. Methods: Twenty LDR prostate brachytherapy cases planned intraoperatively with VariSeed planning system and I-125 seeds were randomly selected as reference rectilinear cases. All the cases were replanned by using curved-needle approach keeping the same individual source strength and the volume receiving 100% of prescribed dose 145 Gy (V{sub 100}). Parameters such as number of needles, seeds, and the dose coverage of the prostate (D{sub 90}, V{sub 150}, V{sub 200}), urethra (D{sub 30}, D{sub 10}) and rectum (D{sub 5}, V{sub 100}) were compared for the rectilinear and the curvilinear methods. Statistical significance was assessed using two-tailed student's t-test. Results: Reduction of the required number of needles and seeds in curvilinear method were 30.5% (p < 0.001) and 11.8% (p < 0.49), respectively. Dose to the urethra was reduced significantly; D{sub 30} reduced by 10.1% (p < 0.01) and D{sub 10} reduced by 9.9% (p < 0.02). Reduction in rectum dose D{sub 5} was 18.5% (p < 0.03) and V{sub 100} was also reduced from 0.93 cc in rectilinear to 0.21 cc in curvilinear (p < 0.001). Also the V{sub 150} and V{sub 200} coverage of prostate reduced by 18.8% (p < 0.01) and 33.9% (p < 0.001), respectively. Conclusions: Significant improvement in the relevant dosimetric parameters was observed in curvilinear needle approach. Prostate dose homogeneity (V{sub 150}, V{sub 200}) improved while urethral dose was reduced, which might potentially result in better treatment outcome. Reduction in rectal dose could potentially reduce rectal toxicity and complications. Reduction in number of needles would minimize edema and thereby could improve postimplant urinary incontinence. This study indicates that the

  15. ALGEBRA: ALgorithm for the heterogeneous dosimetry based on GEANT4 for BRAchytherapy.

    Science.gov (United States)

    Afsharpour, H; Landry, G; D'Amours, M; Enger, S; Reniers, B; Poon, E; Carrier, J-F; Verhaegen, F; Beaulieu, L

    2012-06-07

    Task group 43 (TG43)-based dosimetry algorithms are efficient for brachytherapy dose calculation in water. However, human tissues have chemical compositions and densities different than water. Moreover, the mutual shielding effect of seeds on each other (interseed attenuation) is neglected in the TG43-based dosimetry platforms. The scientific community has expressed the need for an accurate dosimetry platform in brachytherapy. The purpose of this paper is to present ALGEBRA, a Monte Carlo platform for dosimetry in brachytherapy which is sufficiently fast and accurate for clinical and research purposes. ALGEBRA is based on the GEANT4 Monte Carlo code and is capable of handling the DICOM RT standard to recreate a virtual model of the treated site. Here, the performance of ALGEBRA is presented for the special case of LDR brachytherapy in permanent prostate and breast seed implants. However, the algorithm is also capable of handling other treatments such as HDR brachytherapy.

  16. On the question of 3D seed reconstruction in prostate brachytherapy: the determination of x-ray source and film locations

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Mutian [Radiation Safety Office, Columbia University Medical Center, 722 West 168th Street, New York, NY 10032 (United States); Zaider, Marco [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (United States); Worman, Michael [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (United States); Cohen, Gilad [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (United States)

    2004-10-07

    Inaccuracy in seed placement during permanent prostate implants may lead to significant dosimetric deviations from the intended plan. In two recent publications (Todor et al 2002 Phys. Med. Biol. 47 2031-48, Todor et al 2003 Phys. Med. Biol. 48 1153-71), methodology was described for identifying intraoperatively the positions of seeds already implanted, thus allowing re-optimization of the treatment plan and correcting for such seed misplacement. Seed reconstruction is performed using fluoroscopic images and an important (and non-trivial) component of this approach is the ability to accurately determine the position of the gantry relative to the treatment volume. We describe the methodology for acquiring this information, based on the known geometry of six markers attached to the ultrasound probe. This method does not require the C-arm unit to be isocentric and films can be taken with the gantry set at any arbitrary position. This is significant because the patient positioning on the operating table (in the lithotomy position) restricts the range of angles at which films can be taken to a quite narrow (typically {+-}10{sup 0}) interval and, as a general rule, the closer the angles the larger the uncertainty in the seed location reconstruction along the direction from the x-ray source to the film. (note)

  17. Feasibility and impact of the measurement of extracellular fluid volume simultaneous with GFR by I-125-iothalamate

    NARCIS (Netherlands)

    Visser, Folkert W.; Muntinga, Jaap H. J.; Dierckx, Rudi A.; Navis, Gerjan

    2008-01-01

    The feasibility, validity, and possible applications of the assessment of extracellular fluid volume (ECFV) simultaneous with glomerular filtration rate (GFR) were assessed in a series of validation studies using the constant infusion method of I-125-iothalamate (IOT). In 48 subjects with a broad ra

  18. Evaluation of resins for use in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, Luiz Claudio F.M. Garcia; Ferraz, Wilmar Barbosa; Chrcanovic, Bruno Ramos; Santos, Ana Maria M., E-mail: ferrazw@cdtn.b, E-mail: amms@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    Brachytherapy is an advanced cancer treatment where radioactive seeds or sources are placed near or directly into the tumor thus reducing the radiation exposure in the surrounding healthy tissues. Prostate cancer can be treated with interstitial brachytherapy in initial stage of the disease in which tiny radioactive seeds with cylindrical geometry are used. Several kinds of seeds have been developed in order to obtain a better dose distribution around them and with a lower cost manufacturing. These seeds consist of an encapsulation, a radionuclide carrier, and X-ray marker. Among the materials that have potential for innovation in the construction of seeds, biocompatible resins appear as an important option. In this paper, we present some characterization results with Fourier transform infrared spectroscopic (FTIR) and ultraviolet-visible spectroscopy (UV-vis) performed on two types of resins in which curing temperatures for each one were varied as also the results of coatings with these resins under titanium substrates. Interactions of these resins in contact with the simulated body fluid were evaluated by atomic force microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy. (author)

  19. Synthesis and biological evaluation of I-125/I-123-labelled analogues of citalopram and escitalopram as potential radioligands for imaging of the serotonin transporter

    DEFF Research Database (Denmark)

    Madsen, Jacob; Elfving, Betina; Frokjaer, Vibe G.

    2011-01-01

    Two novel radioligands for the serotonin transporter (SERT), [I-125]{3-[5-iodo-1-(4-fluorophenyl)-1,3-dihydroisobenzofuran-1-yl]-propyl}-dimethylamine ([I-125]-2) and S-[I-125]{3-[5-iodo-1-(4-fluorophenyl)-1,3-dihydroisobenzofuran-1-yl]-propyl}-dimethylamine ([I-125]-(S)-2) were synthesized in a ...... of the radioligand in imaging cortical SERT distribution in vivo. These data suggest that the iodine-labelled derivatives of citalopram and escitalopram are not superior to another SPECT tracer for the SERT, namely [I-123] ADAM....

  20. Brachytherapy Application With In Situ Dose Painting Administered by Gold Nanoparticle Eluters

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, Neeharika [Department of Sciences, Wentworth Institute of Technology, Boston, Massachusetts (United States); Cifter, Gizem [Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts (United States); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Sajo, Erno [Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts (United States); Kumar, Rajiv; Sridhar, Srinivas [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Electronic Materials Research Institute and Department of Physics, Northeastern University, Boston, Massachusetts (United States); Nguyen, Paul L.; Cormack, Robert A.; Makrigiorgos, G. Mike [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ngwa, Wilfred, E-mail: wngwa@lroc.harvard.edu [Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts (United States); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States)

    2015-02-01

    Purpose: Recent studies show promise that administering gold nanoparticles (GNP) to tumor cells during brachytherapy could significantly enhance radiation damage to the tumor. A new strategy proposed for sustained administration of the GNP in prostate tumors is to load them into routinely used brachytherapy spacers for customizable in situ release after implantation. This in silico study investigated the intratumor biodistribution and corresponding dose enhancement over time due to GNP released from such GNP-loaded brachytherapy spacers (GBS). Method and Materials: An experimentally determined intratumoral diffusion coefficient (D) for 10-nm nanoparticles was used to estimate D for other sizes by using the Stokes-Einstein equation. GNP concentration profiles, obtained using D, were then used to calculate the corresponding dose enhancement factor (DEF) for each tumor voxel, using dose painting-by-numbers approach, for times relevant to the considered brachytherapy sources' lifetimes. The investigation was carried out as a function of GNP size for the clinically applicable low-dose-rate brachytherapy sources iodine-125 (I-125), palladium-103 (Pd-103), and cesium-131 (Cs-131). Results: Results showed that dose enhancement to tumor voxels and subvolumes during brachytherapy can be customized by varying the size of GNP released or eluted from the GBS. For example, using a concentration of 7 mg/g GNP, significant DEF (>20%) could be achieved 5 mm from a GBS after 5, 12, 25, 46, 72, 120, and 195 days, respectively, for GNP sizes of 2, 5, 10, 20, 30, and 50 nm and for 80 nm when treating with I-125. Conclusions: Analyses showed that using Cs-131 provides the highest dose enhancement to tumor voxels. However, given its relatively longer half-life, I-125 presents the most flexibility for customizing the dose enhancement as a function of GNP size. These findings provide a useful reference for further work toward development of potential new brachytherapy application

  1. Dose Distribution Computation Of I-125 Source In Permanent Implantation Irradiation197%I-125源在永久插植照射中的剂量分布计算

    Institute of Scientific and Technical Information of China (English)

    杨巍; 程品晶

    2008-01-01

    放射源植入人体后在组织中的剂量分布将决定疗效.因此,确定源的剂量分布十分重要.短程治疗源I-125因其能量低,半衰期短,植入组织和淋巴系统区,持续性放疗,在5~10个半衰期后放射性即消失,目前在临床肿瘤治疗中得到广泛应用.文章介绍了I-125源的特点,并用MC1NP程序对其在水模中的剂量分布情况进行模拟,模拟结果用origin软件得出归一化沉积能分布图;针对6711型I-125短程治疗源采用蒙特卡罗方法模拟计算剂量分布情况,且与AAPM TG43U1推荐的剂量估算公式的计算结果进行了比较.

  2. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.;

    1999-01-01

    . Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes...

  3. Development of a voxel phantom specific for simulation of eye brachytherapy; Desenvolvimeto de um fantoma de voxel especifico para simulacao de braquiterapia ocular

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcilio S.; Lima, Fernando R.A., E-mail: msilveira.fisica@gmail.com, E-mail: falima@cnen.gov.br [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Departamento de Energia Nuclear; Vieira, Jose W., E-mail: jose-wilson59@live.com [lnstituto Federal de Educacao, Ciencia e Tecnologia de Pernambuco (IFPE), Recife, PE (Brazil)

    2013-11-01

    The ophthalmic brachytherapy involves inserting a plate with seeds of radioactive material in the patient's eye for the treatment of tumors. The radiation dose to be taken by the patient is prescribed by physicians and time of application of the material is calculated from calibration curves supplied by the manufacturers of the plates. To estimate the dose absorbed by the patient, in a series of diagnostic tests, it is necessary to perform simulations using a computational model of exposure. These models are composed primarily by a anthropomorphic phantom, and a Monte Carlo code. The coupling of a phantom voxel whole body to a Monte Carlo code is a complex process because the computer model simulations with exposure takes time, knowledge of the code used and various adjustments to be implemented. The problem is aggravated even more complex when you want to radiate one region of the body. In this work we developed a phantom, specifically the region containing the eyeball, from MASH (Male Adult voxel). This model was coupled to the Monte Carlo code EGSnrc (Electron Gamma Shower) together with an algorithm simulator source of I-125 , considering only its effect of higher energy range.

  4. Study of the Dose Distribution of 192Ir、 125I Seed in Different Tissue in Brachytherapy%不同人体组织中192Ir、125I粒子源的剂量分布研究

    Institute of Scientific and Technical Information of China (English)

    汤晓斌; 陈飞达; 谢芹; 刘云鹏; 耿长冉; 陈达

    2011-01-01

    目的:计算分析近距离放疗中不同粒子源、不同插植部位的剂量分布.方法:利用蒙特卡罗粒子输运工具包Geant4,计算近距离放疗中192Ir、125I两种粒子源在不同介质中剂量分布的差异,并根据美国医学物理学会43号工作组报告推荐的近距离放疗剂量计算公式(AAPM TG-43)对其重要参数进行修正.结果:计算得到192Ir源、125I源在三种不同组织等效材料中的径向剂量函数、各项异性函数.结论:(1)径向剂量函数决定于介质对光子的线能量衰减系数.衰减系数越大,径向剂量函数下降越快,反之越平缓;125I粒子源的径向剂量函数随距源距离增大而衰减的趋势远大于192Ir粒子源.(2)随着距源距离增大,骨、水等效组织中各向异性函数曲线趋于平坦,肺等效组织则没有变化.%Objective: The dose distribution is one of the most essential questions in brachytherapy. The dose varies largely between different seed and different phantom materials so accurate simulation is needed. Methods: In this paper, a Monte Carlo simulation program toolkits-Geant4 has been used to calculate the dose distribution in different phantom materials around two kinds of brachytherapy source: 192Ir and 125I, respectively. Results: The radial dose function and anisotropy function has been calculated and analyzed detailedly based on the formula recommended by the American Association of Physics in Medicine Report of the Working Group 43(AAPM TG-43). Conclusions: (1) The radial dose function depends on p, en of photon in materials and the radial dose function of I25I fall down much more sharply than 192Ir. (2) The curves of the anisotropy function in water and bone phantom materials become more plain than in lung phantom while the radial distance increases. This phenomenon reflects a law that more attenuation and scatter in materials, the curve of anisotropy function is more plain.

  5. [Permanent implant prostate cancer brachytherapy: 2013 state-of-the art].

    Science.gov (United States)

    Cosset, J-M; Hannoun-Lévi, J-M; Peiffert, D; Delannes, M; Pommier, P; Pierrat, N; Nickers, P; Thomas, L; Chauveinc, L

    2013-04-01

    With an experience of more than 25 years for the pioneers (and more than 14 years in France), permanent implant brachytherapy using iodine 125 seeds (essentially) is now recognized as a valuable alternative therapy for localized low-risk prostate cancer patients. The possible extension of the indications of exclusive brachytherapy towards selected patients in the intermediate-risk group has now been confirmed by several studies. Moreover, for the other patients in the intermediate-risk group and for the patients in the high-risk group, brachytherapy, as an addition to external radiotherapy, could represent one of the best ways to escalate the dose. Different permanent implant brachytherapy techniques have been proposed; preplanning or real-time procedure, loose or stranded seeds (or both), manual or automatic injection of the seeds. The main point here is the ability to perfectly master the procedure and to comply with the dosimetric constraints, which have been recently redefined by the international societies, such as the GEC-ESTRO group. Mid- and long-term results, which are now available in the literature, indicate relapse-free survival rates of about 90% at 5-10 years, the best results being obtained with satisfactory dosimetric data. Comparative data have shown that the incontinence and impotence rates after brachytherapy seemed to be significantly inferior to what is currently observed after surgery. However, a risk of about 3 to 5% of urinary retention is usually reported after brachytherapy, as well as an irritative urinary syndrome, which may significantly alter the quality of life of the patients, and last several months. In spite of those drawbacks, with excellent long-term results, low rates of incontinence and impotence, and emerging new indications (focal brachytherapy, salvage brachytherapy after localized failure of an external irradiation), permanent implant prostate brachytherapy can be expected to be proposed to an increasing number of patients

  6. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer.

    Science.gov (United States)

    Murali, V; Kurup, P G G; Mahadev, P; Mahalakshmi, S

    2010-04-01

    Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR) with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR), namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  7. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Murali V

    2010-01-01

    Full Text Available Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT and intensity modulated radiotherapy (IMRT are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR, namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  8. Vivo dosimetry using TLD detectors in prostate seed implants of I-125: preliminary results; Dosimetria in vivo mediante detectores de TLD en implantes de prostata con semillas de I-125: resultados preliminares

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Reyes, A.; Pedro, A.; Bassas, P.; Duch, M. A.; Cros, M.; Mane, S.

    2011-07-01

    We present preliminary results of a new in vivo dosimetry technique that could allow to know immediately after implantation of the prostate if the dose distribution determined by the scheduler is similar to the actual dose measured with TLD detectors.

  9. Growth delay effect of combined interstitial hyperthermia and brachytherapy in a rat solid tumor model.

    Science.gov (United States)

    Papadopoulos, D; Kimler, B F; Estes, N C; Durham, F J

    1989-01-01

    The rat mammary AC33 solid tumor model was used to investigate the efficacy of interstitial hyperthermia and/or brachytherapy. Subcutaneous flank tumors were heated with an interstitial microwave (915 MHz) antenna to a temperature of 43 +/- 0.5 degrees C for 45 min for two treatments, three days apart, and/or implanted with Ir-192 seeds for three days (-25 Gy tumor dose). Following treatments, tumors were measured 2 to 3 times per week. Hyperthermia alone produced a modest delay in tumor volume regrowth, while brachytherapy was substantially more effective. The combination produced a improvement in tumor regrowth delay compared to brachytherapy alone.

  10. Design and optimization of a brachytherapy robot

    Science.gov (United States)

    Meltsner, Michael A.

    Trans-rectal ultrasound guided (TRUS) low dose rate (LDR) interstitial brachytherapy has become a popular procedure for the treatment of prostate cancer, the most common type of non-skin cancer among men. The current TRUS technique of LDR implantation may result in less than ideal coverage of the tumor with increased risk of negative response such as rectal toxicity and urinary retention. This technique is limited by the skill of the physician performing the implant, the accuracy of needle localization, and the inherent weaknesses of the procedure itself. The treatment may require 100 or more sources and 25 needles, compounding the inaccuracy of the needle localization procedure. A robot designed for prostate brachytherapy may increase the accuracy of needle placement while minimizing the effect of physician technique in the TRUS procedure. Furthermore, a robot may improve associated toxicities by utilizing angled insertions and freeing implantations from constraints applied by the 0.5 cm-spaced template used in the TRUS method. Within our group, Lin et al. have designed a new type of LDR source. The "directional" source is a seed designed to be partially shielded. Thus, a directional, or anisotropic, source does not emit radiation in all directions. The source can be oriented to irradiate cancerous tissues while sparing normal ones. This type of source necessitates a new, highly accurate method for localization in 6 degrees of freedom. A robot is the best way to accomplish this task accurately. The following presentation of work describes the invention and optimization of a new prostate brachytherapy robot that fulfills these goals. Furthermore, some research has been dedicated to the use of the robot to perform needle insertion tasks (brachytherapy, biopsy, RF ablation, etc.) in nearly any other soft tissue in the body. This can be accomplished with the robot combined with automatic, magnetic tracking.

  11. 前列腺癌131Cs和125I及103Pd粒子植入剂量学研究%Dosimetric study of permanent prostate brachytherapy utilizing 131Cs,125 I and103Pd seeds

    Institute of Scientific and Technical Information of China (English)

    杨瑞杰; 张红志; 王俊杰

    2009-01-01

    Objective To compare the dosimetric differences of permanent prostate braehytherapy utilizing 131Cs,125 I and 103 Pd seeds.Methods Twenty-five patients with T1-T2c prostate cancer who had previously implanted with 125I seeds were randomly selected in our study.The patients were re-planned with 131 Cs,125 I and 103 Pd seeds by using the Prowess Brachytherpay 3.1 planning system to the prescription doses of 115 Gy,145 Gy and 125 Gy,respectively.The seed strengths were 1.8 U,0.5 U and 1.8 U,respeetively. The prostate,prostatic urethra and anterior wall of the rectum were contoured on trans-rectal ultrasound ima ges.PTV was outlined based on the prostate volume with no margin applied.The attempted planning goals were that V100(tbe percentage volume of the prostate receiving at least 100% of the prescription doses)= 95%,D90 (the minimum percentage dose covering 90% of the prostate volume) ≥100% ,and prostatic ure thra UD10 (the maximum percentage dose receiving by 10% of the contoured urethra)≤150%.For the plan comparison,we also computed prostate V150,prostatic urethra UV120,rectum RV100,and the number of implan ted seeds and needles.The significance of the differences was tested using one way analysis of variance. Results The average V200 in the 103pd,125 I and 131 Cs plans were 28.7% ,20.9% and 19.6% (F=42.50, P =0.000) ;the average V150 were 51.9% ,42.1% and 39.4% (F=26.15,P =0.000) ;the average UV120 were 26.9% ,29.5% and 23.8% (F = 0.37,P =0.691) ; and the average rectum RV100 were 0.31 cm3, 0.22 cm3 and 0.19 cm3(F=0.43,P=0.652).For 103 Pd,124 I and 131 Cs,the average number of implanted seeds per cm3 prostate were 2.02,2.01 and 1.87(F = 1.92 ,P =0.154) ,and the average number of needles were 33.6,32.9 and 31.6(F=0.26,P=0.772). Conclusions Comparing to 124 I and 103 pd seeds used in permanent prostate brachytherapy ,131 Cs seeds has better dose homogeneity,and possible better sparing of the urethra and rectum,with comparable or less implanted seeds and needles

  12. Kinetic and metabolic considerations in the use of (I-125) HIPDM as a tracer for quantitative measurement of regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, G.; Nehlig, A.; Blasberg, R.; Patlak, C.S.; Anderson, L.; Kung, H.F.; Fieschi, C.; Fazio, F.; Sokoloff, L.

    1984-01-01

    The kinetics of cerebral uptake and the metabolism of radioactive iodine labeled HIPDM (N,N,N'-trimethyl-N'-(2-hydroxy-3-methyl-5-(I-125)iodobenzyl) -1,3-propanediamine)(I-125)HIPDM were studied in vivo in male adult Sprague-Dawley rats in order to evaluate the potential usefulness of this compound for quantitative measurement of regional cerebral blood flow (rCBF). The first pass extraction fraction of (I-125)HIPDM in brain was found to be about 80%. The arterial concentration of unmetabolized (I-125)HIPDM following an i.v. pulse drops rapidly and represents only 30% of the blood sample total radioactivity at 60 minutes, whereas 92% of the radioactivity in brain tissue at the same time is in unaltered (I-125)HIPDM. The rate constant for (I-125)HIPDM transport across the blood-brain barrier (BBB) was calculated on the basis of a distribution model in which bi-directional exchange of the tracer between brain tissue and vascular space is assumed. A kinetic model and an operational equation have been derived for determination of rCBF with this molecule. The model and equation take into account the three following factors: (a) incomplete first pass extraction; (b) HIPDM metabolism; (c) bi-directional flux of tracer across the BBB. The observations suggest that this molecule might be of potential usefulness for rCBF measurements with single photon emission tomography, provided that all these factors are evaluated in man.

  13. Update on prostate brachytherapy: long-term outcomes and treatment-related morbidity.

    Science.gov (United States)

    Kao, Johnny; Cesaretti, Jamie A; Stone, Nelson N; Stock, Richard G

    2011-06-01

    Current research in prostate brachytherapy focuses on five key concepts covered in this review. Transrectal ultrasound-guided prostate brachytherapy assisted by intraoperative treatment planning is the most advanced form of image-guided radiation delivery. Prostate brachytherapy alone for low-risk prostate cancer achieves lower prostate-specific antigen (PSA) nadirs than intensity-modulated radiotherapy (IMRT) or protons while maintaining durable biochemical control in about 90% of patients without late failures seen in surgically treated patients. As an organ-conserving treatment option, seed implant results in a lower rate of erectile dysfunction and urinary incontinence than surgery that has been validated in several recent prospective studies. Combined IMRT and seed implant has emerged as a rational and highly effective approach to radiation-dose escalation for intermediate- and high-risk prostate cancer. Preliminary results suggest that seed implantation may play a role in improving outcomes for historically poor-prognosis locally advanced and recurrent prostate cancers.

  14. SU-E-T-301: Dosimetric Comparison Between Adaptive and Rectilinear Template-Based Prostate Seed Implants

    Energy Technology Data Exchange (ETDEWEB)

    Sugar, E Neubauer; Buzurovic, I; O’Farrell, D; Hansen, J; Devlin, P; Cormack, R; Nguyen, P [Brigham and Women’s Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: To compare the dosimetry of a standard rectilinear and an adaptive technique used in I125 prostate seed implants. Methods: To achieve favorable dosimetry in prostate implants we used adaptive needle updates to match actual positions in real-time. The seed locations were optimized based on actual needle locations. The seeds were delivered automatically with a robotic device seedSelectron™ (Elekta Brachytherapy). In this study, we evaluated the former approach against the standard rectilinear technique in which the needles have a parallel distribution. The treatment plans for 10 patients were analyzed. For comparison, the actual treatment plans were revised so each needle was repositioned to its original parallel location through the template. The analysis was performed by comparing the target coverage and dose to the organs at risk. The comparison was done using the following planning goals: the target D90> 90%, V100% > 90%, V50% <70% and V200% <30%; the urethra V125% < 1cm3 and V150%= 0cm3; and the Rectum V100%<1cm3 and V69% < 8cm3. The prescription dose to the target was 145Gy. Results: The average target volume and number of seeds were 44.39cm3(SD=11.14) and 74(SD=12), respectively. The D90 for adaptive and rectilinear plans was 159.9Gy(SD=2.99) and 155.53Gy(SD=4.04) resulting in a 2.74% difference for the average target coverage. A similar difference (1.75%) was noticed in the target V100[%]. No significant difference was noticed in the dose to the urethra and rectum. All planning goals were met with both the adaptive and rectilinear approach for each plan. Conclusion: The study reveals enhanced coverage of the target when using the adaptive needle adjustments as compared to the rectilinear approach for the analyzed cases. However, the differences in dosimetry did not translate to meaningful clinical outcomes.

  15. Dosimetry Modeling for Focal Low-Dose-Rate Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Al-Qaisieh, Bashar [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Mason, Josh, E-mail: joshua.mason@nhs.net [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Bownes, Peter; Henry, Ann [Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Dickinson, Louise [Division of Surgery and Interventional Science, University College London, London (United Kingdom); Department of Radiology, Northwick Park Hospital, London North West NHS Trust, London (United Kingdom); Ahmed, Hashim U. [Division of Surgery and Interventional Science, University College London, London (United Kingdom); University College London Hospital, London (United Kingdom); Emberton, Mark [University College London Hospital, London (United Kingdom); Langley, Stephen [St Luke' s Cancer Centre, Guildford (United Kingdom)

    2015-07-15

    Purpose: Focal brachytherapy targeted to an individual lesion(s) within the prostate may reduce side effects experienced with whole-gland brachytherapy. The outcomes of a consensus meeting on focal prostate brachytherapy were used to investigate optimal dosimetry of focal low-dose-rate (LDR) prostate brachytherapy targeted using multiparametric magnetic resonance imaging (mp-MRI) and transperineal template prostate mapping (TPM) biopsy, including the effects of random and systematic seed displacements and interseed attenuation (ISA). Methods and Materials: Nine patients were selected according to clinical characteristics and concordance of TPM and mp-MRI. Retrospectively, 3 treatment plans were analyzed for each case: whole-gland (WG), hemi-gland (hemi), and ultra-focal (UF) plans, with 145-Gy prescription dose and identical dose constraints for each plan. Plan robustness to seed displacement and ISA were assessed using Monte Carlo simulations. Results: WG plans used a mean 28 needles and 81 seeds, hemi plans used 17 needles and 56 seeds, and UF plans used 12 needles and 25 seeds. Mean D90 (minimum dose received by 90% of the target) and V100 (percentage of the target that receives 100% dose) values were 181.3 Gy and 99.8% for the prostate in WG plans, 195.7 Gy and 97.8% for the hemi-prostate in hemi plans, and 218.3 Gy and 99.8% for the focal target in UF plans. Mean urethra D10 was 205.9 Gy, 191.4 Gy, and 92.4 Gy in WG, hemi, and UF plans, respectively. Mean rectum D2 cm{sup 3} was 107.5 Gy, 77.0 Gy, and 42.7 Gy in WG, hemi, and UF plans, respectively. Focal plans were more sensitive to seed displacement errors: random shifts with a standard deviation of 4 mm reduced mean target D90 by 14.0%, 20.5%, and 32.0% for WG, hemi, and UF plans, respectively. ISA has a similar impact on dose-volume histogram parameters for all plan types. Conclusions: Treatment planning for focal LDR brachytherapy is feasible. Dose constraints are easily met with a notable

  16. An approach to using conventional brachytherapy software for clinical treatment planning of complex, Monte Carlo-based brachytherapy dose distributions

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, Mark J.; Melhus, Christopher S.; Granero, Domingo; Perez-Calatayud, Jose; Ballester, Facundo [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Radiation Oncology Department, Physics Section, ' ' La Fe' ' University Hospital, Avenida Campanar 21, E-46009 Valencia (Spain); Department of Atomic, Molecular, and Nuclear Physics, University of Valencia, C/Dr. Moliner 50, E-46100 Burjassot, Spain and IFIC (University of Valencia-CSIC), C/Dr. Moliner 50, E-46100 Burjassot (Spain)

    2009-06-15

    Certain brachytherapy dose distributions, such as those for LDR prostate implants, are readily modeled by treatment planning systems (TPS) that use the superposition principle of individual seed dose distributions to calculate the total dose distribution. However, dose distributions for brachytherapy treatments using high-Z shields or having significant material heterogeneities are not currently well modeled using conventional TPS. The purpose of this study is to establish a new treatment planning technique (Tufts technique) that could be applied in some clinical situations where the conventional approach is not acceptable and dose distributions present cylindrical symmetry. Dose distributions from complex brachytherapy source configurations determined with Monte Carlo methods were used as input data. These source distributions included the 2 and 3 cm diameter Valencia skin applicators from Nucletron, 4-8 cm diameter AccuBoost peripheral breast brachytherapy applicators from Advanced Radiation Therapy, and a 16 mm COMS-based eye plaque using {sup 103}Pd, {sup 125}I, and {sup 131}Cs seeds. Radial dose functions and 2D anisotropy functions were obtained by positioning the coordinate system origin along the dose distribution cylindrical axis of symmetry. Origin:tissue distance and active length were chosen to minimize TPS interpolation errors. Dosimetry parameters were entered into the PINNACLE TPS, and dose distributions were subsequently calculated and compared to the original Monte Carlo-derived dose distributions. The new planning technique was able to reproduce brachytherapy dose distributions for all three applicator types, producing dosimetric agreement typically within 2% when compared with Monte Carlo-derived dose distributions. Agreement between Monte Carlo-derived and planned dose distributions improved as the spatial resolution of the fitted dosimetry parameters improved. For agreement within 5% throughout the clinical volume, spatial resolution of

  17. Three-dimensional ultrasound system for guided breast brachytherapy.

    Science.gov (United States)

    De Jean, Paul; Beaulieu, Luc; Fenster, Aaron

    2009-11-01

    Breast-conserving surgery combined with subsequent radiation therapy is a standard procedure in breast cancer treatment. The disadvantage of whole-breast beam irradiation is that it requires 20-25 treatment days, which is inconvenient for patients with limited mobility or who reside far from the treatment center. However, interstitial high-dose-rate (HDR) brachytherapy is an irradiation method requiring only 5 treatment days and that delivers a lower radiation dose to the surrounding healthy tissue. It involves delivering radiation through 192Ir seeds placed inside the catheters, which are inserted into the breast. The catheters are attached to a HDR afterloader, which controls the seed placement within the catheters and irradiation times to deliver the proper radiation dose. One disadvantage of using HDR brachytherapy is that it requires performing at least one CT scan during treatment planning. The procedure at our institution involves the use of two CT scans. Performing CT scans requires moving the patient from the brachytherapy suite with catheters inserted in their breasts. One alternative is using three-dimensional ultrasound (3DUS) to image the patient. In this study, the authors developed a 3DUS translation scanning system for use in breast brachytherapy. The new system was validated using CT, the current clinical standard, to image catheters in a breast phantom. Once the CT and 3DUS images were registered, the catheter trajectories were then compared. The results showed that the average angular separation between catheter trajectories was 2.4 degrees, the average maximum trajectory separation was 1.0 mm, and the average mean trajectory separation was found to be 0.7 mm. In this article, the authors present the 3DUS translation scanning system's capabilities as well as its potential to be used as the primary treatment planning imaging modality in breast brachytherapy.

  18. Prosper: image and robot-guided prostate brachytherapy

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Descotes, Jean-Luc; Giraud, Jean-Yves; Hungr, Nikolai; Leroy, Antoine; Long, Jean-Alexandre; Martin, Sébastien; Troccaz, Jocelyne

    2011-01-01

    Brachytherapy for localized prostate cancer consists in destroying cancer by introducing iodine radioactive seeds into the gland through hollow needles. The planning of the position of the seeds and their introduction into the prostate is based on intra-operative ultrasound (US) imaging. We propose to optimize the global quality of the procedure by: i) using 3D US; ii) enhancing US data with MRI registration; iii) using a specially designed needle-insertion robot, connected to the imaging data. The imaging methods have been successfully tested on patient data while the robot accuracy has been evaluated on a realistic deformable phantom.

  19. Pulsed dose rate brachytherapy – is it the right way?

    Directory of Open Access Journals (Sweden)

    Janusz Skowronek

    2010-10-01

    Full Text Available Pulsed dose rate (PDR-BT treatment is a brachytherapy modality that combines physical advantages of high-doserate (HDR-BT technology (isodose optimization, radiation safety with the radiobiological advantages of low-dose-rate (LDR-BT brachytherapy. Pulsed brachytherapy consists of using stronger radiation source than for LDR-BT and producing series of short exposures of 10 to 30 minutes in every hour to approximately the same total dose in the sameoverall time as with the LDR-BT. Modern afterloading equipment offers certain advantages over interstitial or intracavitaryinsertion of separate needles, tubes, seeds or wires. Isodose volumes in tissues can be created flexibly by a combinationof careful placement of the catheter and the adjustment of the dwell times of the computerized stepping source.Automatic removal of the radiation sources into a shielded safe eliminates radiation exposures to staff and visitors.Radiation exposure is also eliminated to the staff who formerly loaded and unloaded multiplicity of radioactive sources into the catheters, ovoids, tubes etc. This review based on summarized clinical investigations, analyses the feasibility and the background to introduce this brachytherapy technique and chosen clinical applications of PDR-BT.

  20. A study of brachytherapy for intraocular tumor

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Yung Hoon; Lee, Dong Han; Ko, Kyung Hwan; Lee, Tae Won; Lee, Sung Koo; Choi, Moon Sik [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)

    1994-12-01

    Our purpose of this study is to perform brachytherapy for intraocular tumor. The result were as followed. 1. Eye model was determined as a 25 mm diameter sphere. Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15 mm, 17 mm and 20 mm in diameter, and 1.5 mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5 mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within {+-}10% and distance deviations are within 0.4 mm. Maximum error is -11.3% and 0.8 mm, respectively. 7 figs, 2 tabs, 28 refs. (Author).

  1. The application of MR diffusion-weighted imaging in evaluating the efficacy of 125I seed interstitial brachytherapy for pancreatic carcinomas: an experimental study in vivo%磁共振弥散加权成像在125I粒子组织间植入治疗胰腺癌疗效评估中的应用

    Institute of Scientific and Technical Information of China (English)

    宋琦; 刘玉; 胡曙东; 黄蔚; 王忠敏; 陈克敏; 严福华; 田建明

    2012-01-01

    目的 探讨磁共振(MRI)弥散加权(DWI)成像对125I粒子组织间植入治疗人胰腺癌裸鼠移植瘤疗效的评估价值.方法 将人胰腺癌SW1990细胞株接种于BABL/C裸鼠右下肢旁腹股沟区偏背侧皮下,待瘤体长至8~10 mm进行干预,共有16只裸鼠的成瘤大小适用于实验,分为实验组8只,植入1q粒子,和对照组8只,植入空载粒子.粒子植入前及治疗后2周和2个月时分别行MRI常规扫描及DWI成像.取瘤体标本行组织病理学检查.结果 实验组肿瘤细胞坏死明显,而对照组肿瘤细胞无明显或有少许坏死.裸鼠心、肝、肺、肾及脾脏等组织无明显放射炎症表现.常规MRI成像评价125I粒子治疗胰腺癌疗效的价值有限.DWI显示实验组内整个肿瘤组织的表观弥散系数(ADC)值在治疗前为(0.001 15±0.000 13) mm%,治疗后2周为(0.001 29±0.000 038) mm2/s.治疗后2个月为(0.002 08±0.000 14 )mm2/s,与治疗前相比差异有统计学意义(P<0.05).实验组肿瘤实质区的ADC值亦较治疗前及对照组增高,但低于坏死区ADC值.结论 125I粒子组织间植入治疗人胰腺癌裸鼠移植瘤可导致肿瘤坏死,并对周围脏器是安全的.用常规MRI及DWI成像观察裸鼠皮下移植瘤可行.DWI对疗效评估有重要价值.%Objective To discuss the application of MR diffusion weighted imaging (DWI) in evaluating the efficacy of 125I seed interstitial brachytherapy for human pancreatic carcinoma xenografts in nude mice. Methods The human pancreatic cell line SW1990 was subcutaneously injected into the region that was slightly lateral to the right groin of the nude mice. When the tumor grew up to 8-10 mm in size, the intervention was begun. A total of 16 nude mice with suitable sized tumor were used in this study. Implantation of 125I seeds was used in the mice of study group (n = 8), while implantation of empty seeds was performed in the mice of control group (n = 8). Before seed implantation, as well as at 2

  2. Feasibility of salvage interstitial microwave thermal therapy for prostate carcinoma following failed brachytherapy: studies in a tissue equivalent phantom

    Science.gov (United States)

    McCann, Claire; Kumaradas, J. Carl; Gertner, Mark R.; Davidson, Sean R. H.; Dolan, Alfred M.; Sherar, Michael D.

    2003-04-01

    Thermal therapy is an experimental treatment to destroy solid tumours by heating them to temperatures ranging from 55 °C to 90 °C, inducing thermal coagulation and necrosis of the tumour. We are investigating the feasibility of interstitial microwave thermal therapy as a salvage treatment for prostate cancer patients with local recurrence following failed brachytherapy. Due to the electrical and thermal conductivity of the brachytherapy seeds, we hypothesized that the seeds could scatter the microwave energy and cause unpredictable heating. To investigate this, a 915 MHz helical antenna was inserted into a muscle-equivalent phantom with and without brachytherapy seeds. Following a 10 W, 5 s input to the antenna, the temperature rise was used to calculate absorbed power, also referred to as specific absorption rate (SAR). Plane wave models based on Maxwell's equations were also used to characterize the electromagnetic scattering effect of the seeds. In addition, the phantom was heated with 8 W for 5 min to quantify the effect of the seeds on the temperature distribution during extended heating. SAR measurements indicated that the seeds had no significant effect on the shape and size of the SAR pattern of the antenna. However, the plane wave simulations indicated that the seeds could scatter the microwave energy resulting in hot spots at the seed edges. Lack of experimental evidence of these hot spots was probably due to the complex polarization of the microwaves emitted by the helical antenna. Extended heating experiments also demonstrated that the seeds had no significant effect on the temperature distributions and rates of temperature rise measured in the phantom. The results indicate that brachytherapy seeds are not a technical impediment to interstitial microwave thermal therapy as a salvage treatment following failed brachytherapy.

  3. GFRs measured by gates' method according to 5 background sites: comparison with GFR measured by I-125-lothalamate method

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Seok; Chung, Yong An; Kim, Sung Hoon; Kim, Chung Ho; Lee, Sung Young; Sohn, Hyung Seon; Baik, Jun Hyun; Chung, Soo Kyo [School of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2004-08-01

    The aim was to assess how the background site affects the Gates' glomerular filtration rate(GFR) measurement using Tc-99m-DTPA in correlation with GFR by I-125-iothalamate method. The study populations were 63 adults with 39 men and 24 women aged from 20 to 59 yrs (mean = 37.9 yrs). The following five background regions of interest were used in measurement of GFR using Gates' method: 1) lower side of each kidney(subrenal), 2) around each kidney(circumferential), 3) upper side of each kidney(suprarenal), 4) lateral side of each kidney(lateral), 5) between the two kidney(inter-renal). We also measured GFR using I-125-iothalamate in each subject. The two studies were separated by 1 to 3 weeks. The subjects were divided into two groups by renal depth. Group 1 with renal depth{>=}7 cm and group 2 with renal depth < 7 cm. We calculated the means and standard deviations of the GFRs measured by two studies. And we statistically analyzed the correlation and differences among GFRs by Gates' method and the GFR by iothalamate method with correlation analysis. The GFRs Gates' method using suprarenal and inter-renal background correction showed better correlation with the GFR measured by I-125-iothalamate. And GFRs measured by Gates' method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth < 7 cm. But GFRs measured by Gates' method did not show statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth {>=}7 cm. GFRs measured with Gates' method showed higher correlation with the GFR measured by I-125-iothalamate when the regions of interest were placed over the suprarenal and inter-renal backgrounds. And GFRs measured with Gates method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth < 7 cm.

  4. Review of the poster "Dosimetric comparison of gamma knife radiosurgery vs. 125I plaque brachytherapy in a cohort of choroidal melanomas".

    Science.gov (United States)

    Odell, Kelly R

    2009-01-01

    Historically, treatment for choroidal melanomas was surgical enucleation. Currently, treatment methods such as stereotactic radiosurgery and brachytherapy are being used to spare the eye. The poster "Dosimetric Comparison of Gamma Knife Radiosurgery vs. I-125 Plaque Brachytherapy in a Cohort of Choroidal Melanomas" presented at ASTRO 2007 by Anderson et al. provides a comparison of these methods. The dose to disk, fovea and lens in 29 patients from a simulated I-125 treatment and a delivered Gamma Knife radiosurgery was compared. Thirty Gy was prescribed to the 50% Isodose line in the radiosurgery and 85 Gy was prescribed to the apex of the tumor in the I-125 simulation. It was found that the Gamma Knife spares the disk better in 59% of the tumors, including those >or=6.5 mm in height; spares the fovea better in 69% of the tumors, including those >or=5.5 mm; and spares lens better in only 30% of the tumors, with no distinction in size. Tumor location was not taken into account for this study, which could explain the variations in smaller tumors. For larger tumors, gamma knife will protect most organs at risk more effectively. This study shows how a tumor's parameters can be used in selecting treatment modality.

  5. A Customized Finger Brachytherapy Carrier

    OpenAIRE

    Wadhwa, Supneet Singh; Duggal, Nidhi

    2013-01-01

    In recent years, radiation therapy has been used with increasing frequency in the management of neoplasms of the head and neck region. Brachytherapy is a method of radiation treatment in which sealed radioactive sources are used to deliver the dose a short distance by interstitial (direct insertion into tissue), intracavitary (placement within a cavity) or surface application (molds). Mold brachytherapy is radiation delivered via a custom-fabricated carriers, designed to provide a more consta...

  6. Simulation of 3D Needle-Tissue Interaction with Application to Image Guided Prostate Brachytherapy

    Institute of Scientific and Technical Information of China (English)

    姜杉; HATA; Nobuhiko; 肖渤瀚; 安蔚瑾

    2010-01-01

    To improve global control of disease and reduce global toxicity, a complex seed distribution pattern should be achieved with great accuracy during brachytherapy.However, the interaction between the needle and prostate will cause large deformation of soft tissue.As a result, seeds will be misplaced, sharp demarcation between irradiated volume and healthy structures is unavailable and this will cause side effects such as impotence and urinary incontinence.In this paper, a 3D nonlinear dynamic finite element s...

  7. The Effects of Metallic Implants on Electroporation Therapies: Feasibility of Irreversible Electroporation for Brachytherapy Salvage

    Energy Technology Data Exchange (ETDEWEB)

    Neal, Robert E., E-mail: robert.neal@alfred.org.au [The Alfred Hospital, Radiology Research Unit, Department of Radiology (Australia); Smith, Ryan L., E-mail: ryan.smith@wbrc.org.au [The Alfred Hospital, William Buckland Radiotherapy Centre (Australia); Kavnoudias, Helen, E-mail: H.Kavnoudias@alfred.org.au [The Alfred Hospital, Radiology Research Unit, Department of Radiology (Australia); Rosenfeldt, Franklin, E-mail: F.Rosenfeldt@alfred.org.au; Ou, Ruchong, E-mail: Ruchong.Ou@bakeridi.edu.au [Monash University, Department of Surgery (Australia); Mclean, Catriona A., E-mail: C.Mclean@alfred.org.au [The Alfred Hospital, Department of Anatomical Pathology (Australia); Davalos, Rafael V., E-mail: davalos@vt.edu [Virginia Tech, School of Biomedical Engineering and Sciences (United States); Thomson, Kenneth R., E-mail: K.Thomson@alfred.org.au [The Alfred Hospital, Radiology Research Unit, Department of Radiology (Australia)

    2013-12-15

    Purpose: Electroporation-based therapies deliver brief electric pulses into a targeted volume to destabilize cellular membranes. Nonthermal irreversible electroporation (IRE) provides focal ablation with effects dependent on the electric field distribution, which changes in heterogeneous environments. It should be determined if highly conductive metallic implants in targeted regions, such as radiotherapy brachytherapy seeds in prostate tissue, will alter treatment outcomes. Theoretical and experimental models determine the impact of prostate brachytherapy seeds on IRE treatments. Materials and Methods: This study delivered IRE pulses in nonanimal, as well as in ex vivo and in vivo tissue, with and in the absence of expired radiotherapy seeds. Electrical current was measured and lesion dimensions were examined macroscopically and with magnetic resonance imaging. Finite-element treatment simulations predicted the effects of brachytherapy seeds in the targeted region on electrical current, electric field, and temperature distributions. Results: There was no significant difference in electrical behavior in tissue containing a grid of expired radiotherapy seeds relative to those without seeds for nonanimal, ex vivo, and in vivo experiments (all p > 0.1). Numerical simulations predict no significant alteration of electric field or thermal effects (all p > 0.1). Histology showed cellular necrosis in the region near the electrodes and seeds within the ablation region; however, there were no seeds beyond the ablation margins. Conclusion: This study suggests that electroporation therapies can be implemented in regions containing small metallic implants without significant changes to electrical and thermal effects relative to use in tissue without the implants. This supports the ability to use IRE as a salvage therapy option for brachytherapy.

  8. SU-E-T-259: Particle Swarm Optimization in Radial Dose Function Fitting for a Novel Iodine-125 Seed

    Energy Technology Data Exchange (ETDEWEB)

    Wu, X [University of Alabama at Birmingham, Birmingham, Al (United States); Duan, J; Popple, R; Huang, M; Shen, S; Brezovich, I [University of Alabama Birmingham, Birmingham, AL (United States); Cardan, R [UAB University of Alabama, Birmingham, Birmingham, AL (United States); Benhabib, S [University of Alabama at Birmingham, Birmingham, AL (United States)

    2014-06-01

    Purpose: To determine the coefficients of bi- and tri-exponential functions for the best fit of radial dose functions of the new iodine brachytherapy source: Iodine-125 Seed AgX-100. Methods: The particle swarm optimization (PSO) method was used to search for the coefficients of the biand tri-exponential functions that yield the best fit to data published for a few selected radial distances from the source. The coefficients were encoded into particles, and these particles move through the search space by following their local and global best-known positions. In each generation, particles were evaluated through their fitness function and their positions were changed through their velocities. This procedure was repeated until the convergence criterion was met or the maximum generation was reached. All best particles were found in less than 1,500 generations. Results: For the I-125 seed AgX-100 considered as a point source, the maximum deviation from the published data is less than 2.9% for bi-exponential fitting function and 0.2% for tri-exponential fitting function. For its line source, the maximum deviation is less than 1.1% for bi-exponential fitting function and 0.08% for tri-exponential fitting function. Conclusion: PSO is a powerful method in searching coefficients for bi-exponential and tri-exponential fitting functions. The bi- and tri-exponential models of Iodine-125 seed AgX-100 point and line sources obtained with PSO optimization provide accurate analytical forms of the radial dose function. The tri-exponential fitting function is more accurate than the bi-exponential function.

  9. A Monte Carlo investigation of lung brachytherapy treatment planning

    Science.gov (United States)

    Sutherland, J. G. H.; Furutani, K. M.; Thomson, R. M.

    2013-07-01

    Iodine-125 (125I) and Caesium-131 (131Cs) brachytherapy have been used in conjunction with sublobar resection to reduce the local recurrence of stage I non-small cell lung cancer compared with resection alone. Treatment planning for this procedure is typically performed using only a seed activity nomogram or look-up table to determine seed strand spacing for the implanted mesh. Since the post-implant seed geometry is difficult to predict, the nomogram is calculated using the TG-43 formalism for seeds in a planar geometry. In this work, the EGSnrc user-code BrachyDose is used to recalculate nomograms using a variety of tissue models for 125I and 131Cs seeds. Calculated prescription doses are compared to those calculated using TG-43. Additionally, patient CT and contour data are used to generate virtual implants to study the effects that post-implant deformation and patient-specific tissue heterogeneity have on perturbing nomogram-derived dose distributions. Differences of up to 25% in calculated prescription dose are found between TG-43 and Monte Carlo calculations with the TG-43 formalism underestimating prescription doses in general. Differences between the TG-43 formalism and Monte Carlo calculated prescription doses are greater for 125I than for 131Cs seeds. Dose distributions are found to change significantly based on implant deformation and tissues surrounding implants for patient-specific virtual implants. Results suggest that accounting for seed grid deformation and the effects of non-water media, at least approximately, are likely required to reliably predict dose distributions in lung brachytherapy patients.

  10. Radiation Protection in Brachytherapy. Report of the SEFM Task Group on Brachytherapy; Proteccion radiologica en Braquiterapia. Informe del grupo de trabajo de Braquiterapia de la SEFM

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, J.; Corredoira Silva, E.; Crispin Contreras, V.; Eudaldo Puell, T.; Frutos Baraja, J. de; Pino Sorroche, F.; Pujades Claumarchirant, M. C.; Richart Sancho, J.

    2015-07-01

    This document presents the report of the Brachytherapy Task Group of the Spanish Society of Medical Physics. It is dedicated to the radiation protection aspects involved in brachytherapy. The aim of this work is to include the more relevant aspects related to radiation protection issues that appear in clinical practice, and for the current equipment in Spain. Basically this report focuses on the typical contents associated with high dose rate brachytherapy with {sup 1}92Ir and {sup 6}0Co sources, and permanent seed implants with {sup 1}25I, {sup 1}03Pd and {sup 1}31Cs, which are the most current and widespread modalities. Ophthalmic brachytherapy (COMS with {sup 1}25I, {sup 1}06Ru, {sup 9}0Sr) is also included due to its availability in a significant number of spanish hospitals. The purpose of this report is to assist to the medical physicist community in establishing a radiation protection program for brachytherapy procedures, trying to solve some ambiguities in the application of legal requirements and recommendations in clinical practice. (Author)

  11. RNA Nanoparticles Derived from Three-Way Junction of Phi29 Motor pRNA Are Resistant to I-125 and Cs-131 Radiation

    Science.gov (United States)

    Li, Hui; Rychahou, Piotr G.; Cui, Zheng; Pi, Fengmei; Evers, B. Mark; Shu, Dan

    2015-01-01

    Radiation reagents that specifically target tumors are in high demand for the treatment of cancer. The emerging field of RNA nanotechnology might provide new opportunities for targeted radiation therapy. This study investigates whether chemically modified RNA nanoparticles derived from the packaging RNA (pRNA) three-way junction (3WJ) of phi29 DNA-packaging motor are resistant to potent I-125 and Cs-131 radiation, which is a prerequisite for utilizing these RNA nanoparticles as carriers for targeted radiation therapy. pRNA 3WJ nanoparticles were constructed and characterized, and the stability of these nanoparticles under I-125 and Cs-131 irradiation with clinically relevant doses was examined. RNA nanoparticles derived from the pRNA 3WJ targeted tumors specifically and they were stable under irradiation of I-125 and Cs-131 with clinically relevant doses ranging from 1 to 90 Gy over a significantly long time up to 20 days, while control plasmid DNA was damaged at 20 Gy or higher. PMID:26017686

  12. Development of prostate voxel models for brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Adriano M.; Reis, Lucas P.; Grynberg, Suely E., E-mail: amsantos@cdtn.b [Center for Development of Nuclear Technology (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    The tools developed recently in the areas of computer graphics and animation movies to computer games allow the creation of new voxel anthropomorphic phantoms with better resolution and thus, more anatomical details. These phantoms can be used in nuclear applications, especially in radiation protection for estimating doses in cases of occupational or accidental radioactive incidents, and in medical and biological applications. For dose estimates, the phantoms are coupled to a Monte Carlo code, which will be responsible for the transport of radiation in this environment. This study aimed to develop a computational tool to estimate the isodose curves in the prostate after brachytherapy seed implants. For this, we have created a model called FANTPROST in the shape of a 48 mm side cube, with a standard prostate inserted in the center of this cube with different distributions of brachytherapy seeds in this volume. The prostate, according to this model, was obtained from the phantom voxels MASH2 developed by Numerical Dosimetry Group, Department of Nuclear Energy - Federal University of Pernambuco. The modeling of the seeds, added to FANTPROST, was done through the use of geometric information of Iodine-125 Amersham 6711 commercial seed. The simulations were performed by the code MCNP5 for spatial distributions containing different amounts of seeds within the FANTPROST. The obtained curves allowed an estimation of the behavior of the maximum dose that decreases with distance, showing that this tool can be used for a more accurate analysis of the effects produced by the presence of such seeds in the prostate and its vicinity. (author)

  13. Gold nanoparticle-aided brachytherapy with vascular dose painting: estimation of dose enhancement to the tumor endothelial cell nucleus.

    Science.gov (United States)

    Ngwa, Wilfred; Makrigiorgos, G Mike; Berbeco, Ross I

    2012-01-01

    Theoretical microdosimetry at the subcellular level is employed in this study to estimate the dose enhancement to tumor endothelial cell nuclei, caused by radiation-induced photo/Auger electrons originating from gold nanoparticles (AuNPs) targeting the tumor endothelium, during brachytherapy. A tumor vascular endothelial cell (EC) is modeled as a slab of 2 μm (thickness) × 10 μm (length) × 10 μm (width). The EC contains a nucleus of 5 μm diameter and thickness of 0.5-1 μm, corresponding to nucleus size 5%-10% of cellular volume, respectively. Analytic calculations based on the electron energy loss formula of Cole were carried out to estimate the dose enhancement to the nucleus caused by photo/Auger electrons from AuNPs attached to the exterior surface of the EC. The nucleus dose enhancement factor (nDEF), representing the ratio of the dose to the nucleus with and without the presence of gold nanoparticles was calculated for different AuNP local concentrations. The investigated concentration range considers the potential for significantly higher local concentration near the EC due to preferential accumulation of AuNP in the tumor vasculature. Four brachytherapy sources: I-125, Pd-103, Yb-169, and 50 kVp x-rays were investigated. For nucleus size of 10% of the cellular volume and AuNP concentrations ranging from 7 to 140 mg/g, brachytherapy sources Pd-103, I-125, 50 kVp, and Yb-169 yielded nDEF values of 5.6-73, 4.8-58.3, 4.7-56.6, and 3.2-25.8, respectively. Meanwhile, for nucleus size 5% of the cellular volume in the same concentration range, Pd-103, I-125, 50 kVp, and Yb-169 yielded nDEF values of 6.9-79.2, 5.1-63.2, 5.0-61.5, and 3.3-28.3, respectively. The results predict that a substantial dose boost to the nucleus of endothelial cells can be achieved by applying tumor vasculature-targeted AuNPs in combination with brachytherapy. Such vascular dose boosts could induce tumor vascular shutdown, prompting extensive tumor cell death.

  14. Applying gold nanoparticles as tumor-vascular disrupting agents during brachytherapy: estimation of endothelial dose enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Ngwa, Wilfred; Makrigiorgos, G Mike; Berbeco, Ross I, E-mail: mmakrigiorgos@lroc.harvard.ed [Department of Radiation Oncology, Division of Medical Physics and Biophysics, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115 (United States)

    2010-11-07

    Tumor vascular disrupting agents (VDAs) represent a promising approach to the treatment of cancer, in view of the tumor vasculature's pivotal role in tumor survival, growth and metastasis. VDAs targeting the tumor's dysmorphic endothelial cells can cause selective and rapid occlusion of the tumor vasculature, leading to tumor cell death from ischemia and extensive hemorrhagic necrosis. In this study, the potential for applying gold nanoparticles (AuNPs) as VDAs, during brachytherapy, is examined. Analytic calculations based on the electron energy loss formula of Cole were carried out to estimate the endothelial dose enhancement caused by radiation-induced photo/Auger electrons originating from AuNPs targeting the tumor endothelium. The endothelial dose enhancement factor (EDEF), representing the ratio of the dose to the endothelium with and without gold nanoparticles was calculated for different AuNP local concentrations, and endothelial cell thicknesses. Four brachytherapy sources were investigated, I-125, Pd-103, Yb-169, as well as 50 kVp x-rays. The results reveal that, even at relatively low intra-vascular AuNP concentrations, ablative dose enhancement to tumor endothelial cells due to photo/Auger electrons from the AuNPs can be achieved. Pd-103 registered the highest EDEF values of 7.4-271.5 for local AuNP concentrations ranging from 7 to 350 mg g{sup -1}, respectively. Over the same concentration range, I-125, 50 kVp and Yb-169 yielded values of 6.4-219.9, 6.3-214.5 and 4.0-99.7, respectively. Calculations of the EDEF as a function of endothelial cell thickness showed that lower energy sources like Pd-103 reach the maximum EDEF at smaller thicknesses. The results also reveal that the highest contribution to the EDEF comes from Auger electrons, apparently due to their shorter range. Overall, the data suggest that ablative dose enhancement to tumor endothelial cells can be achieved by applying tumor vasculature-targeted AuNPs as adjuvants to

  15. SU-E-T-338: Ultrastable PRNA 3WJ Nanoparticles as Potential I-125 and C-131 Carriers for Targeted Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Luo, W; Li, H; Guo, P [University of Kentucky, Lexington, KY (United States)

    2014-06-01

    Purpose: To study the feasibility of using the pRNA 3WJ nanoparticles to carry I-125 or Cs-131 to target and treat cancer. As the first step, we investigated the stabilities of pRNA 3WJ nanoparticles that are essential for cancer targeting and treatment in this study. Methods: The thermodynamic stability of assembled RNA 3WJ nanoparticles was studied using the TGGE system. The nanoparticles were irradiated with I-125 or Cs-131 radioactive sources that were immersed in the RNA nanoparticle/DNA structure sample liquid contained in a small vial. The irradiation of the RNA samples was performed for different time periods and doses. The purpose was to distinguish the effects of radiation on DNA and RNA structures. Unradiated samples were used as control. Results: RNA nanoparticles were formed by mixing three pieces of oligos, 3WJa, 3WJb, and 3WJc at 1:1:1 molar ratio. Figure 4 demonstrates that 2′-F modified 3WJ nanoparticles remained stable at temperatures as high as 66.8 ± 2°C, and exhibited melting temperatures of 71 ± 2°C. The radiation stability test was performed with I- 125 and Cs-131 irradiation. Several DNA structures including plasmids were included as control. The first test introduced I-125 and a low dose of 1 Gy to both RNA and DNA samples, but no change was observed. When the dose was increased to 30 Gy, DNA was damaged while RNA remained unchanged. Three tests were also conducted with Cs-131 with 7 Gy, 21 Gy, 30 Gy, and 89 Gy, and the results were similar to those with I-125. Conclusion: pRNA 3WJ nanoparticles are able to form efficiently by onepot self-assembly. They remained stable at high temperatures and high therapeutic doses over a long time. These unique features suggest that RNA 3WJ nanoparticles have the potential to be used for targeted radiation therapy for cancer treatment.

  16. AAPM and GEC-ESTRO guidelines for image-guided robotic brachytherapy: Report of Task Group 192

    Energy Technology Data Exchange (ETDEWEB)

    Podder, Tarun K., E-mail: tarun.podder@uhhospitals.org [Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, Ohio 44122 (United States); Beaulieu, Luc [Department of Radiation Oncology, Centre Hospitalier Univ de Quebec, Quebec G1R 2J6 (Canada); Caldwell, Barrett [Schools of Industrial Engineering and Aeronautics and Astronautics, Purdue University, West Lafayette, Indiana 47907 (United States); Cormack, Robert A. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts 02115 (United States); Crass, Jostin B. [Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee 37232 (United States); Dicker, Adam P.; Yu, Yan [Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States); Fenster, Aaron [Department of Imaging Research, Robarts Research Institute, London, Ontario N6A 5K8 (Canada); Fichtinger, Gabor [School of Computer Science, Queen’s University, Kingston, Ontario K7L 3N6 (Canada); Meltsner, Michael A. [Philips Radiation Oncology Systems, Fitchburg, Wisconsin 53711 (United States); Moerland, Marinus A. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht, 3508 GA (Netherlands); Nath, Ravinder [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520 (United States); Rivard, Mark J. [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States); Salcudean, Tim [Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z4 (Canada); Song, Danny Y. [Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231 (United States); Thomadsen, Bruce R. [Department of Medical Physics, University of Wisconsin, Madison, Wisconsin 53705 (United States)

    2014-10-15

    In the last decade, there have been significant developments into integration of robots and automation tools with brachytherapy delivery systems. These systems aim to improve the current paradigm by executing higher precision and accuracy in seed placement, improving calculation of optimal seed locations, minimizing surgical trauma, and reducing radiation exposure to medical staff. Most of the applications of this technology have been in the implantation of seeds in patients with early-stage prostate cancer. Nevertheless, the techniques apply to any clinical site where interstitial brachytherapy is appropriate. In consideration of the rapid developments in this area, the American Association of Physicists in Medicine (AAPM) commissioned Task Group 192 to review the state-of-the-art in the field of robotic interstitial brachytherapy. This is a joint Task Group with the Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology (GEC-ESTRO). All developed and reported robotic brachytherapy systems were reviewed. Commissioning and quality assurance procedures for the safe and consistent use of these systems are also provided. Manual seed placement techniques with a rigid template have an estimated in vivo accuracy of 3–6 mm. In addition to the placement accuracy, factors such as tissue deformation, needle deviation, and edema may result in a delivered dose distribution that differs from the preimplant or intraoperative plan. However, real-time needle tracking and seed identification for dynamic updating of dosimetry may improve the quality of seed implantation. The AAPM and GEC-ESTRO recommend that robotic systems should demonstrate a spatial accuracy of seed placement ≤1.0 mm in a phantom. This recommendation is based on the current performance of existing robotic brachytherapy systems and propagation of uncertainties. During clinical commissioning, tests should be conducted to ensure that this level of accuracy is achieved. These tests

  17. AAPM and GEC-ESTRO guidelines for image-guided robotic brachytherapy: report of Task Group 192.

    Science.gov (United States)

    Podder, Tarun K; Beaulieu, Luc; Caldwell, Barrett; Cormack, Robert A; Crass, Jostin B; Dicker, Adam P; Fenster, Aaron; Fichtinger, Gabor; Meltsner, Michael A; Moerland, Marinus A; Nath, Ravinder; Rivard, Mark J; Salcudean, Tim; Song, Danny Y; Thomadsen, Bruce R; Yu, Yan

    2014-10-01

    In the last decade, there have been significant developments into integration of robots and automation tools with brachytherapy delivery systems. These systems aim to improve the current paradigm by executing higher precision and accuracy in seed placement, improving calculation of optimal seed locations, minimizing surgical trauma, and reducing radiation exposure to medical staff. Most of the applications of this technology have been in the implantation of seeds in patients with early-stage prostate cancer. Nevertheless, the techniques apply to any clinical site where interstitial brachytherapy is appropriate. In consideration of the rapid developments in this area, the American Association of Physicists in Medicine (AAPM) commissioned Task Group 192 to review the state-of-the-art in the field of robotic interstitial brachytherapy. This is a joint Task Group with the Groupe Européen de Curiethérapie-European Society for Radiotherapy & Oncology (GEC-ESTRO). All developed and reported robotic brachytherapy systems were reviewed. Commissioning and quality assurance procedures for the safe and consistent use of these systems are also provided. Manual seed placement techniques with a rigid template have an estimated in vivo accuracy of 3-6 mm. In addition to the placement accuracy, factors such as tissue deformation, needle deviation, and edema may result in a delivered dose distribution that differs from the preimplant or intraoperative plan. However, real-time needle tracking and seed identification for dynamic updating of dosimetry may improve the quality of seed implantation. The AAPM and GEC-ESTRO recommend that robotic systems should demonstrate a spatial accuracy of seed placement ≤1.0 mm in a phantom. This recommendation is based on the current performance of existing robotic brachytherapy systems and propagation of uncertainties. During clinical commissioning, tests should be conducted to ensure that this level of accuracy is achieved. These tests should

  18. Evaluation of the visibility of a new thinner ¹²⁵I radioactive source for permanent prostate brachytherapy.

    Science.gov (United States)

    Roberts, Gemma; Al-Qaisieh, Bashar; Bownes, Peter

    2012-01-01

    The ¹²⁵I source currently used for prostate brachytherapy at St. James's Institute of Oncology is a standard size seed (≈4.5mm in length and 0.8mm in diameter). A new, thinner seed is under evaluation. This is designed to be implanted using narrower needles, potentially reducing edema and improving the dose distribution. This study investigated the visibility of the thinner source on multimodality images and compared it with that of standard size seeds. Images of dummy seeds of both thinner and standard size models were taken using ultrasound, fluoroscopy, computed tomography (CT), and magnetic resonance (MR) imaging. The ultrasound, fluoroscopy, and CT images were acquired with the seeds inserted into phantoms positioned in a water tank. The MR images were acquired using phantoms containing single seeds. The images were analyzed visually and quantitatively. The resolution of closely spaced seeds on CT images was investigated. The visibility of both seeds was similar on ultrasound, fluoroscopy, and MR images. On CT images, the thinner seeds give reduced artifacts and better resolution. The use of the thinner seed would have minimal effect on ultrasound and fluoroscopy imaging during treatment. However on CT images, the use of the thinner seeds may improve seed identification for post-treatment dosimetry. Further study is required into the suitability of MR images alone for post-treatment dosimetry. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  19. Study of two different radioactive sources for prostate brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Pereira Neves, Lucio; Perini, Ana Paula [Instituto de Fisica, Universidade Federal de Uberlandia, Caixa Postal 593, 38400-902, Uberlandia, MG (Brazil); Souza Santos, William de; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares, Comissao Nacional de Energia Nuclear, IPENCNEN/SP, Av. Prof. Lineu Prestes, 2242, Cidade Universitaria, 05508-000 Sao Paulo, SP (Brazil); Belinato, Walmir [Departamento de Ensino, Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia, Campus Vitoria da Conquista, Zabele, Av. Amazonas 3150, 45030-220 Vitoria da Conquista, BA (Brazil)

    2015-07-01

    In this study we evaluated two radioactive sources for brachytherapy treatments. Our main goal was to quantify the absorbed doses on organs and tissues of an adult male patient, submitted to a brachytherapy treatment with two radioactive sources. We evaluated a {sup 192}Ir and a {sup 125}I radioactive sources. The {sup 192}Ir radioactive source is a cylinder with 0.09 cm in diameter and 0.415 cm long. The {sup 125}I radioactive source is also a cylinder, with 0.08 cm in diameter and 0.45 cm long. To evaluate the absorbed dose distribution on the prostate, and other organs and tissues of an adult man, a male virtual anthropomorphic phantom MASH, coupled in the radiation transport code MCNPX 2.7.0, was employed.We simulated 75, 90 and 102 radioactive sources of {sup 125}I and one of {sup 192}Ir, inside the prostate, as normally used in these treatments, and each treatment was simulated separately. As this phantom was developed in a supine position, the displacement of the internal organs of the chest, compression of the lungs and reduction of the sagittal diameter were all taken into account. For the {sup 192}Ir, the higher doses values were obtained for the prostate and surrounding organs, as the colon, gonads and bladder. Considering the {sup 125}I sources, with photons with lower energies, the doses to organs that are far from the prostate were lower. All values for the dose rates are in agreement with those recommended for brachytherapy treatments. Besides that, the new seeds evaluated in this work present usefulness as a new tool in prostate brachytherapy treatments, and the methodology employed in this work may be applied for other radiation sources, or treatments. (authors)

  20. Brachytherapy in Gynecologic Cancers: Why Is It Underused?

    Science.gov (United States)

    Han, Kathy; Viswanathan, Akila N

    2016-04-01

    Despite its established efficacy, brachytherapy is underused in the management of cervical and vaginal cancers in some parts of the world. Possible reasons for the underutilization of brachytherapy include the adoption of less invasive techniques, such as intensity-modulated radiotherapy; reimbursement policies favoring these techniques over brachytherapy; poor physician or patient access to brachytherapy; inadequate maintenance of brachytherapy skills among practicing radiation oncologists; transitioning to high-dose-rate (HDR) brachytherapy with increased time requirements; and insufficient training of radiation oncology residents.

  1. Toward adaptive stereotactic robotic brachytherapy for prostate cancer: demonstration of an adaptive workflow incorporating inverse planning and an MR stealth robot.

    Science.gov (United States)

    Cunha, J Adam; Hsu, I-Chow; Pouliot, Jean; Roach Iii, Mack; Shinohara, Katsuto; Kurhanewicz, John; Reed, Galen; Stoianovici, Dan

    2010-08-01

    To translate any robot into a clinical environment, it is critical that the robot can seamlessly integrate with all the technology of a modern clinic. MRBot, an MR-stealth brachytherapy delivery device, was used in a closed-bore 3T MRI and a clinical brachytherapy cone beam CT suite. Targets included ceramic dummy seeds, MR-Spectroscopy-sensitive metabolite, and a prostate phantom. Acquired DICOM images were exported to planning software to register the robot coordinates in the imager's frame, contour and verify target locations, create dose plans, and export needle and seed positions to the robot. The coordination of each system element (imaging device, brachytherapy planning system, robot control, robot) was validated with a seed delivery accuracy of within 2 mm in both a phantom and soft tissue. An adaptive workflow was demonstrated by acquiring images after needle insertion and prior to seed deposition. This allows for adjustment if the needle is in the wrong position. Inverse planning (IPSA) was used to generate a seed placement plan and coordinates for ten needles and 29 seeds were transferred to the robot. After every two needles placed, an image was acquired. The placed seeds were identified and validated prior to placing the seeds in the next two needles. The ability to robotically deliver seeds to locations determined by IPSA and the ability of the system to incorporate novel needle patterns were demonstrated. Shown here is the ability to overcome this critical step. An adaptive brachytherapy workflow is demonstrated which integrates a clinical anatomy-based seed location optimization engine and a robotic brachytherapy device. Demonstration of this workflow is a key element of a successful translation to the clinic of the MRI stealth robotic delivery system, MRBot.

  2. Outcomes of Iodine-125 Plaque Brachytherapy for Uveal Melanoma With Intraoperative Ultrasonography and Supplemental Transpupillary Thermotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Badiyan, Shahed N. [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, St. Louis, Missouri (United States); Rao, Rajesh C. [Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri (United States); Apicelli, Anthony J.; Acharya, Sahaja; Verma, Vivek; Garsa, Adam A.; DeWees, Todd; Speirs, Christina K.; Garcia-Ramirez, Jose; Esthappan, Jacqueline; Grigsby, Perry W. [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, St. Louis, Missouri (United States); Harbour, J. William, E-mail: JWHarbour@med.miami.edu [Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri (United States); Ocular Oncology Service, Department of Ophthalmology, Bascom Palmer Eye Institute and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States)

    2014-03-15

    Purpose: To assess the impact on local tumor control of intraoperative ultrasonographic plaque visualization and selective application of transpupillary thermotherapy (TTT) in the treatment of posterior uveal melanoma with iodine-125 (I-125) episcleral plaque brachytherapy (EPB). Methods and Materials: Retrospective analysis of 526 patients treated with I-125 EPB for posterior uveal melanoma. Clinical features, dosimetric parameters, TTT treatments, and local tumor control outcomes were recorded. Statistical analysis was performed using Cox proportional hazards and Kaplan-Meier life table method. Results: The study included 270 men (51%) and 256 women (49%), with a median age of 63 years (mean, 62 years; range, 16-91 years). Median dose to the tumor apex was 94.4 Gy (mean, 97.8; range, 43.9-183.9) and to the tumor base was 257.9 Gy (mean, 275.6; range, 124.2-729.8). Plaque tilt >1 mm away from the sclera at plaque removal was detected in 142 cases (27%). Supplemental TTT was performed in 72 patients (13.7%). One or 2 TTT sessions were required in 71 TTT cases (98.6%). After a median follow-up of 45.9 months (mean, 53.4 months; range, 6-175 months), local tumor recurrence was detected in 19 patients (3.6%). Local tumor recurrence was associated with lower dose to the tumor base (P=.02). Conclusions: Ultrasound-guided plaque localization of I-125 EPB is associated with excellent local tumor control. Detection of plaque tilt by ultrasonography at plaque removal allows supplemental TTT to be used in patients at potentially higher risk for local recurrence while sparing the majority of patients who are at low risk. Most patients require only 1 or 2 TTT sessions.

  3. In vivo dosimetry in brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Beddar, Sam; Andersen, Claus Erik;

    2013-01-01

    In vivo dosimetry (IVD) has been used in brachytherapy (BT) for decades with a number of different detectors and measurement technologies. However, IVD in BT has been subject to certain difficulties and complexities, in particular due to challenges of the high-gradient BT dose distribution and th...

  4. Salvage/Adjuvant Brachytherapy After Ophthalmic Artery Chemosurgery for Intraocular Retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Francis, Jasmine H., E-mail: francij1@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Barker, Christopher A.; Wolden, Suzanne L.; McCormick, Beryl; Segal, Kira; Cohen, Gil [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Gobin, Y. Pierre; Marr, Brian P. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States); Brodie, Scott E. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mount Sinai School of Medicine, New York, New York (United States); Dunkel, Ira J.; Abramson, David H. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States)

    2013-11-01

    Purpose: To evaluate the efficacy and toxicity of brachytherapy after ophthalmic artery chemosurgery (OAC) for retinoblastoma. Methods and Materials: This was a single-arm, retrospective study of 15 eyes in 15 patients treated with OAC followed by brachytherapy at (blinded institution) between May 1, 2006, and December 31, 2012, with a median 19 months' follow-up from plaque insertion. Outcome measurements included patient and ocular survival, visual function, and retinal toxicity measured by electroretinogram (ERG). Results: Brachytherapy was used as adjuvant treatment in 2 eyes and as salvage therapy in 13 eyes of which 12 had localized vitreous seeding. No patients developed metastasis or died of retinoblastoma. The Kaplan-Meier estimate of ocular survival was 79.4% (95% confidence interval 48.7%-92.8%) at 18 months. Three eyes were enucleated, and an additional 6 eyes developed out-of-target volume recurrences, which were controlled with additional treatments. Patients with an ocular complication had a mean interval between last OAC and plaque of 2.5 months (SD 2.3 months), which was statistically less (P=.045) than patients without ocular complication who had a mean interval between last OAC and plaque of 6.5 months (SD 4.4 months). ERG responses from pre- versus postplaque were unchanged or improved in more than half the eyes. Conclusions: Brachytherapy following OAC is effective, even in the presence of vitreous seeding; the majority of eyes maintained stable or improved retinal function following treatment, as assessed by ERG.

  5. Material-specific Conversion Factors for Different Solid Phantoms Used in the Dosimetry of Different Brachytherapy Sources

    Directory of Open Access Journals (Sweden)

    Sedigheh Sina

    2015-07-01

    Full Text Available Introduction Based on Task Group No. 43 (TG-43U1 recommendations, water phantom is proposed as a reference phantom for the dosimetry of brachytherapy sources. The experimental determination of TG-43 parameters is usually performed in water-equivalent solid phantoms. The purpose of this study was to determine the conversion factors for equalizing solid phantoms to water. Materials and Methods TG-43 parameters of low- and high-energy brachytherapy sources (i.e., Pd-103, I-125 and Cs-137 were obtained in different phantoms, using Monte Carlo simulations. The brachytherapy sources were simulated at the center of different phantoms including water, solid water, poly(methyl methacrylate, polystyrene and polyethylene. Dosimetric parameters such as dose rate constant, radial dose function and anisotropy function of each source were compared in different phantoms. Then, conversion factors were obtained to make phantom parameters equivalent to those of water. Results Polynomial coefficients of conversion factors were obtained for all sources to quantitatively compare g(r values in different phantom materials and the radial dose function in water. Conclusion Polynomial coefficients of conversion factors were obtained for all sources to quantitatively compare g(r values in different phantom materials and the radial dose function in water.

  6. Brachytherapy in the Management of Uveal Melanomas

    Directory of Open Access Journals (Sweden)

    Samuray Tuncer

    2014-09-01

    Full Text Available Uveal melanoma is the most common intraocular tumor in adults. Clinical studies have shown similar patient survival rates after treatment of medium-sized melanomas when comparing plaque brachytherapy with radioactive iodine-125 versus enucleation. This finding further emphasizes the importance of this globe-sparing treatment. Brachytherapy is a special local radiotherapy technique that aims to deliver high-dose radiation directly to the tumor by sparing the periocular structures. Brachytherapy is still the most widely used treatment for uveal melanoma. Iodine-125 and ruthenium-106 are the most common radioisotopes used in brachytherapy. After brachytherapy, sight-threatening complications occur unavoidably in many patients. Brachytherapy is mostly associated with long-term complications. Radiation retinopathy and cataract formation are the most common treatment-related complications. Brachytherapy provides local tumor control (ocular salvage in about 90% of patients. Adjunctive transpupillary thermotherapy (sandwich therapy improves the control rate of local tumors to 97%. About 10% of patients treated with brachytherapy subsequently require enucleation because of local tumor recurrence or neovascular glaucoma at 5 years of follow-up. Metastatic disease occurs in 10% of patients with medium-sized melanoma at 5-year follow-up. This rate increases to 55% at 10-year follow-up in patients with large melanomas (thickness >8 mm. Thus, it is very important to inform the patients under the light of these data prior to brachytherapy. (Turk J Ophthalmol 2014; 44: Supplement 43-8

  7. LOW POWER BRACHYTHERAPY IN COMBINED TREATMENT IN PATIENTS WITH INTERMEDIATE RISK OF LOCALIZED PROST ATE CANCER

    Directory of Open Access Journals (Sweden)

    V. A. Biryukov

    2014-01-01

    Full Text Available Objective. Estimation of the effectiveness of low power brachytherapy sources I-125 in the combined treatment in group of patients of intermediate risk of localized prostate cancer.Material and methods. The study included 126 patients with prostate cancer of intermediate risk. 104 patients (83,9% were conducted low power brachytherapy I‑125 in combination with hormone therapy by analogues of LHWG. 22 patients (16.1% received external beam irradiation in combination with brachytherapy I‑125 and hormonal treatment. Relapse-free survival of patients was evaluated in accordance with the criteria Phoenix (Nadir PSA + ng/ml. Evaluation of side effects of radiation treatment were carried out according to the RTOG criteria.Results. PSA relapse-free survival in the group of brachytherapy and hormone treatment at the time of observation 5 years amounted to 97.1%. In the group of combined radiation therapy with brachytherapy, and hormonal treatment PSA relapse-free survival rate was 95.5%.In both groups, relapse-free survival was noted in 96,8% of cases. Tumor-specific and overall survival in bothgroups was 100%. The major complications of treatment in both groups were radiation urethritis 1 to 2 degrees in 9.5% of cases (12 patients, urethral stricture in 5 patients (3.9% of cases, acute urinary retention in 1 patient (0.8% of cases and late radiation rectitis of 2 degree in 1.58% of cases (2 patients.Conclusions. It is possible to draw tentative conclusions about the high rate of survival without progression in both treatment groups on the background of the relatively low frequency of adverse reactions. It is necessary further follow-up for patients with estimating of survival for a longer period.

  8. Intravitreal bevacizumab combined with plaque brachytherapy reduces melanoma tumor volume and enhances resolution of exudative detachment

    Directory of Open Access Journals (Sweden)

    Houston SK

    2013-01-01

    Full Text Available Samuel K Houston,1 Nisha V Shah,1 Christina Decatur,1 Marcela Lonngi,1 William Feuer,1 Arnold M Markoe,2 Timothy G Murray1–31Department of Ophthalmology, 2Department of Radiation Oncology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Murray Ocular Oncology and Retina, Miami, FL, USABackground: The purpose of this study was to evaluate intravitreal bevacizumab as an adjuvant treatment to plaque brachytherapy in the treatment of choroidal melanoma.Methods: This was a retrospective, consecutive study of 124 patients treated from 2007 to 2009 for choroidal melanoma with plaque brachytherapy. Patients were treated with I-125 plaque brachytherapy with 2 mm margins and 85 Gy to the tumor apex. Consecutive patients were injected intravitreally with 2.5 mg/0.1 mL bevacizumab at a site away from the primary tumor and immediately following plaque removal. Choroidal melanomas were observed using indirect ophthalmoscopy, wide-angle photography, and ultrasound. The main outcome measures were tumor volume, resolution of exudative retinal detachment, and visual acuity.Results: One hundred and twenty-four patients met our inclusion criteria and were included in the analysis. The mean patient age was 65.7 years, and the mean apical tumor height was 4.0 ± 2.7 mm and basal diameter was 12.7 ± 3.0 mm. Mean follow-up was 24 months. Prior to treatment, 100% of tumors had exudative retinal detachment, and pretreatment visual acuity was 20/55 (median 20/40. Tumor control was 100%, metastasis was 0% at last follow-up, and 89.8% had complete resolution of exudative retinal detachment, with a mean time to resolution of 3.36 months. At one month, 43% had complete resolution of exudative retinal detachment, which increased to 73% at 4 months. Visual acuity was 20/62 (median 20/40 at 4 months, with stabilization to 20/57 (median 20/40 at 8 months, 20/56 (median 20/30 at 12 months, and 20/68 (median 20/50 at 24 months. Tumor

  9. SU-F-BRA-04: Prostate HDR Brachytherapy with Multichannel Robotic System

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, F Maria; Podder, T [University Hospitals Case Medical Center, Cleveland, OH (United States); Yu, Y [Thomas Jefferson University, Philadelphia, PA (United States)

    2015-06-15

    Purpose: High-dose-rate (HDR) brachytherapy is gradually becoming popular in treating patients with prostate cancers. However, placement of the HDR needles at desired locations into the patient is challenging. Application of robotic system may improve the accuracy of the clinical procedure. This experimental study is to evaluate the feasibility of using a multichannel robotic system for prostate HDR brachytherapy. Methods: In this experimental study, the robotic system employed was a 6-DOF Multichannel Image-guided Robotic Assistant for Brachytherapy (MIRAB), which was designed and fabricated for prostate seed implantation. The MIRAB has the provision of rotating 16 needles while inserting them. Ten prostate HDR brachytherapy needles were simultaneously inserted using MIRAB into a commercially available prostate phantom. After inserting the needles into the prostate phantom at desired locations, 2mm thick CT slices were obtained for dosimetric planning. HDR plan was generated using Oncetra planning system with a total prescription dose of 34Gy in 4 fractions. Plan quality was evaluated considering dose coverage to prostate and planning target volume (PTV), with 3mm margin around prostate, as well as the dose limit to the organs at risk (OARs) following the American Brachytherapy Society (ABS) guidelines. Results: From the CT scan, it is observed that the needles were inserted straight into the desired locations and they were adequately spaced and distributed for a clinically acceptable HDR plan. Coverage to PTV and prostate were about 91% (V100= 91%) and 96% (V100=96%), respectively. Dose to 1cc of urethra, rectum, and bladder were within the ABS specified limits. Conclusion: The MIRAB was able to insert multiple needles simultaneously into the prostate precisely. By controlling the MIRAB to insert all the ten utilized needles into the prostate phantom, we could achieve the robotic HDR brachytherapy successfully. Further study for assessing the system

  10. Intravascular brachytherapy for peripheral vascular disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2008-09-01

    Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy

  11. Afterloading: The Technique That Rescued Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Aronowitz, Jesse N., E-mail: jesse.aronowitz@umassmemorial.org

    2015-07-01

    Although brachytherapy had been established as a highly effective modality for the treatment of cancer, its application was threatened by mid-20th century due to appreciation of the radiation hazard to health care workers. This review examines how the introduction of afterloading eliminated exposure and ushered in a brachytherapy renaissance.

  12. Intraoperative HDR Brachytherapy: Present and Future

    NARCIS (Netherlands)

    I.-K.K. Kolkman-Deurloo (Inger-Karina)

    2007-01-01

    textabstractRadiotherapy is one of the most effective modalities in cancer treatment, and can be applied either by external beam radiotherapy or by brachytherapy. Brachytherapy is a treatment modality in which tumors are irradiated by positioning radioactive sources very close to or in the tumor

  13. Intraoperative HDR Brachytherapy: Present and Future

    NARCIS (Netherlands)

    I.-K.K. Kolkman-Deurloo (Inger-Karina)

    2007-01-01

    textabstractRadiotherapy is one of the most effective modalities in cancer treatment, and can be applied either by external beam radiotherapy or by brachytherapy. Brachytherapy is a treatment modality in which tumors are irradiated by positioning radioactive sources very close to or in the tumor vol

  14. Low-dose rate prostate brachytherapy is well tolerated in patients with a history of inflammatory bowel disease.

    Science.gov (United States)

    Peters, Christopher A; Cesaretti, Jamie A; Stone, Nelson N; Stock, Richard G

    2006-10-01

    We report on the follow-up of 24 patients with a prior history of inflammatory bowel disease (IBD) treated with brachytherapy for early-stage prostate cancer. Twenty-four patients with a history of inflammatory bowel disease (17 with ulcerative colitis (UC), 7 with Crohn's disease [CD]) underwent prostate brachytherapy between 1992 and 2004. Fifteen patients were treated with I-125 implantation and 6 patients were treated with Pd-103 alone or in combination with 45 Gy external beam radiation. Charts were reviewed for all patients, and all living patients were contacted by phone. National Cancer Institute common toxicity scores for proctitis were assigned to all patients. Actuarial risk of late toxicity was calculated by the Kaplan-Meier method. Statistical analysis was performed using SPSS software. Follow-up ranged from 3 to 126 months (median, 48.5 months; mean, 56.8 months). None of the patients experienced Grade 3 or 4 rectal toxicity. Four patients experienced Grade 2 late rectal toxicity. The 5-year actuarial freedom from developing late Grade 2 rectal toxicity was 81%. At a median follow-up of 48.5 months, 23 patients were alive and had no evidence of disease with a median prostate-specific antigen for the sample of 0.1 ng/mL (range, <0.05-0.88 ng/mL). One patient died of other causes unrelated to his prostate cancer. Prostate brachytherapy is well tolerated in patients with a history of controlled IBD. Therefore, brachytherapy should be considered a viable therapeutic option in this patient population.

  15. Feasibility and safety of outpatient brachytherapy in 37 patients with brain tumors using the GliaSite Radiation Therapy System.

    Science.gov (United States)

    Chino, Kazumi; Silvain, Daniel; Grace, Ana; Stubbs, James; Stea, Baldassarre

    2008-07-01

    Temporary, low dose rate brachytherapy to the margins of resected brain tumors, using a balloon catheter system (GliaSite Radiation Therapy System) and liquid I-125 radiation source (Iotrex), began in 2002 at the University of Arizona Medical Center. Initially, all patients were treated on an inpatient basis. For patient convenience, we converted to outpatient therapy. In this article we review the exposure data and safety history for the 37 patients treated as outpatients. Proper patient selection and instruction is crucial to having a successful outpatient brachytherapy program. A set of evaluation criteria and patient instructions were developed in compliance with the U.S. Nuclear Regulatory Commission's document NUREG-1556 Volume 9 (Appendix U) and Arizona State Nuclear regulatory guidelines, which specify acceptable exposure rates for outpatient release in this setting. Of the 37 patients monitored, 26 patients were treated for recurrent glioblastoma multiforme (GBM), six for primary GBM, and five for metastatic brain tumors. All 37 patients and their primary caregivers gave signed agreement to follow a specific set of instructions and were released for the duration of brachytherapy (3-7 days). The typical prescription dose was 60 Gy delivered at 0.5 cm from the balloon surface. Afterloaded activities in these patients ranged from 90.9 to 750.0 mCi and measured exposure rates at 1 m from the head were less than 14 mR/h. The mean exposure to the caretaker measured by personal radiation Landauer Luxel + whole body dosimeters for 25 caretakers was found to be 9.6 mR, which was significantly less than the mean calculated exposure of 136.8 mR. For properly selected patients, outpatient brachytherapy is simple and can be performed within established regulatory guidelines.

  16. Dynamic rotating-shield brachytherapy.

    Science.gov (United States)

    Liu, Yunlong; Flynn, Ryan T; Kim, Yusung; Yang, Wenjun; Wu, Xiaodong

    2013-12-01

    To present dynamic rotating shield brachytherapy (D-RSBT), a novel form of high-dose-rate brachytherapy (HDR-BT) with electronic brachytherapy source, where the radiation shield is capable of changing emission angles during the radiation delivery process. A D-RSBT system uses two layers of independently rotating tungsten alloy shields, each with a 180° azimuthal emission angle. The D-RSBT planning is separated into two stages: anchor plan optimization and optimal sequencing. In the anchor plan optimization, anchor plans are generated by maximizing the D90 for the high-risk clinical-tumor-volume (HR-CTV) assuming a fixed azimuthal emission angle of 11.25°. In the optimal sequencing, treatment plans that most closely approximate the anchor plans under the delivery-time constraint will be efficiently computed. Treatment plans for five cervical cancer patients were generated for D-RSBT, single-shield RSBT (S-RSBT), and (192)Ir-based intracavitary brachytherapy with supplementary interstitial brachytherapy (IS + ICBT) assuming five treatment fractions. External beam radiotherapy doses of 45 Gy in 25 fractions of 1.8 Gy each were accounted for. The high-risk clinical target volume (HR-CTV) doses were escalated such that the D2cc of the rectum, sigmoid colon, or bladder reached its tolerance equivalent dose in 2 Gy fractions (EQD2 with α∕β = 3 Gy) of 75 Gy, 75 Gy, or 90 Gy, respectively. For the patients considered, IS + ICBT had an average total dwell time of 5.7 minutes∕fraction (min∕fx) assuming a 10 Ci(192)Ir source, and the average HR-CTV D90 was 78.9 Gy. In order to match the HR-CTV D90 of IS + ICBT, D-RSBT required an average of 10.1 min∕fx more delivery time, and S-RSBT required 6.7 min∕fx more. If an additional 20 min∕fx of delivery time is allowed beyond that of the IS + ICBT case, D-RSBT and S-RSBT increased the HR-CTV D90 above IS + ICBT by an average of 16.3 Gy and 9.1 Gy, respectively. For cervical cancer patients, D-RSBT can boost HR-CTV D90

  17. Iodine-125 interstitial brachytherapy for experimental liver cancer

    Institute of Scientific and Technical Information of China (English)

    ZHOU Fei-guo; YAN Jian-jun; HUANG Liang; LIU Cai-feng; ZHANG Xiang-hua; ZHOU Wei-ping; YAN Yi-qun

    2007-01-01

    Objective:To study the effect of iodine-125 interstitial brachytherapy on liver cancer.Methods:Animal model of human liver cancer was established by injecting SMMC-7721 cells cultivated in vitro subcutaneously into the flank of BALB/c nude mice.Nude mice with tumor of 5 mm in diameter were randomly divided into 2 groups(n=10).One iodine-125 seed of apparent activity 0.8 mCi was implanted into the center of tumor in treatment group,whereas an inactive seed was implanted in control group.The other 20 nude mice with tumor reaching 10 mm in diameter were also treated as above.The size of tumor was determined weekly after implantation,and pathological examination and blood routine were taken on the 28th day.Results:Tumor growth was obviously inhibited in treatment group of tumor of 5 mm in diameter,and there was statistically significant difference in tumor volume between treatment and control groups(P<0.01).Around iodine-125 seed,apparent necrosis of tumor was shown in treatment group,accompanied by karyopyknosis and reduced plasma in residual tumor cells microscopically.Tumor growth was not inhibited in either treatment or control group of tumor of 10 mm in diameter.There was no obvious adverse effect except for decreased white blood cells in treatment groups.Conclusion:There is certain effect of iodine-125 interstitial brachytherapy on liver cancer,which is associated with the size of tumor.

  18. Study of dose calculation on breast brachytherapy using prism TPS

    Energy Technology Data Exchange (ETDEWEB)

    Fendriani, Yoza; Haryanto, Freddy [Nuclear Physics and Biophysics Research Division, FMIPA Institut Teknologi Bandung, Physics Buildings, Jl. Ganesha 10, Bandung 40132 (Indonesia)

    2015-09-30

    PRISM is one of non-commercial Treatment Planning System (TPS) and is developed at the University of Washington. In Indonesia, many cancer hospitals use expensive commercial TPS. This study aims to investigate Prism TPS which been applied to the dose distribution of brachytherapy by taking into account the effect of source position and inhomogeneities. The results will be applicable for clinical Treatment Planning System. Dose calculation has been implemented for water phantom and CT scan images of breast cancer using point source and line source. This study used point source and line source and divided into two cases. On the first case, Ir-192 seed source is located at the center of treatment volume. On the second case, the source position is gradually changed. The dose calculation of every case performed on a homogeneous and inhomogeneous phantom with dimension 20 × 20 × 20 cm{sup 3}. The inhomogeneous phantom has inhomogeneities volume 2 × 2 × 2 cm{sup 3}. The results of dose calculations using PRISM TPS were compared to literature data. From the calculation of PRISM TPS, dose rates show good agreement with Plato TPS and other study as published by Ramdhani. No deviations greater than ±4% for all case. Dose calculation in inhomogeneous and homogenous cases show similar result. This results indicate that Prism TPS is good in dose calculation of brachytherapy but not sensitive for inhomogeneities. Thus, the dose calculation parameters developed in this study were found to be applicable for clinical treatment planning of brachytherapy.

  19. Dosimetry for the brachytherapy; Dosimetrie fuer die Brachytherapie

    Energy Technology Data Exchange (ETDEWEB)

    Ankerhold, Ulrike [Physikalisch-Technische Bundesanstalt (PTB), Braunschweig (Germany). Fachbereich ' Dosimetrie fuer Strahlentherapie und Roentgendiagnostik' ; Schneider, Thorsten [Physikalisch-Technische Bundesanstalt (PTB), Braunschweig (Germany). Arbeitsgruppe ' Brachytherapie'

    2013-06-15

    The authors describe the calibration of high-dose-rate {sup 192}Ir sources for the use in brachytherapy by means of the air-kerma power, which is determined in the PTB by means of an ionization chamber. For this a primary normal for the representation of the water energy dose was constructed. Furthermore the representation of the reference air-kerma rate for low-dose-rate sources in the PTB by means of a large-volume parallel-plate extrapolation chamber is described. (HSI)

  20. Determination of the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters for {sup 125}I and {sup 103}Pd brachytherapy sources relative to {sup 60}Co

    Energy Technology Data Exchange (ETDEWEB)

    Reed, J. L., E-mail: jlreed2@wisc.edu; Micka, J. A.; Culberson, W. S.; DeWerd, L. A. [Department of Medical Physics, University of Wisconsin–Madison, Madison, Wisconsin 53705 (United States); Rasmussen, B. E. [Department of Radiation Oncology, UP Health System Marquette, 580 West College Avenue, Marquette, Michigan 49855 (United States); Davis, S. D. [Department of Medical Physics, McGill University Health Centre, Montreal General Hospital (L5-112), 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada)

    2014-12-15

    Purpose: To determine the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters (TLD-100) for {sup 125}I and {sup 103}Pd brachytherapy sources relative to {sup 60}Co. Methods: LiF:Mg,Ti TLDs were irradiated with low-energy brachytherapy sources and with a {sup 60}Co teletherapy source. The brachytherapy sources measured were the Best 2301 {sup 125}I seed, the OncoSeed 6711 {sup 125}I seed, and the Best 2335 {sup 103}Pd seed. The TLD light output per measured air-kerma strength was determined for the brachytherapy source irradiations, and the TLD light output per air kerma was determined for the {sup 60}Co irradiations. Monte Carlo (MC) simulations were used to calculate the dose-to-TLD rate per air-kerma strength for the brachytherapy source irradiations and the dose to TLD per air kerma for the {sup 60}Co irradiations. The measured and MC-calculated results for all irradiations were used to determine the TLD intrinsic energy dependence for {sup 125}I and {sup 103}Pd relative to {sup 60}Co. Results: The relative TLD intrinsic energy dependences (relative to {sup 60}Co) and associated uncertainties (k = 1) were determined to be 0.883 ± 1.3%, 0.870 ± 1.4%, and 0.871 ± 1.5% for the Best 2301 seed, OncoSeed 6711 seed, and Best 2335 seed, respectively. Conclusions: The intrinsic energy dependence of TLD-100 is dependent on photon energy, exhibiting changes of 13%–15% for {sup 125}I and {sup 103}Pd sources relative to {sup 60}Co. TLD measurements of absolute dose around {sup 125}I and {sup 103}Pd brachytherapy sources should explicitly account for the relative TLD intrinsic energy dependence in order to improve dosimetric accuracy.

  1. A fully actuated robotic assistant for MRI-guided prostate biopsy and brachytherapy

    Science.gov (United States)

    Li, Gang; Su, Hao; Shang, Weijian; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Fischer, Gregory S.

    2013-03-01

    Intra-operative medical imaging enables incorporation of human experience and intelligence in a controlled, closed-loop fashion. Magnetic resonance imaging (MRI) is an ideal modality for surgical guidance of diagnostic and therapeutic procedures, with its ability to perform high resolution, real-time, high soft tissue contrast imaging without ionizing radiation. However, for most current image-guided approaches only static pre-operative images are accessible for guidance, which are unable to provide updated information during a surgical procedure. The high magnetic field, electrical interference, and limited access of closed-bore MRI render great challenges to developing robotic systems that can perform inside a diagnostic high-field MRI while obtaining interactively updated MR images. To overcome these limitations, we are developing a piezoelectrically actuated robotic assistant for actuated percutaneous prostate interventions under real-time MRI guidance. Utilizing a modular design, the system enables coherent and straight forward workflow for various percutaneous interventions, including prostate biopsy sampling and brachytherapy seed placement, using various needle driver configurations. The unified workflow compromises: 1) system hardware and software initialization, 2) fiducial frame registration, 3) target selection and motion planning, 4) moving to the target and performing the intervention (e.g. taking a biopsy sample) under live imaging, and 5) visualization and verification. Phantom experiments of prostate biopsy and brachytherapy were executed under MRI-guidance to evaluate the feasibility of the workflow. The robot successfully performed fully actuated biopsy sampling and delivery of simulated brachytherapy seeds under live MR imaging, as well as precise delivery of a prostate brachytherapy seed distribution with an RMS accuracy of 0.98mm.

  2. Observations on rotating needle insertions using a brachytherapy robot

    Energy Technology Data Exchange (ETDEWEB)

    Meltsner, M A [Department of Medical Physics, University of Wisconsin, Madison, WI 53706 (United States); Ferrier, N J [Department of Mechanical Engineering, University of Wisconsin, Madison, WI 53706 (United States); Thomadsen, B R [Department of Medical Physics, University of Wisconsin, Madison, WI 53706 (United States)

    2007-09-21

    A robot designed for prostate brachytherapy implantations has the potential to greatly improve treatment success. Much of the research in robotic surgery focuses on measuring accuracy. However, there exist many factors that must be optimized before an analysis of needle placement accuracy can be determined. Some of these parameters include choice of the needle type, insertion velocity, usefulness of the rotating needle and rotation speed. These parameters may affect the force at which the needle interacts with the tissue. A reduction in force has been shown to decrease the compression of the prostate and potentially increase the accuracy of seed position. Rotating the needle as it is inserted may reduce frictional forces while increasing accuracy. However, needle rotations are considered to increase tissue damage due to the drilling nature of the insertion. We explore many of the factors involved in optimizing a brachytherapy robot, and the potential effects each parameter may have on the procedure. We also investigate the interaction of rotating needles in gel and suggest the rotate-cannula-only method of conical needle insertion to minimize any tissue damage while still maintaining the benefits of reduced force and increased accuracy.

  3. Optical fibre luminescence sensor for real-time LDR brachytherapy dosimetry

    Science.gov (United States)

    Woulfe, P.; Sullivan, F. J.; O'Keeffe, S.

    2016-05-01

    An optical fibre sensor for monitoring low dose radiation is presented. The sensor is based on a scintillation material embedded within the optical fibre core, which emits visible light when exposed to low level ionising radiation. The incident level of ionising radiation can be determined by analysing the optical emission. An optical fibre sensor is presented, based on radioluminescence whereby radiation sensitive scintillation material, terbium doped gadolinium oxysulphide (Gd2O2S:Tb), is embedded in a cavity of 250μm of a 500μm plastic optical fibre. The sensor is designed for in-vivo monitoring of the radiation dose during radio-active seed implantation for brachytherapy, in prostate cancer treatment, providing oncologists with real-time information of the radiation dose to the target area and/or nearby critical structures. The radiation from the brachytherapy seeds causes emission of visible light from the scintillation material through the process of radioluminescence, which penetrates the fibre, propagating along the optical fibre for remote detection using a multi-pixel photon counter. The sensor demonstrates a high sensitivity to Iodine-125, the radioactive source most commonly used in brachytherapy for treating prostate cancer.

  4. Differential dose contributions on total dose distribution of (125)I brachytherapy source.

    Science.gov (United States)

    Camgöz, B; Yeğin, G; Kumru, M N

    2010-01-01

    This work provides an improvement of the approach using Monte Carlo simulation for the Amersham Model 6711 (125)I brachytherapy seed source, which is well known by many theoretical and experimental studies. The source which has simple geometry was researched with respect to criteria of AAPM Tg-43 Report. The approach offered by this study involves determination of differential dose contributions that come from virtual partitions of a massive radioactive element of the studied source to a total dose at analytical calculation point. Some brachytherapy seeds contain multi-radioactive elements so the dose at any point is a total of separate doses from each element. It is momentous to know well the angular and radial dose distributions around the source that is located in cancerous tissue for clinical treatments. Interior geometry of a source is effective on dose characteristics of a distribution. Dose information of inner geometrical structure of a brachytherapy source cannot be acquired by experimental methods because of limits of physical material and geometry in the healthy tissue, so Monte Carlo simulation is a required approach of the study. EGSnrc Monte Carlo simulation software was used. In the design of a simulation, the radioactive source was divided into 10 rings, partitioned but not separate from each other. All differential sources were simulated for dose calculation, and the shape of dose distribution was determined comparatively distribution of a single-complete source. In this work anisotropy function was examined also mathematically.

  5. Radiological response of ceramic and polymeric devices for breast brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Batista Nogueira, Luciana, E-mail: lucibn19@yahoo.com.br [Departamento de Propedeutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil); Passos Ribeiro de Campos, Tarcisio, E-mail: campos@nuclear.ufmg.br [Departamento de Engenharia Nuclear, Programa de Pos Graduacao em Ciencias e Tecnicas Nucleares, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha 31270901, BH/MG (Brazil)

    2012-04-15

    In the present study, the radiological visibility of ceramic and polymeric devices implanted in breast phantom was investigated for future applications in brachytherapy. The main goal was to determine the radiological viability of ceramic and polymeric devices in vitro by performing simple radiological diagnostic methods such as conventional X-ray analysis and mammography due to its easy access to the population. The radiological response of ceramic and polymeric devices implanted in breast phantom was determined using conventional X-ray, mammography and CT analysis. - Highlights: Black-Right-Pointing-Pointer Radiological visibility of ceramic and polymeric devices implanted in breast phantom. Black-Right-Pointing-Pointer The barium incorporation in the seed improves the radiological contrast. Black-Right-Pointing-Pointer Radiological monitoring shows the position, orientation and degradation of devices. Black-Right-Pointing-Pointer Simple radiological methods such as X-ray and mammography were used for radiological monitoring.

  6. An image-guidance system for dynamic dose calculation in prostate brachytherapy using ultrasound and fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kuo, Nathanael, E-mail: nkuo8@jhmi.edu; Prince, Jerry L. [Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21218 (United States); Dehghan, Ehsan [Philips Research North America, Briarcliff Manor, New York 10510 (United States); Deguet, Anton [Department of Computer Science, Johns Hopkins University, Baltimore, Maryland 21218 (United States); Mian, Omar Y.; Le, Yi; Song, Danny Y. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 (United States); Burdette, E. Clif [Acoustic MedSystems Inc., Savoy, Illinois 61974 (United States); Fichtinger, Gabor [School of Computing, Queen' s University, Kingston, Ontario K7L3N6 (Canada); Lee, Junghoon [Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland 21218 and Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 (United States)

    2014-09-15

    Purpose: Brachytherapy is a standard option of care for prostate cancer patients but may be improved by dynamic dose calculation based on localized seed positions. The American Brachytherapy Society states that the major current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. An image-guidance system was therefore developed to localize seeds for dynamic dose calculation. Methods: The proposed system is based on transrectal ultrasound (TRUS) and mobile C-arm fluoroscopy, while using a simple fiducial with seed-like markers to compute pose from the nonencoded C-arm. Three or more fluoroscopic images and an ultrasound volume are acquired and processed by a pipeline of algorithms: (1) seed segmentation, (2) fiducial detection with pose estimation, (3) seed matching with reconstruction, and (4) fluoroscopy-to-TRUS registration. Results: The system was evaluated on ten phantom cases, resulting in an overall mean error of 1.3 mm. The system was also tested on 37 patients and each algorithm was evaluated. Seed segmentation resulted in a 1% false negative rate and 2% false positive rate. Fiducial detection with pose estimation resulted in a 98% detection rate. Seed matching with reconstruction had a mean error of 0.4 mm. Fluoroscopy-to-TRUS registration had a mean error of 1.3 mm. Moreover, a comparison of dose calculations between the authors’ intraoperative method and an independent postoperative method shows a small difference of 7% and 2% forD{sub 90} and V{sub 100}, respectively. Finally, the system demonstrated the ability to detect cold spots and required a total processing time of approximately 1 min. Conclusions: The proposed image-guidance system is the first practical approach to dynamic dose calculation, outperforming earlier solutions in terms of robustness, ease of use, and functional completeness.

  7. Investigation of the Effects of Tissue Inhomogeneities on the Dosimetric Parameters of a Cs-137 Brachytherapy Source using the MCNP4C Code

    Directory of Open Access Journals (Sweden)

    Mehdi Zehtabian

    2010-09-01

    Full Text Available Introduction: Brachytherapy is the use of small encapsulated radioactive sources in close vicinity of tumors. Various methods are used to obtain the dose distribution around brachytherapy sources. TG-43 is a dosimetry protocol proposed by the AAPM for determining dose distributions around brachytherapy sources. The goal of this study is to update this protocol for presence of bone and air inhomogenities.  Material and Methods: To update the dose rate constant parameter of the TG-43 formalism, the MCNP4C simulations were performed in phantoms composed of water-bone and water-air combinations. The values of dose at different distances from the source in both homogeneous and inhomogeneous phantoms were estimated in spherical tally cells of 0.5 mm radius using the F6 tally. Results: The percentages of dose reductions in presence of air and bone inhomogenities for the Cs-137 source were found to be 4% and 10%, respectively. Therefore, the updated dose rate constant (Λ will also decrease by the same percentages.   Discussion and Conclusion: It can be easily concluded that such dose variations are more noticeable when using lower energy sources such as Pd-103 or I-125.

  8. Comprehensive brachytherapy physical and clinical aspects

    CERN Document Server

    Baltas, Dimos; Meigooni, Ali S; Hoskin, Peter J

    2013-01-01

    Modern brachytherapy is one of the most important oncological treatment modalities requiring an integrated approach that utilizes new technologies, advanced clinical imaging facilities, and a thorough understanding of the radiobiological effects on different tissues, the principles of physics, dosimetry techniques and protocols, and clinical expertise. A complete overview of the field, Comprehensive Brachytherapy: Physical and Clinical Aspects is a landmark publication, presenting a detailed account of the underlying physics, design, and implementation of the techniques, along with practical guidance for practitioners. Bridging the gap between research and application, this single source brings together the technological basis, radiation dosimetry, quality assurance, and fundamentals of brachytherapy. In addition, it presents discussion of the most recent clinical practice in brachytherapy including prostate, gynecology, breast, and other clinical treatment sites. Along with exploring new clinical protocols, ...

  9. Brachytherapy in breast cancer: an effective alternative

    Directory of Open Access Journals (Sweden)

    Janusz Skowronek

    2014-03-01

    Full Text Available Breast conserving surgery (BCS with following external beam radiation therapy (EBRT of the conserved breast has become widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of EBRT after BCS is to treat the whole breast up to a total dose of 42.5 to 50 Gy. An additional dose is given to treated volume as a boost to a portion of the breast. In the early stage of breast cancer, research has shown that the area requiring radiation treatment to prevent the cancer from local recurrence is the breast tissue that surrounds the area where the initial cancer was removed. Accelerated partial breast irradiation (APBI is an approach that treats only the lumpectomy bed plus a 1-2 cm margin rather than the whole breast and as a result allows accelerated delivery of the radiation dose in four to five days. There has been a growing interest for APBI and various approaches have been developed under phase I-III clinical studies; these include multicatheter interstitial brachytherapy, balloon catheter brachytherapy, conformal external beam radiation therapy (3D-EBRT and intra-operative radiation therapy (IORT. Balloon-based brachytherapy approaches include MammoSite, Axxent electronic brachytherapy, Contura, hybrid brachytherapy devices. Another indication for breast brachytherapy is reirradiation of local recurrence after mastectomy. Published results of brachytherapy are very promising. We discuss the current status, indications, and technical aspects of breast cancer brachytherapy.

  10. Isodose curve determination of prostate for the treatment of brachytherapy using MCNPX code

    Energy Technology Data Exchange (ETDEWEB)

    Reis Junior, J.P.; Menezes, A.F.; Medeiros, J.A.C.C., E-mail: jjunior@con.ufrj.br, E-mail: ademir@con.ufrj.br, E-mail: amenezes@con.ufrj.br [Universidade Federal do Rio de Janeiro (UFRJ/COPPE/PEN), RJ (Brazil). Coord. dos Programas de Pos-Graduacao em Engenharia. Programa de Engenharia Nuclear; Salmom, H.A., E-mail: heliosalmom@coinet.com.br [MD.X Barra Medical Center, Barra da Tijuca, Rio de Janeiro, RJ (Brazil); Facure, A.N.S.S., E-mail: facure@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Silva, A.X. [Universidade Federal do Rio de Janeiro (UFRJ/DEN), Rio de Janeiro, RJ (Brazil). Escola Politecnica. Dept. de Engenharia Nuclear

    2011-07-01

    Using voxel phantom MAX 06 coupled to the code MCNPX it possible to plot the isodose curves for the main levels involved in the treatment of prostate brachytherapy, V100 and V150 which are, respectively corresponding curves 144 and 216 Gy to curves are indicative of the quality of the existing implant of prostate brachytherapy. The number of 79 seeds {sup 125}I, were placed in the voxels simulator MAX 06, in the slices x = 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, 10.0 with the calculation model used in MCNPX in all voxels present in a matrix, it was possible to trace the isodose curves for MATLAB. For comparison and using own routines MCNPX it was possible to trace the same curves using mesh tallies. The results showed agreement with predicted values in the planning system prowess 3D. (author)

  11. Plastic optical fibre sensor for in-vivo radiation monitoring during brachytherapy

    Science.gov (United States)

    Woulfe, P.; Sullivan, F. J.; Lewis, E.; O'Keeffe, S.

    2015-09-01

    An optical fibre sensor is presented for applications in real-time in-vivo monitoring of the radiation dose a cancer patient receives during seed implantation in Brachytherapy. The sensor is based on radioluminescence whereby radiation sensitive scintillation material is embedded in the core of a 1mm plastic optical fibre. Three scintillation materials are investigated: thallium-doped caesium iodide (CsI:Tl), terbium-doped gadolinium oxysulphide (Gd2O2S:Tb) and europium-doped lanthanum oxysulphide (La2O2S:Eu). Terbium-doped gadolinium oxysulphide was identified as being the most suitable scintillator and further testing demonstrates its measureable response to different activities of Iodine-125, the radio-active source commonly used in Brachytherapy for treating prostate cancer.

  12. 10 CFR 35.2406 - Records of brachytherapy source accountability.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of brachytherapy source accountability. 35.2406... Records of brachytherapy source accountability. (a) A licensee shall maintain a record of brachytherapy source accountability required by § 35.406 for 3 years. (b) For temporary implants, the record...

  13. 10 CFR 35.406 - Brachytherapy sources accountability.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Brachytherapy sources accountability. 35.406 Section 35....406 Brachytherapy sources accountability. (a) A licensee shall maintain accountability at all times... area. (c) A licensee shall maintain a record of the brachytherapy source accountability in...

  14. Comparison in the calculation of committed effective dose using the ICRP 30 and ICRP 60 models for a repeated incorporation by inhalation of I-125; Comparacion en el calculo de la dosis efectiva comprometida usando los modelos del ICRP 30 y del ICRP 60 para una incorporacion repetida por inhalacion de I-125

    Energy Technology Data Exchange (ETDEWEB)

    Carreno P, A.L.; Cortes C, A. [CNSNS, Dr. Barragan 779, Col. Narvarte, Mexico D.F. (Mexico); Alonso V, G.; Serrano P, F. [IPN, Edificio de Fisica Avanzada Zacatenco, 07300 Mexico D.F. (Mexico)

    2005-07-01

    Presently work, a comparison in the calculation of committed effective dose using the models of the ICRP 30 and those of the ICRP 60 for the analysis of internal dose due to repeated incorporation of I-125 is shown. The estimations of incorporated activity are obtained starting from the proportionate data for an exercise of inter comparison, with which it should be determined the internal dose later on. For to estimate the initial activity incorporated by repeated dose was assumed that this it was given through of multiple individual incorporations which happened in the middle points of the monitoring periods. The results using the models of the ICRP 30 and of the ICRP 60 are compared and the causes of the differences are analyzed. (Author)

  15. Production of {sup 125}I from amorphous films of Si doped with {sup 124}Xe and evaluation of its potential use in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Leal, Alexandre S., E-mail: asleal@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Viana, Gustavo A., E-mail: gviana@eletronuclear.gov.br [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Instituto de Fisica Gleb Wataghin; Siqueira, Paulo T.D.; Saiki, Mitiko, E-mail: mitiko@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This work describes the simulation of a new material that can be used in the brachytherapy treatment. The material consists of xenon-incorporated amorphous silicon (Xe@a-Si). The irradiated {sup 124}Xe atoms of the samples are converted into {sup 125}Xe, according to the reaction: {sup 124}Xe (n,γ) {sup 125}Xe that, in turn, decays to the radioisotope {sup 125}I. A set of simulations performed using the MCNP5 code, shows that, in principle, the material proposed can be used in the seed of brachytherapy in the clinical treatment. (author)

  16. SU-E-T-212: Comparison of TG-43 Dosimetric Parameters of Low and High Energy Brachytherapy Sources Obtained by MCNP Code Versions of 4C, X and 5

    Energy Technology Data Exchange (ETDEWEB)

    Zehtabian, M; Zaker, N; Sina, S [Shiraz University, Shiraz, Fars (Iran, Islamic Republic of); Meigooni, A Soleimani [Comprehensive Cancer Center of Nevada, Las Vegas, Nevada (United States)

    2015-06-15

    Purpose: Different versions of MCNP code are widely used for dosimetry purposes. The purpose of this study is to compare different versions of the MCNP codes in dosimetric evaluation of different brachytherapy sources. Methods: The TG-43 parameters such as dose rate constant, radial dose function, and anisotropy function of different brachytherapy sources, i.e. Pd-103, I-125, Ir-192, and Cs-137 were calculated in water phantom. The results obtained by three versions of Monte Carlo codes (MCNP4C, MCNPX, MCNP5) were compared for low and high energy brachytherapy sources. Then the cross section library of MCNP4C code was changed to ENDF/B-VI release 8 which is used in MCNP5 and MCNPX codes. Finally, the TG-43 parameters obtained using the MCNP4C-revised code, were compared with other codes. Results: The results of these investigations indicate that for high energy sources, the differences in TG-43 parameters between the codes are less than 1% for Ir-192 and less than 0.5% for Cs-137. However for low energy sources like I-125 and Pd-103, large discrepancies are observed in the g(r) values obtained by MCNP4C and the two other codes. The differences between g(r) values calculated using MCNP4C and MCNP5 at the distance of 6cm were found to be about 17% and 28% for I-125 and Pd-103 respectively. The results obtained with MCNP4C-revised and MCNPX were similar. However, the maximum difference between the results obtained with the MCNP5 and MCNP4C-revised codes was 2% at 6cm. Conclusion: The results indicate that using MCNP4C code for dosimetry of low energy brachytherapy sources can cause large errors in the results. Therefore it is recommended not to use this code for low energy sources, unless its cross section library is changed. Since the results obtained with MCNP4C-revised and MCNPX were similar, it is concluded that the difference between MCNP4C and MCNPX is their cross section libraries.

  17. Dose heterogeneity correction for low-energy brachytherapy sources using dual-energy CT images.

    Science.gov (United States)

    Mashouf, S; Lechtman, E; Lai, P; Keller, B M; Karotki, A; Beachey, D J; Pignol, J P

    2014-09-21

    Permanent seed implant brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG-43 formalism, which generates the dose in a homogeneous water medium. Recently, AAPM TG-186 emphasized the importance of accounting for tissue heterogeneities. We have previously reported on a methodology where the absorbed dose in tissue can be obtained by multiplying the dose, calculated by the TG-43 formalism, by an inhomogeneity correction factor (ICF). In this work we make use of dual energy CT (DECT) images to extract ICF parameters. The advantage of DECT over conventional CT is that it eliminates the need for tissue segmentation as well as assignment of population based atomic compositions. DECT images of a heterogeneous phantom were acquired and the dose was calculated using both TG-43 and TG-43 [Formula: see text] formalisms. The results were compared to experimental measurements using Gafchromic films in the mid-plane of the phantom. For a seed implant configuration of 8 seeds spaced 1.5 cm apart in a cubic structure, the gamma passing score for 2%/2 mm criteria improved from 40.8% to 90.5% when ICF was applied to TG-43 dose distributions.

  18. Data fusion for planning target volume and isodose prediction in prostate brachytherapy

    Science.gov (United States)

    Nouranian, Saman; Ramezani, Mahdi; Mahdavi, S. Sara; Spadinger, Ingrid; Morris, William J.; Salcudean, Septimiu E.; Abolmaesumi, Purang

    2015-03-01

    In low-dose prostate brachytherapy treatment, a large number of radioactive seeds is implanted in and adjacent to the prostate gland. Planning of this treatment involves the determination of a Planning Target Volume (PTV), followed by defining the optimal number of seeds, needles and their coordinates for implantation. The two major planning tasks, i.e. PTV determination and seed definition, are associated with inter- and intra-expert variability. Moreover, since these two steps are performed in sequence, the variability is accumulated in the overall treatment plan. In this paper, we introduce a model based on a data fusion technique that enables joint determination of PTV and the minimum Prescribed Isodose (mPD) map. The model captures the correlation between different information modalities consisting of transrectal ultrasound (TRUS) volumes, PTV and isodose contours. We take advantage of joint Independent Component Analysis (jICA) as a linear decomposition technique to obtain a set of joint components that optimally describe such correlation. We perform a component stability analysis to generate a model with stable parameters that predicts the PTV and isodose contours solely based on a new patient TRUS volume. We propose a framework for both modeling and prediction processes and evaluate it on a dataset of 60 brachytherapy treatment records. We show PTV prediction error of 10:02+/-4:5% and the V100 isodose overlap of 97+/-3:55% with respect to the clinical gold standard.

  19. Dose heterogeneity correction for low-energy brachytherapy sources using dual-energy CT images

    Science.gov (United States)

    Mashouf, S.; Lechtman, E.; Lai, P.; Keller, B. M.; Karotki, A.; Beachey, D. J.; Pignol, J. P.

    2014-09-01

    Permanent seed implant brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG-43 formalism, which generates the dose in a homogeneous water medium. Recently, AAPM TG-186 emphasized the importance of accounting for tissue heterogeneities. We have previously reported on a methodology where the absorbed dose in tissue can be obtained by multiplying the dose, calculated by the TG-43 formalism, by an inhomogeneity correction factor (ICF). In this work we make use of dual energy CT (DECT) images to extract ICF parameters. The advantage of DECT over conventional CT is that it eliminates the need for tissue segmentation as well as assignment of population based atomic compositions. DECT images of a heterogeneous phantom were acquired and the dose was calculated using both TG-43 and TG-43 × \\text{ICF} formalisms. The results were compared to experimental measurements using Gafchromic films in the mid-plane of the phantom. For a seed implant configuration of 8 seeds spaced 1.5 cm apart in a cubic structure, the gamma passing score for 2%/2 mm criteria improved from 40.8% to 90.5% when ICF was applied to TG-43 dose distributions.

  20. Tissue modeling schemes in low energy breast brachytherapy.

    Science.gov (United States)

    Afsharpour, Hossein; Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank

    2011-11-21

    Breast tissue is heterogeneous and is mainly composed of glandular (G) and adipose (A) tissues. The proportion of G versus A varies considerably among the population. The absorbed dose distributions in accelerated partial breast irradiation therapy with low energy photon brachytherapy sources are very sensitive to tissue heterogeneities. Current clinical algorithms use the recommendations of the AAPM TG43 report which approximates the human tissues by unit density water. The aim of this study is to investigate various breast tissue modeling schemes for low energy brachytherapy. A special case of breast permanent seed implant is considered here. Six modeling schemes are considered. Uniform and non-uniform water breast (UWB and NUWB) consider the density but neglect the effect of the composition of tissues. The uniform and the non-uniform G/A breast (UGAB and NUGAB) as well the age-dependent breast (ADB) models consider the effect of the composition. The segmented breast tissue (SBT) method uses a density threshold to distinguish between G and A tissues. The PTV D(90) metric is used for the analysis and is based on the dose to water (D(90(w,m))). D(90(m,m)) is also reported for comparison to D(90(w,m)). The two-month post-implant D(90(w,m)) averaged over 38 patients is smaller in NUWB than in UWB by about 4.6% on average (ranging from 5% to 13%). Large average differences of G/A breast models with TG43 (17% and 26% in UGAB and NUGAB, respectively) show that the effect of the chemical composition dominates the effect of the density on dose distributions. D(90(w,m)) is 12% larger in SBT than in TG43 when averaged. These differences can be as low as 4% or as high as 20% when the individual patients are considered. The high sensitivity of dosimetry on the modeling scheme argues in favor of an agreement on a standard tissue modeling approach to be used in low energy breast brachytherapy. SBT appears to generate the most geometrically reliable breast tissue models in this

  1. The calorimetric measurement of low energy brachytherapy sources

    Science.gov (United States)

    Aus, Robert John

    Historically, the dose rate to tissue from 125I and 103Pd sources was based on a source's apparent activity in free space. The American Association of Physicists in Medicine Task Group 43 (TG43) established a protocol that clarified this formalism for the dose rate determination that was universally accepted in the Medical Physics community. The TG43 protocol is based on air kerma strength and a different set of conversion factors for determining the dose rate. However, there are still many uncertainties associated with this methodology. These uncertainties are predominantly the result of the unknown effects of variations in the source encapsulation and internal source structure on the dose distribution surrounding a source. Currently, there is no method of nondestructively determining the contained radioactivity of brachytherapy sources. Without the knowledge of the contained activity, the effects of source construction variations cannot be evaluated accurately. The goal of this work was to develop a calorimeter that measures the total power generated by a source. This information could then be used to nondestructively determine the contained radioactivity activity of a source. The power generated by three different, well characterized source designs of 125I brachytherapy seeds was measured with the calorimeter. A theoretical model of the calorimeter was also developed to demonstrate that the calorimeter operated as expected. The measured and theoretical temperature results for the three different source models were consistent within the uncertainty of the measurements. The consistency between the calorimetric measurements and the theoretical expected results demonstrates proof of principle of the calorimeter. The information determined from the model can also be useful for future calorimetric research by identifying required calorimeter design features, potential design improvements and potential difficulties.

  2. Design of an ultrasound-guided robotic brachytherapy needle insertion system

    CERN Document Server

    Hungr, Nikolai; Zemiti, Nabil; Tripodi, Nathanael

    2009-01-01

    In this paper we describe a new robotic brachytherapy needle-insertion system that is designed to replace the template used in the manual technique. After a brief review of existing robotic systems, we describe the requirements that we based our design upon. A detailed description of the proposed system follows. Our design is capable of positioning and inclining a needle within the same workspace as the manual template. To help improve accuracy, the needle can be rotated about its axis during insertion into the prostate. The system can be mounted on existing steppers and also easily accommodates existing seed dispensers, such as the Mick Applicator.

  3. Investigating the dosimetric and tumor control consequences of prostate seed loss and migration

    Energy Technology Data Exchange (ETDEWEB)

    Knaup, Courtney; Mavroidis, Panayiotis; Esquivel, Carlos; Stathakis, Sotirios; Swanson, Gregory; Baltas, Dimos; Papanikolaou, Nikos [Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States); Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States) and Department of Medical Radiation Physics, Karalinska Institutet and Stockholm University, Stockholm 17176 (Sweden); Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States); Department of Medical Physics and Engineering Offenbach Clinic, Offenbach 63069 (Germany) and Nuclear and Particle Physics Section, Physics Department, University of Athens (Greece); Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States)

    2012-06-15

    Purpose: Low dose-rate brachytherapy is commonly used to treat prostate cancer. However, once implanted, the seeds are vulnerable to loss and movement. The goal of this work is to investigate the dosimetric and radiobiological effects of the types of seed loss and migration commonly seen in prostate brachytherapy. Methods: Five patients were used in this study. For each patient three treatment plans were created using Iodine-125, Palladium-103, and Cesium-131 seeds. The three seeds that were closest to the urethra were identified and modeled as the seeds lost through the urethra. The three seeds closest to the exterior of prostatic capsule were identified and modeled as those lost from the prostate periphery. The seed locations and organ contours were exported from Prowess and used by in-house software to perform the dosimetric and radiobiological evaluation. Seed loss was simulated by simultaneously removing 1, 2, or 3 seeds near the urethra 0, 2, or 4 days after the implant or removing seeds near the exterior of the prostate 14, 21, or 28 days after the implant. Results: Loss of one, two or three seeds through the urethra results in a D{sub 90} reduction of 2%, 5%, and 7% loss, respectively. Due to delayed loss of peripheral seeds, the dosimetric effects are less severe than for loss through the urethra. However, while the dose reduction is modest for multiple lost seeds, the reduction in tumor control probability was minimal. Conclusions: The goal of this work was to investigate the dosimetric and radiobiological effects of the types of seed loss and migration commonly seen in prostate brachytherapy. The results presented show that loss of multiple seeds can cause a substantial reduction of D{sub 90} coverage. However, for the patients in this study the dose reduction was not seen to reduce tumor control probability.

  4. PSA Nadir of <0.5 ng/mL Following Brachytherapy for Early-Stage Prostate Adenocarcinoma is Associated With Freedom From Prostate-Specific Antigen Failure

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eric C. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Stone, Nelson N. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Department of Urology, Mount Sinai Medical Center, New York, NY (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States)

    2012-06-01

    Purpose: Because limited information exists regarding whether the rate or magnitude of PSA decline following brachytherapy predicts long-term clinical outcomes, we evaluated whether achieving a prostate-specific antigen (PSA) nadir (nPSA) <0.5 ng/mL following brachytherapy is associated with decreased PSA failure and/or distant metastasis. Methods and Materials: We retrospectively analyzed our database of early-stage prostate adenocarcinoma patients who underwent brachytherapy, excluding those receiving androgen-deprivation therapy and those with <2 years follow-up. Median and mean pretreatment PSA were 6 ng/mL and 7.16 ng/mL, respectively. By clinical stage, 775 were low risk ({<=}T2a), 126 were intermediate risk (T2b), and 20 were high risk (>T2b). By Gleason score, 840 were low risk ({<=}6), 71 were intermediate risk (7), and 10 were high risk (>7). Patients were treated with brachytherapy only (I-125, n = 779, or Pd-103, n = 47), or brachytherapy + external-beam radiation therapy (n = 95). Median follow-up was 6.3 years. We noted whether nPSA <0.5 ng/mL was achieved and the time to achieve this nadir and tested for associations with pretreatment risk factors. We also determined whether this PSA endpoint was associated with decreased PSA failure or distant metastasis. Results: Absence of high-risk factors in clinical stage ({<=}T2b), Gleason score ({<=}7), and pretreatment PSA ({<=}20 ng/mL) was significantly associated with achieving nPSA <0.5 ng/mL. By Kaplan-Meier analysis, patients achieving nPSA <0.5 ng/mL had significantly higher long-term freedom from biochemical failure (FFBF) than nonresponders (5-year FFBF: 95.2 {+-} 0.8% vs. 71.5 {+-} 6.7%; p < 0.0005). Among responders, those who achieved nPSA <0.5 ng/mL in {<=}5 years had higher FFBF than those requiring >5 years (5-year FFBF: 96.7 {+-} 0.7% vs. 80.8 {+-} 4.6%; p < 0.0005). On multivariate analysis, patients who achieved nPSA <0.5 ng/mL in {<=}5 years had significantly higher FFBF than other

  5. a Study of the Dosimetry of IODINE-125 Seed Interstitial Implants Using Monte Carlo Simulation Methods.

    Science.gov (United States)

    Burns, Gregory Scott

    Monte Carlo simulation methods were used to investigate the absorbed dose distribution around several preliminary source configurations and the 3M Company models 6701, 6702, and 6711 I-125 seeds in water. Simulations for the preliminary sources, all of which were structurally simpler than the seeds, were conducted to demonstrate correct behavior of the computer software. The relative dose distributions of the three seed models were found to be anisotropic, and distinct. Observed differences in the relative dose distributions of the three models are attributable to differences in seed design and photon emission spectrum. Variations in end weld thicknesses and radioactivity distributions within the seeds were found to have substantial influence on the relative dose distributions. Dosimetry estimates along the longitudinal axis of the seeds are particularly uncertain due to such variations. Finally, perturbations of the single seed dose distribution created by neighboring seeds within the implant were determined. Such perturbations are strongly dependent on the seed model used and on the separation between seeds. Simple superposition of single seed dose distributions in multiple seed implants causes overestimation of dose within seed planes. Errors may be quite large for single plane implants with small seed separations. The results of this study provide a means to reduce errors in iodine seed implant dosimetry through the use of seed design-specific two-dimensional dosimetry data, and through improved understanding of the causes of uncertainties in iodine seed relative dose distributions.

  6. Treatment of hepatocellular carcinoma adjacent to large blood vessels using 1.5T MRI-guided percutaneous radiofrequency ablation combined with iodine-125 radioactive seed implantation

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Zheng-Yu, E-mail: linsinlan@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Chen, Jin, E-mail: snow8968851@163.com [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China); Deng, Xiu-Fen, E-mail: dxf197286@yahoo.com.cn [The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005 (China)

    2012-11-15

    Objective: The objective is to study the technology associated with and feasibility of the treatment of hepatocellular carcinoma (HCC) adjacent to large blood vessels using 1.5T MRI-guided radiofrequency ablation combined with iodine-125 (I-125) radioactive seed implantation. Methods: Sixteen patients with a total of 24 HCC lesions (average maximum diameter: 2.35 {+-} 1.03 cm) were pathologically confirmed by biopsy or clinically diagnosed received 1.5T MRI-guided percutaneous radiofrequency ablation (RFA) treatment. Each patient had one lesion adjacent to large blood vessels ({>=}3 mm); after the ablation, I-125 radioactive seeds were implanted in the portions of the lesions that were adjacent to the blood vessels. Results: All the ablations and I-125 radioactive seed implantations were successful; a total of 118 seeds were implanted. The ablated lesions exhibited hypointense signals on the T2WI sequence with a thin rim of hyperintense signals; they also exhibited significant hyperintense signals on the T1WI sequence with clear boundaries. The average follow-up period was 11.1 {+-} 6.2 months. There were 23 complete responses and one partial response in the 24 lesions. The alpha-fetoprotein (AFP) levels of the patients significantly decreased. Conclusion: The 1.5T MRI-guided RFA combined with I-125 radioactive seed implantation for the treatment of HCC adjacent to large blood vessels is an effective technology.

  7. Evaluation of PC-ISO for customized, 3D printed, gynecologic 192Ir HDR brachytherapy applicators.

    Science.gov (United States)

    Cunha, J Adam M; Mellis, Katherine; Sethi, Rajni; Siauw, Timmy; Sudhyadhom, Atchar; Garg, Animesh; Goldberg, Ken; Hsu, I-Chow; Pouliot, Jean

    2015-01-01

    The purpose of this study was to evaluate the radiation attenuation properties of PC-ISO, a commercially available, biocompatible, sterilizable 3D printing material, and its suitability for customized, single-use gynecologic (GYN) brachytherapy applicators that have the potential for accurate guiding of seeds through linear and curved internal channels. A custom radiochromic film dosimetry apparatus was 3D-printed in PC-ISO with a single catheter channel and a slit to hold a film segment. The apparatus was designed specifically to test geometry pertinent for use of this material in a clinical setting. A brachytherapy dose plan was computed to deliver a cylindrical dose distribution to the film. The dose plan used an 192Ir source and was normalized to 1500 cGy at 1 cm from the channel. The material was evaluated by comparing the film exposure to an identical test done in water. The Hounsfield unit (HU) distributions were computed from a CT scan of the apparatus and compared to the HU distribution of water and the HU distribution of a commercial GYN cylinder applicator. The dose depth curve of PC-ISO as measured by the radiochromic film was within 1% of water between 1 cm and 6 cm from the channel. The mean HU was -10 for PC-ISO and -1 for water. As expected, the honeycombed structure of the PC-ISO 3D printing process created a moderate spread of HU values, but the mean was comparable to water. PC-ISO is sufficiently water-equivalent to be compatible with our HDR brachytherapy planning system and clinical workflow and, therefore, it is suitable for creating custom GYN brachytherapy applicators. Our current clinical practice includes the use of custom GYN applicators made of commercially available PC-ISO when doing so can improve the patient's treatment. PACS number: none.

  8. Evaluation of PC-ISO for customized, 3D Printed, gynecologic 192-Ir HDR brachytherapy applicators.

    Science.gov (United States)

    Cunha, J Adam M; Mellis, Katherine; Sethi, Rajni; Siauw, Timmy; Sudhyadhom, Atchar; Garg, Animesh; Goldberg, Ken; Hsu, I-Chow; Pouliot, Jean

    2015-01-08

    The purpose of this study was to evaluate the radiation attenuation properties of PC-ISO, a commercially available, biocompatible, sterilizable 3D printing material, and its suitability for customized, single-use gynecologic (GYN) brachytherapy applicators that have the potential for accurate guiding of seeds through linear and curved internal channels. A custom radiochromic film dosimetry apparatus was 3D-printed in PC-ISO with a single catheter channel and a slit to hold a film segment. The apparatus was designed specifically to test geometry pertinent for use of this material in a clinical setting. A brachytherapy dose plan was computed to deliver a cylindrical dose distribution to the film. The dose plan used an 192Ir source and was normalized to 1500 cGy at 1 cm from the channel. The material was evaluated by comparing the film exposure to an identical test done in water. The Hounsfield unit (HU) distributions were computed from a CT scan of the apparatus and compared to the HU distribution of water and the HU distribution of a commercial GYN cylinder applicator. The dose depth curve of PC-ISO as measured by the radiochromic film was within 1% of water between 1 cm and 6 cm from the channel. The mean HU was -10 for PC-ISO and -1 for water. As expected, the honeycombed structure of the PC-ISO 3D printing process created a moderate spread of HU values, but the mean was comparable to water. PC-ISO is sufficiently water-equivalent to be compatible with our HDR brachytherapy planning system and clinical workflow and, therefore, it is suitable for creating custom GYN brachytherapy applicators. Our current clinical practice includes the use of custom GYN applicators made of commercially available PC-ISO when doing so can improve the patient's treatment. 

  9. Methodology study for fixation of radioactive iodine in polymeric substrate for brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Bruna T.; Rostelato, Maria Elisa C.M.; Souza, Carla D.; Tiezzi, Rodrigo; Souza, Daiane B. de; Benega, Marcos A.G.; Souza, Anderson S. de; Peleias Junior, Fernando S.; Zeituni, Calos A.; Fernandes, Vagner; Melo, Emerson Ronaldo de; Camargo, Anderson Rogerio de, E-mail: bteigarodrigues@gmail.com [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Cancer is now the second leading cause of death by disease in several countries, including Brazil. Prostate cancer is the most common among men. Brachytherapy is a modality of radiotherapy in which radioactive seeds are placed inside or in contact with the organ to be treated. The most widely used radioisotope in prostate brachytherapy is Iodine-125 which is presented fixated on a silver substrate that is subsequently placed inside a titanium capsule. A large dose of radiation is released only in the targeted tumor protecting healthy surrounding tissues. The technique requires the application of 80 - 120 seeds per patient. The implants of seeds have low impact and non-surgical procedures. Most patients can return to normal life within three days with little or no pain. This work proposes an alternative to the seeds that have already been developed, in order to reduce the cost by obtaining a better efficiency on fixing the radioactive iodine onto the epoxy resin. Methods have been developed to perform the fixation of Iodine-125 onto polymeric substrates. The parameters analyzed were the immersion time, type of static or dynamic reaction, concentration of the adsorption solution, the specific activity of the radioactive source, the need for carrier and chemical form of the radioactive Iodine. These experiments defined the most effective method to fixate the Iodine onto the polymeric material (epoxy resin), the Iodine activity in the polymeric substrate, the activity of the distribution of variation in a plot of polymeric cores and the efficiency of the epoxy resin to seal the seed. (author)

  10. Dose optimisation in single plane interstitial brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Hellebust, Taran Paulsen; Honoré, Henriette Benedicte;

    2006-01-01

    BACKGROUND AND PURPOSE: Brachytherapy dose distributions can be optimised       by modulation of source dwell times. In this study dose optimisation in       single planar interstitial implants was evaluated in order to quantify the       potential benefit in patients. MATERIAL AND METHODS: In 14...

  11. Seed quality in informal seed systems

    NARCIS (Netherlands)

    Biemond, P.C.

    2013-01-01

    Keywords:     informal seed systems, seed recycling, seed quality, germination, seed pathology, seed health, seed-borne diseases, mycotoxigenic fungi, Fusarium verticillioides, mycotoxins, Vigna unguiculata, Zea mays, Nigeria.   Seed is a crucial input for agricultural producti

  12. Seed quality in informal seed systems

    NARCIS (Netherlands)

    Biemond, P.C.

    2013-01-01

    Keywords:     informal seed systems, seed recycling, seed quality, germination, seed pathology, seed health, seed-borne diseases, mycotoxigenic fungi, Fusarium verticillioides, mycotoxins, Vigna unguiculata, Zea mays, Nigeria.   Seed is a crucial input for agricultural

  13. MO-D-BRD-00: Electronic Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic

  14. Occupational exposure of professionals during interstitial permanent prostate brachytherapy implants

    Energy Technology Data Exchange (ETDEWEB)

    Pirraco, R.; Pereira, A.; Viterbo, T.; Cavaco, A. [Instituto Portugues de Oncologia Francisco Gentil, Centro R egional de Oncologia do Porto, SA, Porto (Portugal)

    2006-07-01

    Full text of publication follows: Introduction: In this study we present dose measurements for professionals exposed during interstitial 125 I permanent prostate brachytherapy implants. Methods and Materials: The implant technique used was intra operative real time using strand and loose seeds. The professionals inside the operating room are an oncologist, a radiologist, a physicist, a nurse and an anesthesiologist. The oncologist and the physicist contact directly the loaded needle with radioactive seeds and two types of measurements were taken: total body and extremities (finger) dose. The rest of the team operates at long distances, but measurements were made. To measure total body equivalent dose we use a Berthold Umo LB 123 coupled with a LB 1236-H10 detector, and we recorded dose, time and distance from implant location. Finger dosemeters are thermo -luminescent dosimeter (TLD) rings that were controlled over one month. Results: 50 cases (average number of applications per year) were analysed for extremities measurements and 9 cases for total body measurements (in this case, the results were extrapolated for 50 cases), with an average of 26.1 mCi total activity per implant (in a range of 17.4 - 40.3 mCi). The finger dose was 1.8 mSv for the oncologist and 1.9 mSv for the physicist. The interpolation of total body equivalent dose for the oncologist was 24 mSv, for the radiologist 6 mSv and 9 mSv for the physicist. The rest of the team did not receive anything but background radiation. The annual national limit dose for workers is 20 mSv for total body irradiation, and 500 mSv for extremities. Conclusion: In conclusion we may say that during interstitial permanent prostate brachytherapy implants, total doses received for all groups are not significant when compared to annual limits for Portuguese laws 1. Even so, our main goal is always to get the less possible dose (ALARA principle). References: 1. Decreto Lei n. 180/2002 de 8 de Agosto. (authors)

  15. CT-based interstitial HDR brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kolotas, C.; Baltas, D.; Zamboglou, N. [Staedtische Kliniken Offenbach (Germany). Strahlenklinik

    1999-09-01

    Purpose: Development, application and evaluation of a CT-guided implantation technique and a fully CT-based treatment planning procedure for brachytherapy. Methods and Materials: A brachytherapy procedure based on CT-guided implantation technique and CT-based treatment planning has been developed and clinical evaluated. For this purpose a software system (PROMETHEUS) for the 3D reconstruction of brachytherapy catheters and patient anatomy using only CT scans has been developed. An interface for the Nucletron PLATO BPS treatment planning system for optimization and calculation of dose distribution has been devised. The planning target volume(s) are defined as sets of points using contouring tools and are used for optimization of the 3D dose distribution. Dose-volume histogram based analysis of the dose distribution (COIN analysis) enables a clinically realistic evaluation of the brachytherapy application to be made. The CT-guided implantation of catheters and the CT-based treatment planning procedure has been performed for interstitial brachytherapy and for different tumor sites in 197 patients between 1996 and 1997. Results: The accuracy of the CT reconstruction was tested using first a quality assurance phantom and second, a simulated interstitial implant of 12 needles. These were compared with the results of reconstruction using radiographs. Both methods gave comparable results with regard to accuracy, but the CT based reconstruction was faster. Clinical feasibility was proved in pre-irradiated recurrences of brain tumors, in pretreated recurrences or metastatic disease, and in breast carcinomas. The tumor volumes treated were in the range 5.1 to 2,741 cm{sup 3}. Analysis of implant quality showed a slightly significant lower COIN value for the bone implants, but no differences with respect to the planning target volume. Conclusions: The Offenbach system, incorporating the PROMETHEUS software for interstitial HDR brachytherapy has proved to be extremely valuable

  16. Dosimetry for 125I radioactive seed implantation therapy for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Jin Lü; Xiufeng Cao

    2008-01-01

    Hepatocellular carcinoma (HCC) is an aggressive malignancy. Early lesions respond well to hepatic resection or liver transplantation.However, only a few of HCC patients are suitable for surgical intervention. External beam radiation and chemotherapy is poorly efficacious.In the last 20 years, HCCs belonging to the radiosensitive tumor group has been confirmed. Along with the development of new radiotherapy technology and facilities, the research about brachytherapy(especially 125I seed implantation therapy) has provoked more interests in the world. Radioactive seed implantation therapy is a form of interstitial brachytherapy, with the property of local "conformal radiotherapy" and the advantages of minimal invasion, convenience, high performance, and minimal adverse effects. It is a promising therapy for HCC, however the dosimetry hasn't yet been identified and lacks verification in prospective research. This report aims to further explore the best prescription dose and radioactivity for 125I interstitial implantation brachytherapy for HCC.

  17. Automated intraoperative calibration for prostate cancer brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kuiran Chen, Thomas; Heffter, Tamas; Lasso, Andras; Pinter, Csaba; Abolmaesumi, Purang; Burdette, E. Clif; Fichtinger, Gabor [Queen' s University, Kingston, Ontario K7L 3N6 (Canada); University of British Columbia, Vancouver, British Columbia V6T 1Z4 (Canada); Acoustic MedSystems, Inc., Champaign, Illinois 61820-3979 (United States); Queen' s University, Kingston, Ontario K7L 3N6 (Canada) and Johns Hopkins University, Baltimore, Maryland 21218-2682 (United States)

    2011-11-15

    Purpose: Prostate cancer brachytherapy relies on an accurate spatial registration between the implant needles and the TRUS image, called ''calibration''. The authors propose a new device and a fast, automatic method to calibrate the brachytherapy system in the operating room, with instant error feedback. Methods: A device was CAD-designed and precision-engineered, which mechanically couples a calibration phantom with an exact replica of the standard brachytherapy template. From real-time TRUS images acquired from the calibration device and processed by the calibration system, the coordinate transformation between the brachytherapy template and the TRUS images was computed automatically. The system instantly generated a report of the target reconstruction accuracy based on the current calibration outcome. Results: Four types of validation tests were conducted. First, 50 independent, real-time calibration trials yielded an average of 0.57 {+-} 0.13 mm line reconstruction error (LRE) relative to ground truth. Second, the averaged LRE was 0.37 {+-} 0.25 mm relative to ground truth in tests with six different commercial TRUS scanners operating at similar imaging settings. Furthermore, testing with five different commercial stepper systems yielded an average of 0.29 {+-} 0.16 mm LRE relative to ground truth. Finally, the system achieved an average of 0.56 {+-} 0.27 mm target registration error (TRE) relative to ground truth in needle insertion tests through the template in a water tank. Conclusions: The proposed automatic, intraoperative calibration system for prostate cancer brachytherapy has achieved high accuracy, precision, and robustness.

  18. Automation system for quality control in manufacture of iodine-125 sealed sources used in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Somessari, Samir L.; Feher, Anselmo; Sprenger, Francisco E.; Rostellato, Maria E.C.M.; Moura, Joao A.; Costa, Osvaldo L.; Calvo, Wilson A.P., E-mail: somessar@ipen.b, E-mail: afeher@ipen.b, E-mail: sprenger@ipen.b, E-mail: elisaros@ipen.b, E-mail: olcosta@ipen.b, E-mail: wapcalvo@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The objective of this work is to develop an automation system for Quality Control in the production of Iodine-125 sealed sources, after undergoing the process of laser beam welding. These sources, also known as Iodine-125 seeds are used, successfully, in the treatment of cancer by brachytherapy, with low-dose rates. Each small seed is composed of a welded titanium capsule with 0.8 mm diameter and 4.5 mm in length, containing Iodine-125 adsorbed on an internal silver wire. The seeds are implanted in the human prostate to irradiate the tumor and treat the cancerous cells. The technology to automate the quality control system in the manufacture of Iodine-125 seeds consists in developing and associate mechanical parts, electronic components and pneumatic circuits to control machines and processes. The automation technology for Iodine-125 seed production developed in this work employs programmable logic controller, step motors, drivers of control, electrical-electronic interfaces, photoelectric sensors, interfaces of communication and software development. Industrial automation plays an important role in the production of Iodine-125 seeds, with higher productivity and high standard of quality, facilitating the implementation and operation of processes with good manufacturing practices. Nowadays, the Radiation Technology Center at IPEN-CNEN/SP imports and distributes 36,000 Iodine-125 seeds per year for clinics and hospitals in the whole country. However, the Brazilian potential market is of 8,000 Iodine-125 seeds per month. Therefore, the local production of these radioactive seeds has become a priority for the Institute, aiming to reduce the price and increase the supply to the population in Brazil. (author)

  19. 1251 seed calibration using afterloading equipment Seed Selectron. Practical solution to meet the recommendations of the AAPM; Calibracion de semillas de {sup 1}25I usando el equipo de carga difereida SeedSelectron. Solucion practica para cumplir las recomendaciones de la AAPM

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, J.; Richart, J.; Perez-Garcia, J.; Guirado, D.; Ballester, F.; Rodriguez, S.; Santos, M.; Depiaggio, M.; Carmona, V.; Lliso, F.; Camacho, C.; Pujades, M. C.

    2011-07-01

    Seed Selectron is a system used in the after loader permanent implant brachytherapy seeds 1-125 interstitial prostate. Two aspects are critical when you can meet the recommendations of the AAPM: a practical difficulty to check the quantity of seed required, and the great uncertainty of all measured diodes. The purpose of this paper is to present a practical solution that has been adopted to implement the recommendations of the AAPM.

  20. Iodine-125 seeds for cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Rostelato, Maria E.C.M.; Zeituni, Carlos A.; Feher, Anselmo; Moura, Joao A.; Moura, Eduardo S.; Nagatomi, Helio R.; Manzoli, Jose E.; Souza, Carla D., E-mail: elisaros@ipen.b, E-mail: czeituni@pobox.co, E-mail: afeher@ipen.b, E-mail: jmoura31@yahoo.com.b, E-mail: esmoura@ipen.b, E-mail: hrnagato@ipen.b, E-mail: jemanzoli@ipen.b, E-mail: cdsouza@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Karam, Dib, E-mail: dib.karan@usp.b [Universidade de Sao Paulo (USP), SP (Brazil). Escola de Artes, Ciencias e Humanidades

    2009-07-01

    In Brazil, cancer has become one of the major public health problems. An estimate by the Health Ministry showed that 466,430 people had the disease in the country in 2008. The prostate cancer is the second largest death cause among men. The National Institute of Cancer estimated the occurrence of 50,000 new cases for 2009. Some of these patients are treated with Brachytherapy, using Iodine-125 seeds. By this technique, small seeds with Iodine-125, a radioactive material, are implanted in the prostate. The advantages of radioactive seed implants are the preservation of healthy tissues and organs near the prostate, besides the low rate of impotence and urinary incontinence. The Energy and Nuclear Research Institute - IPEN, which belongs to the Nuclear Energy National Commission - CNEN, established a program for the development of the technique and production of Iodine-125 seeds in Brazil. The estimate for the 125-Iodine seeds demand is of 8,000 seeds/month and the laboratory to be implanted will need this production capacity. The purpose of this paper is to explain the project status and show some data about the seeds used in the country. The project will be divided in two phases: technological development of a prototype and a laboratory implementation for the seeds production. (author)

  1. Effects of insertion speed and trocar stiffness on the accuracy of needle position for brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    McGill, Carl S.; Schwartz, Jonathon A.; Moore, Jason Z.; McLaughlin, Patrick W.; Shih, Albert J. [Biomedical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 (United States); Department of Mechanical and Nuclear Engineering, The Pennsylvania State University, State College, Pennsylvania 16802 (United States); Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109 (United States); Biomedical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 and Mechanical Engineering Department, University of Michigan, Ann Arbor, Michigan 48109 (United States)

    2012-04-15

    Purpose: In prostate brachytherapy, accurate positioning of the needle tip to place radioactive seeds at its target site is critical for successful radiation treatment. During the procedure, needle deflection leads to seed misplacement and suboptimal radiation dose to cancerous cells. In practice, radiation oncologists commonly use high-speed hand needle insertion to minimize displacement of the prostate as well as the needle deflection. Effects of speed during needle insertion and stiffness of trocar (a solid rod inside the hollow cannula) on needle deflection are studied. Methods: Needle insertion experiments into phantom were performed using a 2{sup 2} factorial design (2 parameters at 2 levels), with each condition having replicates. Analysis of the deflection data included calculating the average, standard deviation, and analysis of variance (ANOVA) to find significant single and two-way interaction factors. Results: The stiffer tungsten carbide trocar is effective in reducing the average and standard deviation of needle deflection. The fast insertion speed together with the stiffer trocar generated the smallest average and standard deviation for needle deflection for almost all cases. Conclusions: The combination of stiff tungsten carbide trocar and fast needle insertion speed are important to decreasing needle deflection. The knowledge gained from this study can be used to improve the accuracy of needle insertion during brachytherapy procedures.

  2. Effects of insertion speed and trocar stiffness on the accuracy of needle position for brachytherapy.

    Science.gov (United States)

    McGill, Carl S; Schwartz, Jonathon A; Moore, Jason Z; McLaughlin, Patrick W; Shih, Albert J

    2012-04-01

    In prostate brachytherapy, accurate positioning of the needle tip to place radioactive seeds at its target site is critical for successful radiation treatment. During the procedure, needle deflection leads to seed misplacement and suboptimal radiation dose to cancerous cells. In practice, radiation oncologists commonly use high-speed hand needle insertion to minimize displacement of the prostate as well as the needle deflection. Effects of speed during needle insertion and stiffness of trocar (a solid rod inside the hollow cannula) on needle deflection are studied. Needle insertion experiments into phantom were performed using a 2(2) factorial design (2 parameters at 2 levels), with each condition having replicates. Analysis of the deflection data included calculating the average, standard deviation, and analysis of variance (ANOVA) to find significant single and two-way interaction factors. The stiffer tungsten carbide trocar is effective in reducing the average and standard deviation of needle deflection. The fast insertion speed together with the stiffer trocar generated the smallest average and standard deviation for needle deflection for almost all cases. The combination of stiff tungsten carbide trocar and fast needle insertion speed are important to decreasing needle deflection. The knowledge gained from this study can be used to improve the accuracy of needle insertion during brachytherapy procedures.

  3. Clinical implementation of MR‐guided vaginal cylinder brachytherapy

    National Research Council Canada - National Science Library

    Owrangi, Amir M; Jolly, Shruti; Balter, James M; Cao, Yue; Maturen, Katherine E; Young, Lisa; Zhu, Tong; Prisciandaro, Joann I

    2015-01-01

    ...)‐guided vaginal brachytherapy using commercially available solid applicator models. To test the fidelity of solid applicator models to digitize vaginal cylinder applicators, three datasets were evaluated...

  4. State-of-the-art: prostate LDR brachytherapy.

    Science.gov (United States)

    Voulgaris, S; Nobes, J P; Laing, R W; Langley, S E M

    2008-01-01

    This article on low dose rate (LDR) prostate brachytherapy reviews long-term results, patient selection and quality of life issues. Mature results from the United States and United Kingdom are reported and issues regarding definitions of biochemical failure are discussed. Latest data comparing brachytherapy with radical prostatectomy or no definitive treatment and also the risk of secondary malignancies after prostate brachytherapy are presented. Urological parameters of patient selection and quality of life issues concerning urinary, sexual and bowel function are reviewed. The position of prostate brachytherapy next to surgery as a first-line treatment modality is demonstrated.

  5. SU-D-BRF-07: Ultrasound and Fluoroscopy Based Intraoperative Image-Guidance System for Dynamic Dosimetry in Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kuo, N; Le, Y; Deguet, A; Prince, J; Song, D; Lee, J [Johns Hopkins University, Baltimore, MD (United States); Dehghan, E [Philips Research North America, Briarcliff Manor, NY (United States); Burdette, E [Acoustic MedSystems Inc., Savoy, IL (United States); Fichtinger, G [Queen' s University, Kingston, ON (Canada)

    2014-06-01

    Purpose: Prostate brachytherapy is a common treatment method for low-risk prostate cancer patients. Intraoperative treatment planning is known to improve the treatment procedure and the outcome. The current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. We developed an image-guidance system to fulfill this need to achieve intraoperative dynamic dosimetry in prostate brachytherapy. Methods: Our system is based on standard imaging equipments available in the operating room, including the transrectal ultrasound (TRUS) and the mobile C-arm. A simple fiducial is added to compute the C-arm pose. Three fluoroscopic images and an ultrasound volume of the seeds and the prostate are acquired and processed by four image processing algorithms: seed segmentation, fiducial detection with pose estimation, seed reconstruction, and seeds-to-TRUS registration. The updated seed positions allow the physician to assess the quality of implantation and dynamically adjust the treatment plan during the course of surgery to achieve improved exit dosimetry. Results: The system was tested on 10 phantoms and 37 patients. Seed segmentation resulted in a 1% false negative and 2% false positive rates. Fiducial detection with pose estimation resulted in a detection rate of 98%. Seed reconstruction had a mean reconstruction error of 0.4 mm. Seeds-to-TRUS registration had a mean registration error of 1.3 mm. The total processing time from image acquisition to registration was approximately 1 minute. Conclusion: We present an image-guidance system for intraoperative dynamic dosimetry in prostate brachytherapy. Using standard imaging equipments and a simple fiducial, our system can be easily adopted in any clinics. Robust image processing algorithms enable accurate and fast computation of the delivered dose. Especially, the system enables detection of possible hot/cold spots during the surgery, allowing the physician to address these

  6. Radiation protection after interstitial permanent prostate brachytherapy implants

    Energy Technology Data Exchange (ETDEWEB)

    Pirraco, R.; Pereira, A.; Cavaco, A. [Instituto Portugues de Oncologia Francisco Gentil - Centro R egional de Oncologia do Porto, SA, Porto (Portugal)

    2006-07-01

    Full text of publication follows: In this study we measure patients radiation exposure dose after interstitial {sup 125}I permanent prostate Brachytherapy implants, and correlate it with dose limits for public, total activity implanted, patient preoperative weight(1), distance between prostate walls and anterior skin surface. Methods and Material: We analyse 20 patients who were implanted with {sup 125}I seeds. The instrument used to measure radiation is a calibrated Berthold Umo LB 123 aco-plated to a LB 1236-H10 detector. Three measurements were taken: at the perineal and anterior pelvic zones on contact with the skin and at 1 m from the patient. The maximum value was taken for all measurements. The dose at a distance of one meter is obtained at anterior pelvic zone, perpendicular to the skin, according to the recommendations of A.A.P.M.(1). The distance between prostate walls was determined using post -operative CT images. Results: The doses at the perineal zone have determined an average of 186 {mu}Sv/h (range: 110 340 {mu}Sv/h) and at surface pelvic zone of 41 {mu}Sv/h (range: 15 103 {mu}Sv/h). The dose at a distance of 1 meter has an average value of 0.4 {mu}Sv/h (range: 0.2 1.0 {mu}Sv/h). The average total activity implanted was 25 mCi (range: 17 38 mCi). The distance between prostate walls and skin pelvic surface of the patients has an average value of 8.9 cm (range: 6.6 -11.5 cm). At a distance of 1 meter from the pelvic zone the dose measured is very low and below dose limits imposed by the European Directive EURATOM 2 and the Portuguese law. For general public to reach annual dose limit (EURATOM - 1 mSv/year) when contacting the pelvic zone, we extrapolate that 4 days (range: 1.6 11.1 days) would be needed, assuming a daily contact period of 6 hours. Conclusion: We established a correlation between the distance of prostate walls to the skin perineal surface and the total dose, but we find no correlation between measured doses, total activity implanted

  7. Monte Carlo dosimetry for 125I and 103Pd eye plaque brachytherapy.

    Science.gov (United States)

    Thomson, R M; Taylor, R E P; Rogers, D W O

    2008-12-01

    A Monte Carlo study of dosimetry for eye plaque brachytherapy is performed. BrachyDose, an EGSnrc user code which makes use of Yegin's multi-geometry package, is used to fully model 125I (model 6711) and 103Pd (model 200) brachytherapy seeds and the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). Three-dimensional dose distributions in the eye region are obtained. In general, dose to water is scored; however, the implications of replacing water with eye tissues are explored. The effect of the gold alloy (Modulay) backing is investigated and the dose is found to be sensitive to the elemental composition of the backing. The presence of the silicone polymer (Silastic) seed carrier results in substantial dose decreases relative to water, particularly for 103Pd. For a 20 mm plaque with a Modulay backing and Silastic insert, fully loaded with 24 seeds, the dose decrease relative to water is of the order of 14% for 125I and 20% for 103Pd at a distance of 1 cm from the inner sclera along the plaque's central axis. For the configurations of seeds used in COMS plaques, interseed attenuation is a small effect within the eye region. The introduction of an air interface results in a dose reduction in its vicinity which depends on the plaque's position within the eye and the radionuclide. Introducing bone in the eye's vicinity also causes dose reductions. The dose distributions in the eye for the two different radionuclides are compared and, for the same prescription dose, 103Pd generally offers a lower dose to critical normal structures. BrachyDose is sufficiently fast to allow full Monte Carlo dose calculations for routine clinical treatment planning.

  8. SU-F-BRA-03: Integrating Novel Electromagnetic Tracking Hollow Needle Assistance in Permanent Implant Brachytherapy Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Racine, E; Hautvast, G; Binnekamp, D [Philips Group Innovation - Biomedical Systems, Eindhoven (Netherlands); Beaulieu, L [Centre Hospitalier Univ de Quebec, Quebec, QC (Canada)

    2015-06-15

    Purpose: To report on the results of a complete permanent implant brachytherapy procedure assisted by an electromagnetic (EM) hollow needle possessing both 3D tracking and seed drop detection abilities. Methods: End-to-end in-phantom EM-assisted LDR procedures were conducted. The novel system consisted of an EM tracking apparatus (NDI Aurora V2, Planar Field Generator), a 3D US scanner (Philips CX50), a hollow needle prototype allowing 3D tracking and seed drop detection and a specially designed treatment planning software (Philips Healthcare). A tungsten-doped 30 cc spherical agarose prostate immersed in gelatin was used for the treatment. A cylindrical shape of 0.8 cc was carved along its diameter to mimic the urethra. An initial plan of 26 needles and 47 seeds was established with the system. The plan was delivered with the EM-tracked hollow needle, and individual seed drop locations were recorded on the fly. The phantom was subsequently imaged with a CT scanner from which seed positions and contour definitions were obtained. The DVHs were then independently recomputed and compared with those produced by the planning system, both before and after the treatment. Results: Of the 47 seeds, 45 (96%) were detected by the EM technology embedded in the hollow needle design. The executed plan (from CT analysis) differed from the initial plan by 2%, 14% and 8% respectively in terms of V100, D90 and V150 for the prostate, and by 8%, 7% and 10% respectively in terms of D5, V100 and V120 for the urethra. Conclusion: The average DVH deviations between initial and executed plans were within a 5% tolerance imposed for this proof-of-concept assessment. This relatively good concordance demonstrates the feasibility and potential benefits of combining EM tracking and seed drop detection for real-time dosimetry validation and assistance in permanent implant brachytherapy procedures. This project has been entirely funded by Philips Healthcare.

  9. Research of 103Pd Seed Source Preparation

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Having very good nuclide properties, 103Pd is an important radioisotope for the use of cancer local treatment (brachytherapy).Using the high puried 103Pd solution, by the way of electroplating, the 103Pd is deposited on the surface of metal bar, then the metal bar coated with 103Pd is sealed in titanium tube. For a seed, the dimensions are φ0.8 mm× 4.5 mm and the typical activity of individual 103Pd seed varies from 18.5-37 MBq. 103Pd seeds by batches can be offered at present and the product is checked out by SDA. Clinical trials have finished in Beijing and Guangzhou,

  10. Application of spherical micro diodes for brachytherapy dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Broisman, Andrey, E-mail: andreybr@ariel.ac.i [Medical Physics, Ariel University Center, Ariel 40700 (Israel); Shani, Gad [Biomedical Engineering, Ben Gurion University, P.O. Box 653, Beer Sheva 84105 (Israel)

    2011-03-15

    The research presented in this paper demonstrates the feasibility and the advantages of using spherical micro diodes for radiation dosimetry. The spherical symmetry of the diode response is demonstrated, compared to that of planar diodes. The application of the spherical diode described here is for radiotherapy dosimetry, particularly brachytherapy. Measurements were done in PMMA phantoms. The advantage of the spherical diode is that it can be used for radiation measurement in a 4{pi} geometry, it was demonstrated by measurements in both axial and azimuthal planes. The diodes were found to respond equally to radiation coming from all directions, directly from the source or due to scattered radiation within the medium. In the present work 1.8 mm diameter silicone diodes were used. The small size of these spherical diodes provides local dose measurement and can be used for in situ dosimetry while treatment takes place. Treatment planning correction can be made accordingly. Commercially available seeds of the isotopes I{sup 125} and Pd{sup 103} were used as radiation sources. The spherical diodes response was compared with that of planar diodes XRB generally used for UV and X-ray dosimetry, and with TLD measurements. We have also compared the measured results with Monte Carlo simulation, applying the MCNP code and with calculations shown in the TG-43 report.

  11. Time-driven activity-based costing of low-dose-rate and high-dose-rate brachytherapy for low-risk prostate cancer.

    Science.gov (United States)

    Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher

    Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. Physics and basic parameters of brachytherapy.

    Science.gov (United States)

    Lee, E J; Weinhous, M S

    1997-06-01

    Brachytherapy (short-distance therapy) is the therapeutic process whereby radioactive sources are placed into very close proximity to target tissue. Radioactive materials were so used beginning shortly after the discovery of radium by Marie and Pierre Curie in 1898. For the purposes of brachytherapy, radioactive materials are those that emit "rays" that can cause ionization (and hence DNA damage and the destruction of target cells). The potentially useful rays include beta, gamma, and other possibilities such as neutrons. Beta rays, properly beta particles, are simply high energy electrons. Gamma rays are high energy photons (part of the electromagnetic spectrum like visible light, but with much higher energy). These particles are produced during the radioactive decay of certain isotopes. The physics of those events and the parameters that apply to the therapeutic use of the isotopes are the primary topics of this report.

  13. Rotating-shield brachytherapy for cervical cancer

    Science.gov (United States)

    Yang, Wenjun; Kim, Yusung; Wu, Xiaodong; Song, Qi; Liu, Yunlong; Bhatia, Sudershan K.; Sun, Wenqing; Flynn, Ryan T.

    2013-06-01

    In this treatment planning study, the potential benefits of a rotating shield brachytherapy (RSBT) technique based on a partially-shielded electronic brachytherapy source were assessed for treating cervical cancer. Conventional intracavitary brachytherapy (ICBT), intracavitary plus supplementary interstitial (IS+ICBT), and RSBT treatment plans for azimuthal emission angles of 180° (RSBT-180) and 45° (RSBT-45) were generated for five patients. For each patient, high-risk clinical target volume (HR-CTV) equivalent dose in 2 Gy fractions (EQD2) (α/β = 10 Gy) was escalated until bladder, rectum, or sigmoid colon tolerance EQD2 values were reached. External beam radiotherapy dose (1.8 Gy × 25) was accounted for, and brachytherapy was assumed to have been delivered in 5 fractions. IS+ICBT provided a greater HR-CTV D90 (minimum EQD2 to the hottest 90%) than ICBT. D90 was greater for RSBT-45 than IS+ICBT for all five patients, and greater for RSBT-180 than IS+ICBT for two patients. When the RSBT-45/180 plan with the lowest HR-CTV D90 that was greater than the D90 the ICBT or IS+ICBT plan was selected, the average (range) of D90 increases for RSBT over ICBT and IS+ICBT were 16.2 (6.3-27.2)and 8.5 (0.03-20.16) Gy, respectively. The average (range) treatment time increase per fraction of RSBT was 34.56 (3.68-70.41) min over ICBT and 34.59 (3.57-70.13) min over IS+ICBT. RSBT can increase D90 over ICBT and IS+ICBT without compromising organ-at-risk sparing. The D90 and treatment time improvements from RSBT depend on the patient and shield emission angle.

  14. Managing the consequences of aggressive conservative treatment for refractory retinoblastoma with vitreous seeding

    OpenAIRE

    2014-01-01

    A 4 year-old girl with bilateral, non-familial retinoblastoma (RB) was referred to our care after primary enucleation OS and active tumor OD refractory to multiple therapies (intravenous chemotherapy, laser/cryotherapy, and I-125 plaque radiotherapy). Vitreous seeding OD, initially controlled by several sessions of Ophthalmic Artery Infusion Chemotherapy (OAIC) and periocular chemotherapy, recurred shortly thereafter. The patient underwent intravitreal (IVit) Melphalan injections achieving tu...

  15. A fibre optic dosimeter customised for brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Suchowerska, N. [Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, NSW 2050 (Australia); School of Physics, University of Sydney, NSW 2006 (Australia)], E-mail: Natalka@email.cs.nsw.gov.au; Lambert, J.; Nakano, T. [Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, NSW 2050 (Australia); School of Physics, University of Sydney, NSW 2006 (Australia); Law, S. [School of Physics, University of Sydney, NSW 2006 (Australia); Optical Fibre Technology Centre, University of Sydney, 206 National Innovation Centre, Australian Technology Park, Eveleigh, NSW 1430 (Australia); Elsey, J. [Bandwidth Foundry Pty Ltd, Australian Technology Park, NSW, 1430 (Australia); McKenzie, D.R. [School of Physics, University of Sydney, NSW 2006 (Australia)

    2007-04-15

    In-vivo dosimetry for brachytherapy cancer treatment requires a small dosimeter with a real time readout capability that can be inserted into the patient to determine the dose to critical organs. Fibre optic scintillation dosimeters, consisting of a plastic scintillator coupled to an optical fibre, are a promising dosimeter for this application. We have implemented specific design features to optimise the performance of the dosimeter for specific in-vivo dosimetry during brachytherapy. Two sizes of the BrachyFOD{sup TM} scintillation dosimeter have been developed, with external diameters of approximately 2 and 1 mm. We have determined their important dosimetric characteristics (depth dose relation, angular dependence, energy dependence). We have shown that the background signal created by Cerenkov and fibre fluorescence does not significantly affect the performance in most clinical geometries. The dosimeter design enables readout at less than 0.5 s intervals. The clinical demands of real time in-vivo brachytherapy dosimetry can uniquely be satisfied by the BrachyFOD{sup TM}.

  16. Brachytherapy for the treatment of prostate cancer.

    Science.gov (United States)

    Cesaretti, Jamie A; Stone, Nelson N; Skouteris, Vassilios M; Park, Janelle L; Stock, Richard G

    2007-01-01

    Low-dose rate brachytherapy has become a mainstream treatment option for men diagnosed with prostate cancer because of excellent long-term treatment outcomes in low-, intermediate-, and high-risk patients. Largely due to patient lead advocacy for minimally invasive treatment options, high-quality prostate implants have become widely available in the US, Europe, and Japan. The reason that brachytherapy results are reproducible in several different practice settings is because numerous implant quality factors have been defined over the last 20 years, which can be applied objectively to judge the success of the intervention both during and after the procedure. In addition, recent long-term follow-up studies have clarified that the secondary cancer incidence of brachytherapy is not clinically meaningful. In terms of future directions, the study of radiation repair genetics may allow for the counseling physician to better estimate any given patients risk for side effects, thereby substantially reducing the therapeutic uncertainties faced by patients choosing a prostate cancer intervention.

  17. A robotic device for MRI-guided prostate brachytherapy

    NARCIS (Netherlands)

    Lagerburg, V.

    2008-01-01

    One of the treatment options for prostate cancer is brachytherapy with iodine-125 sources. In prostate brachytherapy a high radiation dose is delivered to the prostate with a steep dose fall off to critical surrounding organs. The implantation of the iodine sources is currently performed under

  18. A robotic device for MRI-guided prostate brachytherapy

    NARCIS (Netherlands)

    Lagerburg, V.

    2008-01-01

    One of the treatment options for prostate cancer is brachytherapy with iodine-125 sources. In prostate brachytherapy a high radiation dose is delivered to the prostate with a steep dose fall off to critical surrounding organs. The implantation of the iodine sources is currently performed under ultra

  19. Establishing High-Quality Prostate Brachytherapy Using a Phantom Simulator Training Program

    Energy Technology Data Exchange (ETDEWEB)

    Thaker, Nikhil G. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kudchadker, Rajat J. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swanson, David A. [Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Albert, Jeffrey M. [Department of Radiation Oncology, Banner Health, Loveland/Greeley, Colorado (United States); Mahmood, Usama; Pugh, Thomas J.; Boehling, Nicholas S. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Bruno, Teresa L. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Prestidge, Bradley R. [Department of Radiation Oncology, Bon Secours Health System, Norfolk, Virginia (United States); Crook, Juanita M. [Department of Radiation Oncology, Cancer Center for the Southern Interior, Kelowna, British Columbia (Canada); Cox, Brett W.; Potters, Louis [Department of Radiation Medicine, North Shore-LIJ Health System, New Hyde Park, New York (United States); Moran, Brian J. [Chicago Prostate Center, Westmont, Illinois (United States); Keyes, Mira [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Center, Vancouver, British Columbia (Canada); Kuban, Deborah A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Frank, Steven J., E-mail: sjfrank@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-11-01

    Purpose: To design and implement a unique training program that uses a phantom-based simulator to teach the process of prostate brachytherapy (PB) quality assurance and improve the quality of education. Methods and Materials: Trainees in our simulator program were practicing radiation oncologists, radiation oncology residents, and fellows of the American Brachytherapy Society. The program emphasized 6 core areas of quality assurance: patient selection, simulation, treatment planning, implant technique, treatment evaluation, and outcome assessment. Using the Iodine 125 ({sup 125}I) preoperative treatment planning technique, trainees implanted their ultrasound phantoms with dummy seeds (ie, seeds with no activity). Pre- and postimplant dosimetric parameters were compared and correlated using regression analysis. Results: Thirty-one trainees successfully completed the simulator program during the period under study. The mean phantom prostate size, number of seeds used, and total activity were generally consistent between trainees. All trainees met the V100 >95% objective both before and after implantation. Regardless of the initial volume of the prostate phantom, trainees' ability to cover the target volume with at least 100% of the dose (V100) was not compromised (R=0.99 pre- and postimplant). However, the V150 had lower concordance (R=0.37) and may better reflect heterogeneity control of the implant process. Conclusions: Analysis of implants from this phantom-based simulator shows a high degree of consistency between trainees and uniformly high-quality implants with respect to parameters used in clinical practice. This training program provides a valuable educational opportunity that improves the quality of PB training and likely accelerates the learning curve inherent in PB. Prostate phantom implantation can be a valuable first step in the acquisition of the required skills to safely perform PB.

  20. Image fusion techniques in permanent seed implantation

    Directory of Open Access Journals (Sweden)

    Alfredo Polo

    2010-10-01

    Full Text Available Over the last twenty years major software and hardware developments in brachytherapy treatment planning, intraoperative navigation and dose delivery have been made. Image-guided brachytherapy has emerged as the ultimate conformal radiation therapy, allowing precise dose deposition on small volumes under direct image visualization. In thisprocess imaging plays a central role and novel imaging techniques are being developed (PET, MRI-MRS and power Doppler US imaging are among them, creating a new paradigm (dose-guided brachytherapy, where imaging is used to map the exact coordinates of the tumour cells, and to guide applicator insertion to the correct position. Each of these modalities has limitations providing all of the physical and geometric information required for the brachytherapy workflow.Therefore, image fusion can be used as a solution in order to take full advantage of the information from each modality in treatment planning, intraoperative navigation, dose delivery, verification and follow-up of interstitial irradiation.Image fusion, understood as the visualization of any morphological volume (i.e. US, CT, MRI together with an additional second morpholo gical volume (i.e. CT, MRI or functional dataset (functional MRI, SPECT, PET, is a well known method for treatment planning, verification and follow-up of interstitial irradiation. The term image fusion is used when multiple patient image datasets are registered and overlaid or merged to provide additional information. Fused images may be created from multiple images from the same imaging modality taken at different moments (multi-temporalapproach, or by combining information from multiple modalities. Quality means that the fused images should provide additional information to the brachythe rapy process (diagnosis and staging, treatment planning, intraoperative imaging, treatment delivery and follow-up that cannot be obtained in other ways. In this review I will focus on the role of

  1. Predictive Factors and Management of Rectal Bleeding Side Effects Following Prostate Cancer Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Price, Jeremy G. [Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Stone, Nelson N. [Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York (United States)

    2013-08-01

    Purpose: To report on the incidence, nature, and management of rectal toxicities following individual or combination brachytherapy following treatment for prostate cancer over a 17-year period. We also report the patient and treatment factors predisposing to acute ≥grade 2 proctitis. Methods and Materials: A total of 2752 patients were treated for prostate cancer between October 1990 and April 2007 with either low-dose-rate brachytherapy alone or in combination with androgen depletion therapy (ADT) or external beam radiation therapy (EBRT) and were followed for a median of 5.86 years (minimum 1.0 years; maximum 19.19 years). We investigated the 10-year incidence, nature, and treatment of acute and chronic rectal toxicities following BT. Using univariate, and multivariate analyses, we determined the treatment and comorbidity factors predisposing to rectal toxicities. We also outline the most common and effective management for these toxicities. Results: Actuarial risk of ≥grade 2 rectal bleeding was 6.4%, though notably only 0.9% of all patients required medical intervention to manage this toxicity. The majority of rectal bleeding episodes (72%) occurred within the first 3 years following placement of BT seeds. Of the 27 patients requiring management for their rectal bleeding, 18 underwent formalin treatment and nine underwent cauterization. Post-hoc univariate statistical analysis revealed that coronary artery disease (CAD), biologically effective dose, rectal volume receiving 100% of the prescription dose (RV100), and treatment modality predict the likelihood of grade ≥2 rectal bleeding. Only CAD, treatment type, and RV100 fit a Cox regression multivariate model. Conclusions: Low-dose-rate prostate brachytherapy is very well tolerated and rectal bleeding toxicities are either self-resolving or effectively managed by medical intervention. Treatment planning incorporating adjuvant ADT while minimizing RV100 has yielded the best toxicity-free survival following

  2. SU-E-T-547: Rotating Shield Brachytherapy (RSBT) for Cervical Cancer.

    Science.gov (United States)

    Yang, W; Kim, Y; Liu, Y; Wu, X; Flynn, R

    2012-06-01

    To assess rotating shield brachytherapy (RSBT) delivered with the electronic brachytherapy (eBT) source comparing to intracavitary (IC) and intracavitary plus supplemental interstitial brachytherapy (IC+IS BT) delivered with conventional isotope radiation source. IC, IC+IS and RSBT plan was simulated for 5 patients with advanced cervical cancer (>40cc). One BT plan for each patient (fraction 1) guided by magnetic resonance imaging (MRI) was used in our treatment planning system (TPS). A bio- and MRI-compatible polycarbonate (Makrolon Rx3158) intrauterine applicator was simulated for IC and RSBT, and the vienna applicator was simulated for IC+IS BT. 192Ir was used as the radiation source of IC and IC+IS BT; Xoft AxxentTM eBT source was used for RSBT. A 0.5 mm thick tungsten shield was used for RS-BT with different azimuthal and zenith angles. The total dose for each plan was escalated as the external beam radiation therapy (EBRT) plus BT times fraction number (5 in our case). RSBT and IC+IS BT had higher dose conformity in terms of D90 than IC BT for all the patients. The advantage of RSBT over IC+IS BT was dependent on the shield emission angle, tumor shape and tandem applicator location. The delivery time of RSBT was increased as finer emission angle was selected. RSBT is a less-invasive potential alternative to conventional IC and IC+IS BT for treating bulky (>40cc) cervical cancer. RSBT can provide better treatment outcome with clinically acceptable increased delivery time if proper emission angle is selected based on the tumor shape and tandem applicator location. supported in part by NSF grants CCF-0830402 and CCF-0844765; and the NIH grant K25-CA123112, and American Cancer Society seed grant (IRG-77-004-31). © 2012 American Association of Physicists in Medicine.

  3. A new optimization method using a compressed sensing inspired solver for real-time LDR-brachytherapy treatment planning

    Science.gov (United States)

    Guthier, C.; Aschenbrenner, K. P.; Buergy, D.; Ehmann, M.; Wenz, F.; Hesser, J. W.

    2015-03-01

    This work discusses a novel strategy for inverse planning in low dose rate brachytherapy. It applies the idea of compressed sensing to the problem of inverse treatment planning and a new solver for this formulation is developed. An inverse planning algorithm was developed incorporating brachytherapy dose calculation methods as recommended by AAPM TG-43. For optimization of the functional a new variant of a matching pursuit type solver is presented. The results are compared with current state-of-the-art inverse treatment planning algorithms by means of real prostate cancer patient data. The novel strategy outperforms the best state-of-the-art methods in speed, while achieving comparable quality. It is able to find solutions with comparable values for the objective function and it achieves these results within a few microseconds, being up to 542 times faster than competing state-of-the-art strategies, allowing real-time treatment planning. The sparse solution of inverse brachytherapy planning achieved with methods from compressed sensing is a new paradigm for optimization in medical physics. Through the sparsity of required needles and seeds identified by this method, the cost of intervention may be reduced.

  4. Intercomparison of ionisation chamber measurements from (125)I seeds.

    Science.gov (United States)

    Davies, J B; Enari, K F; Baldock, C

    2007-05-01

    The reference air kerma rates of a set of individual (125)I seeds were calculated from current measurements of a calibrated re-entrant ionisation chamber. Single seeds were distributed to seven Australian brachytherapy centres for the same measurement with the user's instrumentation. Results are expressed as the ratio of the reference air kerma rate measured by the Australian Nuclear Science & Technology Organisation (ANSTO) to the reference air kerma rate measured at the centre. The intercomparison ratios of all participants were within +/-5% of unity.

  5. Experimental dosimetry of Ho-166 bioglass seed polymer-protected

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Luciana B.; Campos, Tarcisio P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This study aims to develop experimental dosimetry of Ho-166 bio glass seed for brachytherapy studies using GAFCHROMIC EBT2 radio chromium films. The methodology consists of placement of radio chromium films in a compressed breast phantom, along with bio glass polymer-protected seeds of [Si: Ca: Ho] and [Si: Ca: Ho: Zr]. The bio glass seeds were encapsulated with polyvinyl alcohol, before being activated and used in the study. The bio glass seeds were introduced into the breast phantom, along with radio chromium films for a period of 2 hours. After the exposure time, radio chromium films were removed from phantom and digitized for analysis in ImageDIG 2.0 program, which quantifies the intensity of RGB (Red, Green, Blue). The dose calculation was evaluated by Monte Carlo technique. Experimental and theoretical data were used to calibrate the dose distribution. The results were plotted on graphs and dose iso curves were obtained. As conclusion it is possible to perform dosimetry in Ho-166 seed brachytherapy using radio chromium films, limited to a short exposure time and small activity. (author)

  6. SU-E-T-635: Process Mapping of Eye Plaque Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huynh, J; Kim, Y [University of Arizona, Tucson, AZ (United States)

    2015-06-15

    Purpose: To apply a risk-based assessment and analysis technique (AAPM TG 100) to eye plaque brachytherapy treatment of ocular melanoma. Methods: The role and responsibility of personnel involved in the eye plaque brachytherapy is defined for retinal specialist, radiation oncologist, nurse and medical physicist. The entire procedure was examined carefully. First, major processes were identified and then details for each major process were followed. Results: Seventy-one total potential modes were identified. Eight major processes (corresponding detailed number of modes) are patient consultation (2 modes), pretreatment tumor localization (11), treatment planning (13), seed ordering and calibration (10), eye plaque assembly (10), implantation (11), removal (11), and deconstruction (3), respectively. Half of the total modes (36 modes) are related to physicist while physicist is not involved in processes such as during the actual procedure of suturing and removing the plaque. Conclusion: Not only can failure modes arise from physicist-related procedures such as treatment planning and source activity calibration, but it can also exist in more clinical procedures by other medical staff. The improvement of the accurate communication for non-physicist-related clinical procedures could potentially be an approach to prevent human errors. More rigorous physics double check would reduce the error for physicist-related procedures. Eventually, based on this detailed process map, failure mode and effect analysis (FMEA) will identify top tiers of modes by ranking all possible modes with risk priority number (RPN). For those high risk modes, fault tree analysis (FTA) will provide possible preventive action plans.

  7. Multihelix rotating shield brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States); Kim, Yusung; Flynn, Ryan T., E-mail: ryan-flynn@uiowa.edu [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Wu, Xiaodong [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States)

    2015-11-15

    Purpose: To present a novel brachytherapy technique, called multihelix rotating shield brachytherapy (H-RSBT), for the precise angular and linear positioning of a partial shield in a curved applicator. H-RSBT mechanically enables the dose delivery using only linear translational motion of the radiation source/shield combination. The previously proposed approach of serial rotating shield brachytherapy (S-RSBT), in which the partial shield is rotated to several angular positions at each source dwell position [W. Yang et al., “Rotating-shield brachytherapy for cervical cancer,” Phys. Med. Biol. 58, 3931–3941 (2013)], is mechanically challenging to implement in a curved applicator, and H-RSBT is proposed as a feasible solution. Methods: A Henschke-type applicator, designed for an electronic brachytherapy source (Xoft Axxent™) and a 0.5 mm thick tungsten partial shield with 180° or 45° azimuthal emission angles and 116° asymmetric zenith angle, is proposed. The interior wall of the applicator contains six evenly spaced helical keyways that rigidly define the emission direction of the partial radiation shield as a function of depth in the applicator. The shield contains three uniformly distributed protruding keys on its exterior wall and is attached to the source such that it rotates freely, thus longitudinal translational motion of the source is transferred to rotational motion of the shield. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients with a diverse range of high-risk target volume (HR-CTV) shapes and applicator positions. For each patient, the total number of emission angles was held nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. Treatment delivery time and tumor coverage (D{sub 90} of HR-CTV) were the two metrics used as the basis for evaluation and

  8. Urethral dosimetry constraints in 125I permanent prostate brachytherapy used as boost to external radiotherapy; Restricciones dosimetricas de la uretra en el caso de braquiterapia permanente de prostata con 125I utilizada como complemento a radioterapia externa

    Energy Technology Data Exchange (ETDEWEB)

    Lliso, F.; Perez-Calatayud, J.; Carmona, V.; Guirado, D.; Munoz, M.; Richart, J.; Ballester, F.; Granero, D.; Rodriguez, S.; Tormo, A.; Santos, M.

    2010-07-01

    With 125I monotherapy in permanent brachytherapy implants, the recommendation is to deliver to the urethra less than 150% of the prescribed dose, 145 Gy, that is a limit of 217.5 Gy. However, there are not recommendations in the case of the brachytherapy boost. At our hospitals, permanent brachytherapy implants are used as a 108 Gy boost in intermediate risk patients with prostate carcinoma, which have undergone an external beam radiotherapy course ranging between 45 and 50.4 Gy. The purpose of this work is to present a simple radiobiologically-based analysis performed in order to obtain the urethral dose limit in permanent prostate brachytherapy boost. The linear-quadratic model has been used to determine the biologically effective dose, analysing the results for different dose/fraction, t1/2 and a/b values. Assuming 46 Gy delivered by external beam radiotherapy, it is found that a limit value of 145 Gy, corresponding to the isodose level of 135% of the prescribed dose, is adequate. The results for a ten patients sample are shown in order to illustrate the values that are obtained in clinical practice. In conclusion, we present the method employed to find the urethral dose limit in the case of the combination of external beam radiotherapy and permanent 125I seeds brachytherapy boost implants (Author).

  9. [Perioperative interstitial brachytherapy for recurrent keloid scars].

    Science.gov (United States)

    Rio, E; Bardet, E; Peuvrel, P; Martinet, L; Perrot, P; Baraer, F; Loirat, Y; Sartre, J-Y; Malard, O; Ferron, C; Dreno, B

    2010-01-01

    Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (LDR) Ir-192 in the treatment of keloid scars. We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medicosurgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6h). The median dose was 20Gy (range, 15-40Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early - within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6cm long. The rate was 100% for treated scars below 4.5cm in length, 95% (95% CI: 55-96) for those 4.5-6cm long, and 75% (95% CI: 56-88) beyond 6cm (p=0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Early perioperative LDR brachytherapy delivering 20Gy at 5mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. 2009 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  10. Seed quality in informal seed systems

    OpenAIRE

    Biemond, P.C.

    2013-01-01

    Keywords:     informal seed systems, seed recycling, seed quality, germination, seed pathology, seed health, seed-borne diseases, mycotoxigenic fungi, Fusarium verticillioides, mycotoxins, Vigna unguiculata, Zea mays, Nigeria.   Seed is a crucial input for agricultural production. Approximately 80% of the smallholder farmers in Africa depend for their seed on the informal seed system, consisting of farmers involved in selection, production and dissemination of seed. The la...

  11. The application of Geant4 simulation code for brachytherapy treatment

    CERN Document Server

    Agostinelli, S; Garelli, S; Paoli, G; Nieminen, P; Pia, M G

    2000-01-01

    Brachytherapy is a radiotherapeutic modality that makes use of radionuclides to deliver a high radiation dose to a well-defined volume while sparing surrounding healthy structures. At the National Institute for Cancer Research of Genova a High Dose Rate remote afterloading system provides Ir(192) endocavitary brachytherapy treatments. We studied the possibility to use the Geant4 Monte Carlo simulation toolkit in brachytherapy for calculation of complex physical parameters, not directly available by experiment al measurements, used in treatment planning dose deposition models.

  12. Image-guided high-dose-rate brachytherapy in inoperable endometrial cancer

    Science.gov (United States)

    Petsuksiri, J; Chansilpa, Y; Hoskin, P J

    2014-01-01

    Inoperable endometrial cancer may be treated with curative aim using radical radiotherapy alone. The radiation techniques are external beam radiotherapy (EBRT) alone, EBRT plus brachytherapy and brachytherapy alone. Recently, high-dose-rate brachytherapy has been used instead of low-dose-rate brachytherapy. Image-guided brachytherapy enables sufficient coverage of tumour and reduction of dose to the organs at risk, thus increasing the therapeutic ratio of treatment. Local control rates with three-dimensional brachytherapy appear better than with conventional techniques (about 90–100% and 70–90%, respectively). PMID:24807067

  13. Stereotactic interstitial brachytherapy for the treatment of oligodendroglial brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    El Majdoub, Faycal; Neudorfer, Clemens; Maarouf, Mohammad [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University of Witten/Herdecke, Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), Cologne (Germany); Blau, Tobias; Deckert, Martina [University Hospital of Cologne, Department of Neuropathology, Cologne (Germany); Hellmich, Martin [University Hospital of Cologne, Institute of Statistics, Informatics and Epidemiology, Cologne (Germany); Buehrle, Christian [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); Sturm, Volker [University Hospital of Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne (Germany); University Hospital of Wurzburg, Department of Neurosurgery, Wuerzburg (Germany)

    2015-12-15

    We evaluated the treatment of oligodendroglial brain tumors with interstitial brachytherapy (IBT) using {sup 125}iodine seeds ({sup 125}I) and analyzed prognostic factors. Between January 1991 and December 2010, 63 patients (median age 43.3 years, range 20.8-63.4 years) suffering from oligodendroglial brain tumors were treated with {sup 125}I IBT either as primary, adjuvantly after incomplete resection, or as salvage therapy after tumor recurrence. Possible prognostic factors influencing disease progression and survival were retrospectively investigated. The actuarial 2-, 5-, and 10-year overall and progression-free survival rates after IBT for WHO II tumors were 96.9, 96.9, 89.8 % and 96.9, 93.8, 47.3 %; for WHO III tumors 90.3, 77, 54.9 % and 80.6, 58.4, 45.9 %, respectively. Magnetic resonance imaging demonstrated complete remission in 2 patients, partial remission in 13 patients, stable disease in 17 patients and tumor progression in 31 patients. Median time to progression for WHO II tumors was 87.6 months and for WHO III tumors 27.8 months. Neurological status improved in 10 patients and remained stable in 20 patients, while 9 patients deteriorated. There was no treatment-related mortality. Treatment-related morbidity was transient in 11 patients. WHO II, KPS ≥ 90 %, frontal location, and tumor surface dose > 50 Gy were associated with increased overall survival (p ≤ 0.05). Oligodendroglioma and frontal location were associated with a prolonged progression-free survival (p ≤ 0.05). Our study indicates that IBT achieves local control rates comparable to surgery and radio-/chemotherapy treatment, is minimally invasive, and safe. Due to the low rate of side effects, IBT may represent an attractive option as part of a multimodal treatment schedule, being supplementary to microsurgery or as a salvage therapy after chemotherapy and conventional irradiation. (orig.) [German] Die Behandlung oligodendroglialer Hirntumoren durch die interstitielle Brachytherapie

  14. Monte Carol-Based Dosimetry of Beta-Emitters for Intravascular Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, C.K.

    2002-06-25

    Monte Carlo simulations for radiation dosimetry and the experimental verifications of the simulations have been developed for the treatment geometry of intravascular brachytherapy, a form of radionuclide therapy for occluded coronary disease (restenosis). Monte Carlo code, MCNP4C, has been used to calculate the radiation dose from the encapsulated array of B-emitting seeds (Sr/Y-source train). Solid water phantoms have been fabricated to measure the dose on the radiochromic films that were exposed to the beta source train for both linear and curved coronary vessel geometries. While the dose difference for the 5-degree curved vessel at the prescription point of f+2.0 mm is within the 10% guideline set by the AAPM, however, the difference increased dramatically to 16.85% for the 10-degree case which requires additional adjustment for the acceptable dosimetry planning. The experimental dose measurements agree well with the simulation results

  15. Image-Based Brachytherapy for the Treatment of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harkenrider, Matthew M., E-mail: mharkenrider@lumc.edu; Alite, Fiori; Silva, Scott R.; Small, William

    2015-07-15

    Cervical cancer is a disease that requires considerable multidisciplinary coordination of care and labor in order to maximize tumor control and survival while minimizing treatment-related toxicity. As with external beam radiation therapy, the use of advanced imaging and 3-dimensional treatment planning has generated a paradigm shift in the delivery of brachytherapy for the treatment of cervical cancer. The use of image-based brachytherapy, most commonly with magnetic resonance imaging (MRI), requires additional attention and effort by the treating physician to prescribe dose to the proper volume and account for adjacent organs at risk. This represents a dramatic change from the classic Manchester approach of orthogonal radiographic images and prescribing dose to point A. We reviewed the history and currently evolving data and recommendations for the clinical use of image-based brachytherapy with an emphasis on MRI-based brachytherapy.

  16. Patient release criteria for low dose rate brachytherapy implants.

    Science.gov (United States)

    Boyce, Dale E; Sheetz, Michael A

    2013-04-01

    A lack of consensus regarding a model governing the release of patients following sealed source brachytherapy has led to a set of patient release policies that vary from institution to institution. The U.S. Nuclear Regulatory Commission has issued regulatory guidance on patient release in NUREG 1556, Volume 9, Rev. 2, Appendix U, which allows calculation of release limits following implant brachytherapy. While the formalism presented in NUREG is meaningful for the calculation of release limits in the context of relatively high energy gamma emitters, it does not estimate accurately the effective dose equivalent for the common low dose rate brachytherapy sources Cs, I, and Pd. NUREG 1556 states that patient release may be based on patient-specific calculations as long as the calculation is documented. This work is intended to provide a format for patient-specific calculations to be used for the consideration of patients' release following the implantation of certain low dose rate brachytherapy isotopes.

  17. Brachytherapy on urethral carcinoma; Braquiterapia no carcinoma da uretra

    Energy Technology Data Exchange (ETDEWEB)

    Novaes, Paulo Eduardo R.S. [Fundacao Antonio Prudente, Sao Paulo, SP (Brazil). Hospital A.C. Camargo. Dept. de Radioterapia

    1996-04-01

    From 1954 to 1992 21 patients with primary urethral carcinoma were attended at A.C.Camargo Hospital - Fundacao Antonio Prudente - Sao Paulo. There were 17 female and 4 male with a median age of 58 years old. Eight patients received surgery, 8 radiation therapy and 5 were treated with palliative intention or were not treated. Patients treated by radiotherapy received 60 Gy to 80 Gy. Three patients were submitted to exclusive brachytherapy, 4 to the association of external beam and brachytherapy and 1 to external radiotherapy. Interstitial techniques were employed in 5 patients and intraluminal brachytherapy with special applicator in 2. Seven of 8 patients (87.5%) had local control and disease free survival with a minimum follow-up 4 years. Late effects were not observed. Primary urethral carcinoma is a curable disease by radiotherapy and the association of external irradiation and brachytherapy is the ideal approach. (author) 11 refs.

  18. Brachytherapy in thetreatment of the oral and oropharyngeal cancer

    Directory of Open Access Journals (Sweden)

    A. M. Zhumankulov

    2015-01-01

    Full Text Available Background. One of the methods of radiotherapy of malignant tumors of oral cavity and oropharyngeal region today is interstitial radiation therapy – brachytherapy, allowing you to create the optimum dose of irradiation to the tumor, necessary for its destruction, without severe radiation reactions in the surrounding tissues unchanged. Brachytherapy has the following advantages: high precision – the ability of the local summarization of high single doses in a limited volume of tissue; good tolerability; a short time of treatment. At this time, brachytherapy is the method of choice used as palliative therapy and as a component of radical treatment.Objective: The purpose of this article is a literature review about the latest achievements of interstitial brachytherapy in malignant tumors of the oral cavity and oropharynx.

  19. Radiotherapy and Brachytherapy : Proceedings of the NATO Advanced Study Institute on Physics of Modern Radiotherapy & Brachytherapy

    CERN Document Server

    Lemoigne, Yves

    2009-01-01

    This volume collects a series of lectures presented at the tenth ESI School held at Archamps (FR) in November 2007 and dedicated to radiotherapy and brachytherapy. The lectures focus on the multiple facets of radiotherapy in general, including external radiotherapy (often called teletherapy) as well as internal radiotherapy (called brachytherapy). Radiotherapy strategy and dose management as well as the decisive role of digital imaging in the associated clinical practice are developed in several articles. Grouped under the discipline of Conformal Radiotherapy (CRT), numerous modern techniques, from Multi-Leaf Collimators (MLC) to Intensity Modulated RadioTherapy (IMRT), are explained in detail. The importance of treatment planning based upon patient data from digital imaging (Computed Tomography) is also underlined. Finally, despite the quasi- totality of patients being presently treated with gamma and X-rays, novel powerful tools are emerging using proton and light ions (like carbon ions) beams, bound to bec...

  20. Electromagnetic tracking for treatment verification in interstitial brachytherapy

    Science.gov (United States)

    Kellermeier, Markus; Tanderup, Kari

    2016-01-01

    Electromagnetic tracking (EMT) is used in several medical fields to determine the position and orientation of dedicated sensors, e.g., attached to surgical tools. Recently, EMT has been introduced to brachytherapy for implant reconstruction and error detection. The manuscript briefly summarizes the main issues of EMT and error detection in brachytherapy. The potential and complementarity of EMT as treatment verification technology will be discussed in relation to in vivo dosimetry and imaging. PMID:27895688

  1. [Edge effect and late thrombosis -- inevitable complications of vascular brachytherapy?].

    Science.gov (United States)

    Schiele, T M; Staber, L; Kantlehner, R; Pöllinger, B; Dühmke, E; Theisen, K; Klauss, V

    2002-11-01

    Restenosis is the limiting entity after percutaneous coronary angioplasty. Vascular brachytherapy for the treatment of in-stent restenosis has been shown to reduce the repeat restenosis rate and the incidence of major adverse events in several randomized trials. Besides the beneficial effects, brachytherapy yielded some unwanted side effects. The development of new stenoses at the edges of the target lesion treated with radiation is termed edge effect. It occurs after afterloading brachytherapy as well as after implantation of radioactive stents. It is characterized by extensive intimal hyperplasia and negative remodeling. As contributing factors the axial dose fall-off, inherent to all radioactive sources, and the application of vessel wall trauma by angioplasty have been identified. The combination of both factors, by insufficient overlap of the radiation length over the injured vessel segment, has been referred to as geographic miss. It has been shown to be associated with a very high incidence of the edge effect. Avoidance of geographic miss is strongly recommended in vascular brachytherapy procedures. Late thrombosis after vascular brachytherapy is of multifactorial origin. It comprises platelet recruitment, fibrin deposition, disturbed vasomotion, non-healing dissection and stent malapposition predisposing to turbulent blood flow. The strongest predictors for late thrombosis are premature discontinuation of antiplatelet therapy and implantation of new stents during the brachytherapy procedure. With a consequent and prolonged antiplatelet therapy, the incidence of late thrombosis has been reduced to placebo levels. Edge effect and late thrombosis represent unwanted side effects of vascular brachytherapy. By means of a thorough treatment planning and prolonged antiplatelet therapy their incidences can be largely reduced. With regard to the very favorable net effect, they do not constitute relevant limitations of vascular brachytherapy.

  2. Review of advanced catheter technologies in radiation oncology brachytherapy procedures

    OpenAIRE

    Zhou J.; Zamdborg L; Sebastian E

    2015-01-01

    Jun Zhou,1,2 Leonid Zamdborg,1 Evelyn Sebastian1 1Department of Radiation Oncology, Beaumont Health System, 2Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Abstract: The development of new catheter and applicator technologies in recent years has significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. In this paper, we review these advances, focusing on the performance of catheter imaging and reconstruction techniques in brachytherapy ...

  3. Use of novel thermobrachytherapy seeds for realistic prostate seed implant treatments.

    Science.gov (United States)

    Warrell, Gregory; Shvydka, Diana; Parsai, E Ishmael

    2016-11-01

    A practical means of delivering both therapeutic radiation and hyperthermia to a deep-seated target has been identified in the literature as highly desirable, provided it is capable of generating sufficient temperatures over the defined target volume. The authors present continued development of a dual-modality thermobrachytherapy (TB) seed, investigating its capabilities in delivering prescribed hyperthermia to realistic deep-seated targets. The TB seed is based on the ubiquitous low dose-rate (LDR) brachytherapy permanent implant. Heat is generated by incorporating a ferromagnetic core within the seed and placing the patient in an oscillating external magnetic field, producing eddy currents within the core and hence Joule heating. A strategically selected Curie temperature results in thermal self-regulation. The magnetic and thermal properties of the TB seed were studied experimentally by means of seed prototypes placed in a tissue-mimicking phantom and heated with an industrial induction heater, as well as computationally in the finite element analysis solver COMSOL Multiphysics. Patient-specific seed distributions derived from LDR permanent prostate implants previously conducted at their institution were modeled in COMSOL to evaluate their ability to adequately cover a defined target volume and to overcome the loss of heat due to blood perfusion within tissue. The calculated temperature distributions were analyzed by generating temperature-volume histograms, which were used to quantify coverage and temperature homogeneity for varied blood perfusion rates, seed Curie temperatures, and thermal power production rates. Use of additional hyperthermia-only (HT-only) seeds in unused spots within the implantation needles was investigated, as was an increase in these seeds' core size to increase their power. The impact of the interseed attenuation and scatter (ISA) effect on radiation dose distributions of this seed was also quantified by Monte Carlo studies in the

  4. Brachytherapy optimization using radiobiological-based planning for high dose rate and permanent implants for prostate cancer treatment

    Science.gov (United States)

    Seeley, Kaelyn; Cunha, J. Adam; Hong, Tae Min

    2017-01-01

    We discuss an improvement in brachytherapy--a prostate cancer treatment method that directly places radioactive seeds inside target cancerous regions--by optimizing the current standard for delivering dose. Currently, the seeds' spatiotemporal placement is determined by optimizing the dose based on a set of physical, user-defined constraints. One particular approach is the ``inverse planning'' algorithms that allow for tightly fit isodose lines around the target volumes in order to reduce dose to the patient's organs at risk. However, these dose distributions are typically computed assuming the same biological response to radiation for different types of tissues. In our work, we consider radiobiological parameters to account for the differences in the individual sensitivities and responses to radiation for tissues surrounding the target. Among the benefits are a more accurate toxicity rate and more coverage to target regions for planning high-dose-rate treatments as well as permanent implants.

  5. Intraluminal brachytherapy in the treatment of bile duct carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Leung, J.T. [Adelaide Radiotherapy Centre, Adelaide, SA (Australia); Kuan, R. [Sir Charles Gairdner Hospital, Nedlands, Perth, WA (Australia)

    1997-05-01

    Patients with carcinoma of the biliary tract have a poor prognosis because the disease is often unresectable at diagnosis. Intraluminal brachytherapy has been reported as an effective treatment for localized cholangiocarcinoma of the biliary tract. The purpose of our study was to analyse the survival of patients treated with brachytherapy and make some recommendations regarding its use. Fifteen patients underwent brachytherapy via a trans-hepatic approach at the Royal Prince Alfred Hospital from 1983 to 1993. Eleven patients had low-dose rate brachytherapy and four patients had high-dose rate treatment. There were nine males and six females. The median age was 64 years. Other treatment included bypass procedures in two patients, endoscopic stents in 14 patients and external beam irradiation in one patient. The median survival was 12.5 months and 47% of the patients survived 1 year. The only complication reported was cholangitis which was seen in one patient. There did not seem to be any difference in survival or complications between low- and high-dose rate brachytherapy. It is concluded that the addition of intraluminal brachytherapy after biliary drainage prolongs survival and is a safe and effective treatment, but patients still have a high rate of local failure, and further studies will be needed to address this problem. (authors). 28 refs., 3 figs.

  6. Electronic brachytherapy management of atypical fibroxanthoma: report of 8 lesions

    Directory of Open Access Journals (Sweden)

    Stephen Doggett

    2017-01-01

    Full Text Available Purpose : To evaluate the suitability of treating atypical fibroxanthoma (AFX, an uncommon skin malignancy, with electronic brachytherapy. Material and methods : From Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent®, Fremont, California. All lesions received 40 Gy in two fractions per week with 5mm margins. Results : At a median follow-up of 23.7 months, the local recurrence rate is 12.5%. The single lesion that failed was not debulked surgically prior to electronic brachytherapy. Conclusions : To our knowledge, this is the first report in the literature on the use of radiation therapy as curative primary treatment for AFX. No contraindication to the use of radiations is found in the literature, with surgery being the sole treatment for AFX noted. Our recurrence rate is 0% for debulked lesions. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for debulked AFX. Multiple excisions, skin grafting, and wound care can be avoided in elderly patients by the use of electronic brachytherapy.

  7. Dose calculation formalisms and consensus dosimetry parameters for intravascular brachytherapy dosimetry: recommendations of the AAPM Therapy Physics Committee Task Group No. 149.

    Science.gov (United States)

    Chiu-Tsao, Sou-Tung; Schaart, Dennis R; Soares, Christopher G; Nath, Ravinder

    2007-11-01

    Since the publication of AAPM Task Group 60 report in 1999, a considerable amount of dosimetry data for the three coronary brachytherapy systems in use in the United States has been reported. A subgroup, Task Group 149, of the AAPM working group on Special Brachytherapy Modalities (Bruce Thomadsen, Chair) was charged to develop recommendations for dose calculation formalisms and the related consensus dosimetry parameters. The recommendations of this group are presented here. For the Cordis 192Ir and Novoste 90Sr/90Y systems, the original TG-43 formalism in spherical coordinates should be used along with the consensus values of the dose rate constant, geometry function, radial dose function, and anisotropy function for the single seeds. Contributions from the single seeds should be added linearly for the calculation of dose distributions from a source train. For the Guidant 32P wire system, the modified TG-43 formalism in cylindrical coordinates along with the recommended data for the 20 and 27 mm wires should be used. Data tables for the 6, 10, 14, 18, and 22 seed trains of the Cordis system, 30, 40, and 60 mm seed trains of the Novoste system, and the 20 and 27 mm wires of the Guidant system are presented along with our rationale and methodology for selecting the consensus data. Briefly, all available datasets were compared with each other and the consensus dataset was either an average of available data or the one obtained from the most densely populated study; in most cases this was a Monte Carlo calculation.

  8. 78 FR 41125 - Interim Enforcement Policy for Permanent Implant Brachytherapy Medical Event Reporting

    Science.gov (United States)

    2013-07-09

    ... COMMISSION Interim Enforcement Policy for Permanent Implant Brachytherapy Medical Event Reporting AGENCY... Commission (NRC) is issuing an interim Enforcement Policy that allows the staff to exercise enforcement...'s permanent implant brachytherapy program. This interim policy affects NRC licensees that...

  9. A review of the clinical experience in pulsed dose rate brachytherapy.

    Science.gov (United States)

    Balgobind, Brian V; Koedooder, Kees; Ordoñez Zúñiga, Diego; Dávila Fajardo, Raquel; Rasch, Coen R N; Pieters, Bradley R

    2015-01-01

    Pulsed dose rate (PDR) brachytherapy is a treatment modality that combines physical advantages of high dose rate (HDR) brachytherapy with the radiobiological advantages of low dose rate brachytherapy. The aim of this review was to describe the effective clinical use of PDR brachytherapy worldwide in different tumour locations. We found 66 articles reporting on clinical PDR brachytherapy including the treatment procedure and outcome. Moreover, PDR brachytherapy has been applied in almost all tumour sites for which brachytherapy is indicated and with good local control and low toxicity. The main advantage of PDR is, because of the small pulse sizes used, the ability to spare normal tissue. In certain cases, HDR resembles PDR brachytherapy by the use of multifractionated low-fraction dose.

  10. The investigation of prostatic calcifications using μ-PIXE analysis and their dosimetric effect in low dose rate brachytherapy treatments using Geant4

    Science.gov (United States)

    Pope, D. J.; Cutajar, D. L.; George, S. P.; Guatelli, S.; Bucci, J. A.; Enari, K. E.; Miller, S.; Siegele, R.; Rosenfeld, A. B.

    2015-06-01

    Low dose rate brachytherapy is a widely used modality for the treatment of prostate cancer. Most clinical treatment planning systems currently in use approximate all tissue to water, neglecting the existence of inhomogeneities, such as calcifications. The presence of prostatic calcifications may perturb the dose due to the higher photoelectric effect cross section in comparison to water. This study quantitatively evaluates the effect of prostatic calcifications on the dosimetric outcome of brachytherapy treatments by means of Monte Carlo simulations and its potential clinical consequences. Four pathological calcification samples were characterised with micro-particle induced x-ray emission (μ-PIXE) to determine their heavy elemental composition. Calcium, phosphorus and zinc were found to be the predominant heavy elements in the calcification composition. Four clinical patient brachytherapy treatments were modelled using Geant4 based Monte Carlo simulations, in terms of the distribution of brachytherapy seeds and calcifications in the prostate. Dose reductions were observed to be up to 30% locally to the calcification boundary, calcification size dependent. Single large calcifications and closely placed calculi caused local dose reductions of between 30-60%. Individual calculi smaller than 0.5 mm in diameter showed minimal dosimetric impact, however, the effects of small or diffuse calcifications within the prostatic tissue could not be determined using the methods employed in the study. The simulation study showed a varying reduction on common dosimetric parameters. D90 showed a reduction of 2-5%, regardless of calcification surface area and volume. The parameters V100, V150 and V200 were also reduced by as much as 3% and on average by 1%. These reductions were also found to relate to the surface area and volume of calcifications, which may have a significant dosimetric impact on brachytherapy treatment, however, such impacts depend strongly on specific factors

  11. CT-guided {sup 125}I brachytherapy for mediastinal metastatic lymph nodes recurrence from esophageal carcinoma: Effectiveness and safety in 16 patients

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Fei, E-mail: gaof@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Li, Chuanxing, E-mail: licx@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Gu, Yangkui, E-mail: guyk@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Huang, Jinhua, E-mail: huangjh@sysucc.org.cn [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China); Wu, Peihong, E-mail: vivian-link@163.com [State Key Laboratory of Oncology in South China, Guangzhou 510060 (China); Department of Interventional Radiology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060 (China)

    2013-02-15

    Objectives: To retrospectively evaluate effectiveness and safety of CT-guided {sup 125}I brachytherapy in 16 patients with mediastinal metastatic lymph nodes recurrence from esophageal carcinoma. Materials and methods: Sixteen metastatic lymph nodes in 16 patients were percutaneously treated in 19 {sup 125}I brachytherapy sessions. Each metastatic lymph node was treated with computed tomographic (CT) guidance. Follow-up contrast material-enhanced CT or positron emission tomographic (PET) scans were reviewed and the treatment's effectiveness was evaluated. Results: Months are counted from the first time of {sup 125}I brachytherapy and the median duration of follow-up was 11 months (range, 5–16 months). The local control rates after 3, 6, 10 and 15 months were 75.0, 50.0, 42.9 and 33.3% respectively. At the time of writing, four patients are alive without evidence of recurrence at 16, 9, 16 and 9 months. The 4 patients presented good control of local tumor and no systemic recurrence, and survived throughout the follow-up period. The other 12 patients died of multiple hematogenous metastases 5–15 months after brachytherapy. A small amount of local hematoma occurred in 2 patients that involved applicator insertion through the lung. Two patients presented pneumothorax with pulmonary compression of 30 and 40% after the procedure and recovered after drainage. One patient had minor displacement of radioactive seeds. Severe complications such as massive bleeding and radiation pneumonitis did not occur. Conclusion: {sup 125}I radioactive seed implantation is effective and may be safely applied to mediastinal metastatic lymph nodes recurrence from esophageal carcinoma.

  12. Study of the Dependence of the Source check ionization chamber with pressure; Estudio de la dependencia de la camara de ionizacion Sourcecheck con la presion

    Energy Technology Data Exchange (ETDEWEB)

    Tornero-Lopez, A. M.; Ruiz-Arrabola, S.; Moreno-Torres, M.; Simancas, F.; Guerrero, R.; Guirado, D.

    2013-07-01

    Because of the importance of accurate measurement of power low-energy photons, such as I-125 seeds used in brachytherapy, and the widespread use of Source Check in Europe, this work is to study whether this camera features any dependence the pressure and shows included in the pressure-temperature factor usual. (Author)

  13. Interstitial brachytherapy in carcinoma of the penis

    Energy Technology Data Exchange (ETDEWEB)

    Chaudhary, A.J.; Ghosh, S.; Bhalavat, R.L. [Tata Memorial Hospital, Mumbai (India). Dept. of Radiation Oncology; Kulkarni, J.N. [Tata Memorial Hospital, Mumbai (India). Dept. of Surgery; Sequeira, B.V.E. [Tata Memorial Hospital, Mumbai (India). Dept. of Medical Physics

    1999-01-01

    Aim: Keeping in line with the increasing emphasis on organ preservation, we at the Tata Memorial Hospital have evaluated the role of Ir-192 interstitial implant as regards local control, functional and cosmetic outcome in early as well as locally recurrent carcinoma of the distal penis. Patients and Methods: From October 1988 to December 1996, 23 patients with histopathologically proven cancer of the penis were treated with radical radiation therapy using Ir-192 temporary interstitial implant. Our patients were in the age group of 20 to 60 years. The primary lesions were T1 and 7, T2 in 7 and recurrent in 9 patients. Only 7 patients had palpable groin nodes at presentation, all of which were pathologically negative. The median dose of implant was 50 Gy (range 40 to 60 Gy), using the LDR afterloading system and the Paris system of implant rules for dosimetry. Follow-up ranged from 4 to 117 months (median 24 months). Results: At last follow-up 18 of the 23 patients remained locally controlled with implant alone. Three patients failed only locally, 2 locoregionally and 1 only at the groin. Of the 5 patients who failed locally, 4 were successfully salvaged with partial penectomy and remained controlled when last seen. Local control with implant alone at 8 years was 70% by life table analysis. The patients had excellent functional and cosmetic outcome. We did not record any case of skin or softtissue necrosis. Only 2 patients developed meatal stenosis, both of which were treated endoscopically. Conclusion: Our results lead us to interpret that interstitial brachytherapy with Ir-192 offers excellent local control rates with preservation of organ and function. Penectomy can be reserved as a means for effective salvage. (orig.) [Deutsch] Ziel: Das Prinzip des Organerhalts gewinnt in der Onkologie zunehmend an Bedeutung. Ziel dieser Untersuchung war es, die Rolle der interstitiellen Brachytherapie mit Ir-192 zur Behandlung des fruehen und rezidivierten Peniskarzinoms zu

  14. Paddle-based rotating-shield brachytherapy

    Science.gov (United States)

    Liu, Yunlong; Flynn, Ryan T.; Kim, Yusung; Dadkhah, Hossein; Bhatia, Sudershan K.; Buatti, John M.; Xu, Weiyu; Wu, Xiaodong

    2015-01-01

    Purpose: The authors present a novel paddle-based rotating-shield brachytherapy (P-RSBT) method, whose radiation-attenuating shields are formed with a multileaf collimator (MLC), consisting of retractable paddles, to achieve intensity modulation in high-dose-rate brachytherapy. Methods: Five cervical cancer patients using an intrauterine tandem applicator were considered to assess the potential benefit of the P-RSBT method. The P-RSBT source used was a 50 kV electronic brachytherapy source (Xoft Axxent™). The paddles can be retracted independently to form multiple emission windows around the source for radiation delivery. The MLC was assumed to be rotatable. P-RSBT treatment plans were generated using the asymmetric dose–volume optimization with smoothness control method [Liu et al., Med. Phys. 41(11), 111709 (11pp.) (2014)] with a delivery time constraint, different paddle sizes, and different rotation strides. The number of treatment fractions (fx) was assumed to be five. As brachytherapy is delivered as a boost for cervical cancer, the dose distribution for each case includes the dose from external beam radiotherapy as well, which is 45 Gy in 25 fx. The high-risk clinical target volume (HR-CTV) doses were escalated until the minimum dose to the hottest 2 cm3 (D2cm3) of either the rectum, sigmoid colon, or bladder reached their tolerance doses of 75, 75, and 90 Gy3, respectively, expressed as equivalent doses in 2 Gy fractions (EQD2 with α/β = 3 Gy). Results: P-RSBT outperformed the two other RSBT delivery techniques, single-shield RSBT (S-RSBT) and dynamic-shield RSBT (D-RSBT), with a properly selected paddle size. If the paddle size was angled at 60°, the average D90 increases for the delivery plans by P-RSBT on the five cases, compared to S-RSBT, were 2.2, 8.3, 12.6, 11.9, and 9.1 Gy10, respectively, with delivery times of 10, 15, 20, 25, and 30 min/fx. The increases in HR-CTV D90, compared to D-RSBT, were 16.6, 12.9, 7.2, 3.7, and 1.7 Gy10

  15. Paddle-based rotating-shield brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yunlong; Xu, Weiyu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 (United States); Flynn, Ryan T.; Kim, Yusung; Bhatia, Sudershan K.; Buatti, John M. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, Iowa 52242 (United States); Wu, Xiaodong, E-mail: xiaodong-wu@uiowa.edu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 and Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2015-10-15

    Purpose: The authors present a novel paddle-based rotating-shield brachytherapy (P-RSBT) method, whose radiation-attenuating shields are formed with a multileaf collimator (MLC), consisting of retractable paddles, to achieve intensity modulation in high-dose-rate brachytherapy. Methods: Five cervical cancer patients using an intrauterine tandem applicator were considered to assess the potential benefit of the P-RSBT method. The P-RSBT source used was a 50 kV electronic brachytherapy source (Xoft Axxent™). The paddles can be retracted independently to form multiple emission windows around the source for radiation delivery. The MLC was assumed to be rotatable. P-RSBT treatment plans were generated using the asymmetric dose–volume optimization with smoothness control method [Liu et al., Med. Phys. 41(11), 111709 (11pp.) (2014)] with a delivery time constraint, different paddle sizes, and different rotation strides. The number of treatment fractions (fx) was assumed to be five. As brachytherapy is delivered as a boost for cervical cancer, the dose distribution for each case includes the dose from external beam radiotherapy as well, which is 45 Gy in 25 fx. The high-risk clinical target volume (HR-CTV) doses were escalated until the minimum dose to the hottest 2 cm{sup 3} (D{sub 2cm{sup 3}}) of either the rectum, sigmoid colon, or bladder reached their tolerance doses of 75, 75, and 90 Gy{sub 3}, respectively, expressed as equivalent doses in 2 Gy fractions (EQD2 with α/β = 3 Gy). Results: P-RSBT outperformed the two other RSBT delivery techniques, single-shield RSBT (S-RSBT) and dynamic-shield RSBT (D-RSBT), with a properly selected paddle size. If the paddle size was angled at 60°, the average D{sub 90} increases for the delivery plans by P-RSBT on the five cases, compared to S-RSBT, were 2.2, 8.3, 12.6, 11.9, and 9.1 Gy{sub 10}, respectively, with delivery times of 10, 15, 20, 25, and 30 min/fx. The increases in HR-CTV D{sub 90}, compared to D-RSBT, were 16

  16. Outpatient template-guided permanent interstitial brachytherapy using (131)Cs in gynecologic malignancies: Initial report.

    Science.gov (United States)

    Feddock, Jonathan; Aryal, Prakash; Steber, Cole; Edwards, Jason; Cheek, Dennis; Randall, Marcus

    Optimal curative intent brachytherapy for certain gynecologic cancers requires interstitial brachytherapy, often using template-guided techniques such as a Syed-Neblett implant. Whether high or low dose rate (LDR), these procedures pose significant risks to patients, partly attributable to the prolonged period of bed rest. Published results of free-handed permanent interstitial brachytherapy (PIB) with (131)Cs demonstrate it to be an effective modality for the management of small volume gynecologic cancers. This report is the first to describe a permanent template-guided interstitial technique using (131)Cs for gynecologic cancers, performed as an LDR outpatient procedure. Five sequential patients with recurrent or primary gynecologic malignancies underwent template-guided PIB using (131)Cs. A posttreatment planning CT was obtained immediately after the procedure and again 3-4 weeks later. Both CT data sets were fused and the relative positions compared to assess for migration in the x, y, and z planes. Seed positions as well as dosimetric parameters including D90, D100, V100, and the dose to 2 cc of rectum and bladder were compared to quantify migration of sources and the resulting effect, if any, on the treatment. The median age was 69 years (range 64-85). All patients received a template-guided (131)Cs PIB implant to treat gross disease. All 5 patients had significant medical comorbidities that limited treatment options. Considering all 5 patients, a total of 40 interstitial needles were placed. Ten needles carried only Vicryl-stranded sources, and 30 needles carried a combination of stranded (131)Cs seeds and free seeds. Needle count was between 6 and 10 needles per patient, with active lengths of 4-10 cm. The median dose was 30 Gy (range 25-55 Gy) to permanent decay, enabling a cumulative median biological effective dose 91.5 Gy (range 60.9-92.1 Gy) and equivalent dose at 2 Gy per fraction 75.9 Gy (range 50.7-76.8 Gy). All implants were performed as

  17. Seed regulations and local seed systems

    NARCIS (Netherlands)

    Louwaars, N.

    2000-01-01

    Seed regulations have been introduced in most countries based on the development of formal seed production. Concerns about seed quality and about the varietal identity of the seeds have commonly led to seed laws. However, formal regulations are often inappropriate for informal seed systems, which

  18. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  19. Vaginal brachytherapy for postoperative endometrial cancer: 2014 Survey of the American Brachytherapy Society.

    Science.gov (United States)

    Harkenrider, Matthew M; Grover, Surbhi; Erickson, Beth A; Viswanathan, Akila N; Small, Christina; Kliethermes, Stephanie; Small, William

    2016-01-01

    Report current practice patterns for postoperative endometrial cancer emphasizing vaginal brachytherapy (VBT). A 38-item survey was e-mailed to 1,598 American Brachytherapy Society (ABS) members and 4,329 US radiation oncologists in 2014 totaling 5,710 recipients. Responses of practitioners who had delivered VBT in the previous 12 months were included in the analysis. Responses were tabulated to determine relative frequency distributions. χ(2) analysis was used to compare current results with those from the 2003 ABS survey. A total of 331 respondents initiated the VBT survey, of whom 289 (87.3%) administered VBT in the prior 12 months. Lymph node dissection and number of nodes removed influenced treatment decisions for 90.5% and 69.8%, respectively. High-dose-rate was used by 96.2%. The most common vaginal length treated was 4 cm (31.0%). Three-dimensional planning was used by 83.2% with 73.4% of those for the first fraction only. Doses to normal tissues were reported by 79.8%. About half optimized to the location of dose specification and/or normal tissues. As monotherapy, the most common prescriptions were 7 Gy for three fractions to 0.5-cm depth and 6 Gy for five fractions to the surface. As a boost, the most common prescriptions were 5 Gy for three fractions to 0.5-cm depth and 6 Gy for three fractions to the vaginal surface. Optimization points were placed at the apex and lateral vagina by 73.1%. Secondary quality assurance checks were performed by 98.9%. VBT is a common adjuvant therapy for endometrial cancer patients, most commonly with HDR. Fractionation and planning processes are variable but generally align with ABS recommendations. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  20. Reliability of EUCLIDIAN: an autonomous robotic system for image-guided prostate brachytherapy.

    Science.gov (United States)

    Podder, Tarun K; Buzurovic, Ivan; Huang, Ke; Showalter, Timothy; Dicker, Adam P; Yu, Yan

    2011-01-01

    Recently, several robotic systems have been developed to perform accurate and consistent image-guided brachytherapy. Before introducing a new device into clinical operations, it is important to assess the reliability and mean time before failure (MTBF) of the system. In this article, the authors present the preclinical evaluation and analysis of the reliability and MTBF of an autonomous robotic system, which is developed for prostate seed implantation. The authors have considered three steps that are important in reliability growth analysis. These steps are: Identification and isolation of failures, classification of failures, and trend analysis. For any one-of-a-kind product, the reliability enhancement is accomplished through test-fix-test. The authors have used failure mode and effect analysis for collection and analysis of reliability data by identifying and categorizing the failure modes. Failures were classified according to severity. Failures that occurred during the operation of this robotic system were considered as nonhomogenous Poisson process. The failure occurrence trend was analyzed using Laplace test. For analyzing and predicting reliability growth, commonly used and widely accepted models, Duane's model and the Army Material Systems Analysis Activity, i.e., Crow's model, were applied. The MTBF was used as an important measure for assessing the system's reliability. During preclinical testing, 3196 seeds (in 53 test cases) were deposited autonomously by the robot and 14 critical failures were encountered. The majority of the failures occurred during the first few cases. The distribution of failures followed Duane's postulation as well as Crow's postulation of reliability growth. The Laplace test index was -3.82 (robotic system. At 95% confidence, the reliability for deposition of 65 seeds was more than 90%. Analyses of failure mode strongly indicated a gradual improvement of reliability of this autonomous robotic system. High MTBF implied that

  1. Seed planting

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes prairie seed plantings on Neal Smith National Wildlife Refuge (formerly Walnut Creek National Wildlife Refuge) between 1992 and 2009.

  2. Model-based dose calculations for {sup 125}I lung brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, J. G. H.; Furutani, K. M.; Garces, Y. I.; Thomson, R. M. [Carleton Laboratory for Radiotherapy Physics, Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada); Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905 (United States); Carleton Laboratory for Radiotherapy Physics, Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada)

    2012-07-15

    Purpose: Model-baseddose calculations (MBDCs) are performed using patient computed tomography (CT) data for patients treated with intraoperative {sup 125}I lung brachytherapy at the Mayo Clinic Rochester. Various metallic artifact correction and tissue assignment schemes are considered and their effects on dose distributions are studied. Dose distributions are compared to those calculated under TG-43 assumptions. Methods: Dose distributions for six patients are calculated using phantoms derived from patient CT data and the EGSnrc user-code BrachyDose. {sup 125}I (GE Healthcare/Oncura model 6711) seeds are fully modeled. Four metallic artifact correction schemes are applied to the CT data phantoms: (1) no correction, (2) a filtered back-projection on a modified virtual sinogram, (3) the reassignment of CT numbers above a threshold in the vicinity of the seeds, and (4) a combination of (2) and (3). Tissue assignment is based on voxel CT number and mass density is assigned using a CT number to mass density calibration. Three tissue assignment schemes with varying levels of detail (20, 11, and 5 tissues) are applied to metallic artifact corrected phantoms. Simulations are also performed under TG-43 assumptions, i.e., seeds in homogeneous water with no interseed attenuation. Results: Significant dose differences (up to 40% for D{sub 90}) are observed between uncorrected and metallic artifact corrected phantoms. For phantoms created with metallic artifact correction schemes (3) and (4), dose volume metrics are generally in good agreement (less than 2% differences for all patients) although there are significant local dose differences. The application of the three tissue assignment schemes results in differences of up to 8% for D{sub 90}; these differences vary between patients. Significant dose differences are seen between fully modeled and TG-43 calculations with TG-43 underestimating the dose (up to 36% in D{sub 90}) for larger volumes containing higher proportions of

  3. 125 I粒子植入治疗难治性体表恶性肿瘤的局部疗效及临床意义--附105例报告%Local Effects and Clinical Significance of Radioactive 125 I Seed Brachytherapy for Superficial Refractory Neoplasm:a Report of 105 Cases

    Institute of Scientific and Technical Information of China (English)

    雷光焰; 杨得振; 吕卫东; 付改发; 宋养荣; 张曦; 高巍; 刘佳; 刘志刚

    2014-01-01

    Objective To investigate the local efficacy as well as the complications of percutaneous radioactive 125 I seed implantation in the treatment of superficial refractory neoplasm. Methods A total of 105 patients ( 123 lesions ) diagnosed as having superficial refractory neoplasm from April 2003 to April 2013 was retrospectively collected. All patients were treated with percutaneous radioactive 125I seed implantation.Follow-up observations were conducted monthly or bi-monthly by CT scanning. Results The average number of implanted seed was 13.6 in the 105 patients.The local curative effects was as follows: CR 17.1%(21/123), PR 73.9%(91/123), NC 8.9%(11/123).The total effective rate (CR+PR) was 91.1% (112/123).The rate of relief from local pain was 88.8%(87/98).The rate of relief from pressure symptom was 85.7%(18/21).The complication rate was 16.2%(17/105), including bleeding of needle path in 9 cases, tumor rupture in 4 cases, radioactive dermatitis in 2 cases, nerve injury in 1 case, and seed displacement in 1 case. Conclusion Percutaneous radioactive 125 I seed implantation can significantly relieve the local symptoms, being a feasible, safe, and effective method for treating superficial refractory neoplasm.%目的:探讨经皮穿刺放射性125 I粒子植入治疗体表难治性恶性肿瘤的局部疗效和副作用。方法2003年4月~2013年4月对105例(共123个部位)因体表难治性恶性肿瘤出现疼痛及肿瘤压迫等症状行经皮穿刺放射性粒子植入治疗,每1~2个月 CT 复查1次。结果105例共123个部位平均每个部位植入粒子13.6颗。局部疗效:CR 17.1%(21/123),PR 73.9%(91/123),NC 8.9%(11/123),总有效率(CR+PR)91.1%(112/123)。局部疼痛缓解有效率88.8%(87/98),肿瘤压迫症状缓解率85.7%(18/21)。并发症发生率16.2%(17/105):穿刺针道出血9例,治疗后肿瘤破溃4例,放射性皮炎2

  4. Interstitial microwave-induced hyperthermia and iridium brachytherapy for the treatment of obstructing biliary carcinomas.

    Science.gov (United States)

    Coughlin, C T; Wong, T Z; Ryan, T P; Jones, E L; Crichlow, R W; Spiegel, P K; Jeffery, R

    1992-01-01

    In a phase I clinical study, 10 patients with obstructive biliary carcinomas were treated with single-antenna interstitial microwave hyperthermia and iridium-192 brachytherapy. For each patient a standard biliary drainage catheter was implanted percutaneously through the obstructed common bile duct. This catheter accommodated a single microwave antenna which operated at 915 MHz, and one or two fibreoptic thermometry probes for temperature measurement. Under fluoroscopic guidance the microwave antenna and temperature probes were positioned in the CT-determined tumour mass. The 60-min heat treatment achieved a central tumour temperature of 45-55 degrees C while keeping temperatures at the proximal and distal margins at 43 degrees C. Immediately following the hyperthermia treatment the microwave antenna and temperature probes were removed, and a single strand of iridium-192 double-strength seeds was inserted to irradiate the tumour length. A dose of 5500-7900 cGy calculated at 0.5 cm radially from the catheter was administered over 5-7 days. Upon removal of the iridium a second hyperthermia treatment was performed. A total of 18 hyperthermia treatments were administered to the 10 patients. In two cases the second hyperthermia treatment after brachytherapy was not possible due to a kink in the catheter, or bile precipitation in the catheter. All patients tolerated the procedure well, and there were no acute complications. To evaluate the volumetric heating potential of this hyperthermia method, specific absorption rate (SAR) values were measured at 182 planar points in muscle phantom. Insulated and non-insulated antenna performance was tested at 915 MHz in a biliary catheter filled with air, saline, or bile to mimic clinical treatments. The insulated antenna exhibited the best performance. Differences between antenna performance in saline and bile were also noted. In summary, this technique may have potential for tumours which obstruct biliary drainage and are

  5. Comparison between methods for fixing radioactive iodine in silver substrate for manufacturing brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    Peleias Junior, Fernando S.; Zeituni, Carlos A.; Rostelato, Maria Elisa C.M., E-mail: fernandopeleias@gmail.com, E-mail: czeituni@ipen.br, E-mail: elisaros@ipen.br; and others

    2013-07-01

    Cancer is a term used generically to represent a group of more than 100 illnesses, including malignant tumors from different locations. According to World Health Organization (WHO), is a leading cause of death worldwide, accounted for 7.6 million deaths. Prostate cancer is the sixth most common type in the world, representing about 10% of all cases of cancer and its treatment may be by surgery, radiotherapy or even vigilant observation. A method of radiotherapy which has been extensively used in the early and intermediate stages of the illness is brachytherapy, where radioactive seeds are placed inside or next to the area requiring treatment, which reduces the probability of unnecessary damage to surrounding healthy tissues. Currently, the radioactive isotope Iodine-125, adsorbed on silver substrate, is one of the most used in prostate brachytherapy. The present study compares several deposition methods of radioactive Iodine on silver substrate, in order to choose the most suitable one to be implemented at the laboratory of radioactive sources production of IPEN. The methodology used was chosen based on the available infrastructure and experience of the researchers of the institute. Therefore, Iodine-131 was used for testing (same chemical behavior of Iodine -125). Three methods were selected: method 1 (test based on electrodeposition method, developed by David Kubiatowicz) which presented efficiency of 65.16% ; method 2 (chemical reaction based on the method developed by David Kubiatowicz -HCl) which presented efficiency of 70.80%; method 3 (chemical reaction based on the method developed by Dr. Maria Elisa Rostelato) which presented efficiency of 55.80% . Based on the results, the second method is the suggested one to be implemented at the laboratory of radioactive sources production of IPEN. (author)

  6. Irradiation and dosimetry of Nitinol stent for renal artery brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Arbabi, Azim [Science and Research Campus, Islamic Azad University, P.O. Box 14515-775, Tehran (Iran, Islamic Republic of); Shahid Beheshti Medical University, P.O. Box 14335-1419, Tehran (Iran, Islamic Republic of); Sadeghi, Mahdi [Science and Research Campus, Islamic Azad University, P.O. Box 14515-775, Tehran (Iran, Islamic Republic of); Nuclear Medicine Research Group, Agricultural, Medical and Industrial Research School, P.O. Box 31485-498, Karaj (Iran, Islamic Republic of)], E-mail: msadeghi@nrcam.org; Joharifard, Mahdi [Science and Research Campus, Islamic Azad University, P.O. Box 14515-775, Tehran (Iran, Islamic Republic of)

    2009-01-15

    This study was conducted to assess the suitability of {sup 48}V radioactive stent for use in renal artery brachytherapy. A nickel-titanium alloy Nitinol stent was irradiated over the proton energy range of up to 8.5 MeV, to obtain {sup 48}V. The depth dose distribution analysis of the activated stent was done with TLD-700GR in a Perspex phantom. We investigated a unique mixed gamma/beta brachytherapy source of {sup 48}V. For a 10 mm outer-diameter {sup 48}V stent, the average measured dose rate to vessel was 37 mGy/h. The dosimetry results of the {sup 48}V stent suggest that the stent is suitable for use in renal artery brachytherapy.

  7. Fast dose optimization for rotating shield brachytherapy.

    Science.gov (United States)

    Cho, Myung; Wu, Xiaodong; Dadkhah, Hossein; Yi, Jirong; Flynn, Ryan T; Kim, Yusung; Xu, Weiyu

    2017-07-26

    To provide a fast computational method, based on the proximal graph solver (POGS) - a convex optimization solver using the alternating direction method of multipliers (ADMM), for calculating an optimal treatment plan in rotating shield brachytherapy (RSBT). RSBT treatment planning has more degrees of freedom than conventional high-dose-rate brachytherapy due to the addition of emission direction, and this necessitates a fast optimization technique to enable clinical usage. The multi-helix RSBT (H-RSBT) delivery technique(1) was investigated for five representative cervical cancer patients. Treatment plans were generated for all patients using the POGS method and the commercially available solver IBM ILOG CPLEX(2) . The rectum, bladder, sigmoid colon, high-risk clinical target volume (HRCTV), and HR-CTV boundary were the structures included in our optimization, which applied an asymmetric dose-volume optimization with smoothness control. Dose calculation resolution was 1X1X3 mm(3) for all cases. The H-RSBT applicator had 6 helices, with 33:3 mm of translation along the applicator per helical rotation and 1:7 mm spacing between dwell positions, yielding 17.5° emission angle spacing per 5 mm along the applicator. For each patient, HR-CTV D90, HR-CTV D100, rectum D2cc, sigmoid D2cc, and bladder D2cc matched within 1% for CPLEX and POGS methods. Also, similar EQD2 values between CPLEX and POGS methods were obtained. POGS was around 18 times faster than CPLEX. Over all patients, total optimization times were 32.1-65.4 seconds for CPLEX and 2.1-3.9 seconds for POGS. POGS reduced treatment plan optimization time approximately 18 times for RSBT with similar HR-CTV D90, organ at risk (OAR) D2cc values, and EQD2 values compared to CPLEX, which is significant progress toward clinical translation of RSBT. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Interstitial rotating shield brachytherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Quentin E., E-mail: quentin-adams@uiowa.edu; Xu, Jinghzu; Breitbach, Elizabeth K.; Li, Xing; Rockey, William R.; Kim, Yusung; Wu, Xiaodong; Flynn, Ryan T. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Enger, Shirin A. [Medical Physics Unit, McGill University, 1650 Cedar Ave, Montreal, Quebec H3G 1A4 (Canada)

    2014-05-15

    Purpose: To present a novel needle, catheter, and radiation source system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate. I-RSBT is a promising technique for reducing urethra, rectum, and bladder dose relative to conventional interstitial high-dose-rate brachytherapy (HDR-BT). Methods: A wire-mounted 62 GBq{sup 153}Gd source is proposed with an encapsulated diameter of 0.59 mm, active diameter of 0.44 mm, and active length of 10 mm. A concept model I-RSBT needle/catheter pair was constructed using concentric 50 and 75 μm thick nickel-titanium alloy (nitinol) tubes. The needle is 16-gauge (1.651 mm) in outer diameter and the catheter contains a 535 μm thick platinum shield. I-RSBT and conventional HDR-BT treatment plans for a prostate cancer patient were generated based on Monte Carlo dose calculations. In order to minimize urethral dose, urethral dose gradient volumes within 0–5 mm of the urethra surface were allowed to receive doses less than the prescribed dose of 100%. Results: The platinum shield reduced the dose rate on the shielded side of the source at 1 cm off-axis to 6.4% of the dose rate on the unshielded side. For the case considered, for the same minimum dose to the hottest 98% of the clinical target volume (D{sub 98%}), I-RSBT reduced urethral D{sub 0.1cc} below that of conventional HDR-BT by 29%, 33%, 38%, and 44% for urethral dose gradient volumes within 0, 1, 3, and 5 mm of the urethra surface, respectively. Percentages are expressed relative to the prescription dose of 100%. For the case considered, for the same urethral dose gradient volumes, rectum D{sub 1cc} was reduced by 7%, 6%, 6%, and 6%, respectively, and bladder D{sub 1cc} was reduced by 4%, 5%, 5%, and 6%, respectively. Treatment time to deliver 20 Gy with I-RSBT was 154 min with ten 62 GBq {sup 153}Gd sources. Conclusions: For the case considered, the proposed{sup 153}Gd-based I-RSBT system has the potential to lower the urethral dose relative to HDR-BT by 29

  9. Developing a Verification and Training Phantom for Gynecological Brachytherapy System

    Directory of Open Access Journals (Sweden)

    Mahbobeh Nazarnejad

    2012-03-01

    Full Text Available Introduction Dosimetric accuracy is a major issue in the quality assurance (QA program for treatment planning systems (TPS. An important contribution to this process has been a proper dosimetry method to guarantee the accuracy of delivered dose to the tumor. In brachytherapy (BT of gynecological (Gyn cancer it is usual to insert a combination of tandem and ovoid applicators with a complicated geometry which makes their dosimetry verification difficult and important. Therefore, evaluation and verification of dose distribution is necessary for accurate dose delivery to the patients. Materials and Methods The solid phantom was made from Perspex slabs as a tool for intracavitary brachytherapy dosimetric QA. Film dosimetry (EDR2 was done for a combination of ovoid and tandem applicators introduced by Flexitron brachytherapy system. Treatment planning was also done with Flexiplan 3D-TPS to irradiate films sandwiched between phantom slabs. Isodose curves obtained from treatment planning system and the films were compared with each other in 2D and 3D manners. Results The brachytherapy solid phantom was constructed with slabs. It was possible to insert tandems and ovoids loaded with radioactive source of Ir-192 subsequently. Relative error was 3-8.6% and average relative error was 5.08% in comparison with the films and TPS isodose curves. Conclusion Our results showed that the difference between TPS and the measurements is well within the acceptable boundaries and below the action level according to AAPM TG.45. Our findings showed that this phantom after minor corrections can be used as a method of choice for inter-comparison analysis of TPS and to fill the existing gap for accurate QA program in intracavitary brachytherapy. The constructed phantom also showed that it can be a valuable tool for verification of accurate dose delivery to the patients as well as training for brachytherapy residents and physics students.

  10. Novel Silicone-Coated 125I Seeds for the Treatment of Extrahepatic Cholangiocarcinoma.

    Science.gov (United States)

    Lin, Lizhou; Guo, Lili; Zhang, Weixing; Cai, Xiaobo; Chen, Dafan; Wan, Xinjian

    2016-01-01

    125I seeds coated with titanium are considered a safe and effective interstitial brachytherapy for tumors, while the cost of 125I seeds is a major problem for the patients implanting lots of seeds. The aim of this paper was to develop a novel silicone coating for 125I seeds with a lower cost. In order to show the radionuclide utilization ratio, the silicone was coated onto the seeds using the electro-spinning method and the radioactivity was evaluated, then the anti-tumor efficacy of silicone 125I seeds was compared with titanium 125I seeds. The seeds were divided into four groups: A (control), B (pure silicone), C (silicone 125I), D (titanium 125I) at 2 Gy or 4 Gy. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human extrahepatic cholangiocarcinoma cell line FRH-0201 and tumor-bearing BALB/c nude mice. The silicone 125I seeds showed higher radioactivity; the rate of cell apoptosis in vitro and the histopathology in vivo demonstrated that the silicone 125I seeds shared similar anti-tumor efficacy with the titanium 125I seeds for the treatment of extrahepatic cholangiocarcinoma, while they have a much lower cost.

  11. Imaging method for monitoring delivery of high dose rate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Weisenberger, Andrew G; Majewski, Stanislaw

    2012-10-23

    A method for in-situ monitoring both the balloon/cavity and the radioactive source in brachytherapy treatment utilizing using at least one pair of miniature gamma cameras to acquire separate images of: 1) the radioactive source as it is moved in the tumor volume during brachytherapy; and 2) a relatively low intensity radiation source produced by either an injected radiopharmaceutical rendering cancerous tissue visible or from a radioactive solution filling a balloon surgically implanted into the cavity formed by the surgical resection of a tumor.

  12. Current state of the art brachytherapy treatment planning dosimetry algorithms.

    Science.gov (United States)

    Papagiannis, P; Pantelis, E; Karaiskos, P

    2014-09-01

    Following literature contributions delineating the deficiencies introduced by the approximations of conventional brachytherapy dosimetry, different model-based dosimetry algorithms have been incorporated into commercial systems for (192)Ir brachytherapy treatment planning. The calculation settings of these algorithms are pre-configured according to criteria established by their developers for optimizing computation speed vs accuracy. Their clinical use is hence straightforward. A basic understanding of these algorithms and their limitations is essential, however, for commissioning; detecting differences from conventional algorithms; explaining their origin; assessing their impact; and maintaining global uniformity of clinical practice.

  13. Uncertainty analysis in MCNP5 calculations for brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Gerardy, I., E-mail: gerardy@isib.be [Institut Superieur Industriel de Bruxelles, 150, Rue Royale, B-1000 Brussels (Belgium); Rodenas, J.; Gallardo, S. [Departamento de Ingenieria Quimica y Nuclear, Universidad Politecnica de Valencia (Spain)

    2011-08-15

    The Monte Carlo (MC) method can be applied to simulate brachytherapy treatment planning. The MCNP5 code gives, together with results, a statistical uncertainty associated with them. However, the latter is not the only existing uncertainty related to the simulation and other uncertainties must be taken into account. A complete analysis of all sources of uncertainty having some influence on results of the simulation of brachytherapy treatment is presented in this paper. This analysis has been based on the recommendations of the American Association for Physicist in Medicine (AAPM) and of the International Standard Organisation (ISO).

  14. Epimacular brachytherapy for wet AMD: current perspectives.

    Science.gov (United States)

    Casaroli-Marano, Ricardo P; Alforja, Socorro; Giralt, Joan; Farah, Michel E

    2014-01-01

    Age-related macular degeneration (AMD) is considered the most common cause of blindness in the over-60 age group in developed countries. There are basically two forms of presentation: geographic (dry or atrophic) and wet (neovascular or exudative). Geographic atrophy accounts for approximately 85%-90% of ophthalmic frames and leads to a progressive degeneration of the retinal pigment epithelium and the photoreceptors. Wet AMD causes the highest percentage of central vision loss secondary to disease. This neovascular form involves an angiogenic process in which newly formed choroidal vessels invade the macular area. Today, intravitreal anti-angiogenic drugs attempt to block the angiogenic events and represent a major advance in the treatment of wet AMD. Currently, combination therapy for wet AMD includes different forms of radiation delivery. Epimacular brachytherapy (EMBT) seems to be a useful approach to be associated with current anti-vascular endothelial growth factor agents, presenting an acceptable efficacy and safety profile. However, at the present stage of research, the results of the clinical trials carried out to date are insufficient to justify extending routine use of EMBT for the treatment of wet AMD.

  15. Collision-kerma conversion between dose-to-tissue and dose-to-water by photon energy-fluence corrections in low-energy brachytherapy

    Science.gov (United States)

    Giménez-Alventosa, Vicent; Antunes, Paula C. G.; Vijande, Javier; Ballester, Facundo; Pérez-Calatayud, José; Andreo, Pedro

    2017-01-01

    The AAPM TG-43 brachytherapy dosimetry formalism, introduced in 1995, has become a standard for brachytherapy dosimetry worldwide; it implicitly assumes that charged-particle equilibrium (CPE) exists for the determination of absorbed dose to water at different locations, except in the vicinity of the source capsule. Subsequent dosimetry developments, based on Monte Carlo calculations or analytical solutions of transport equations, do not rely on the CPE assumption and determine directly the dose to different tissues. At the time of relating dose to tissue and dose to water, or vice versa, it is usually assumed that the photon fluence in water and in tissues are practically identical, so that the absorbed dose in the two media can be related by their ratio of mass energy-absorption coefficients. In this work, an efficient way to correlate absorbed dose to water and absorbed dose to tissue in brachytherapy calculations at clinically relevant distances for low-energy photon emitting seeds is proposed. A correction is introduced that is based on the ratio of the water-to-tissue photon energy-fluences. State-of-the art Monte Carlo calculations are used to score photon fluence differential in energy in water and in various human tissues (muscle, adipose and bone), which in all cases include a realistic modelling of low-energy brachytherapy sources in order to benchmark the formalism proposed. The energy-fluence based corrections given in this work are able to correlate absorbed dose to tissue and absorbed dose to water with an accuracy better than 0.5% in the most critical cases (e.g. bone tissue).

  16. Reliability of EUCLIDIAN: An autonomous robotic system for image-guided prostate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Podder, Tarun K.; Buzurovic, Ivan; Huang Ke; Showalter, Timothy; Dicker, Adam P.; Yu, Yan [Department of Radiation Oncology, Kimmel Cancer Center (NCI-designated), Thomas Jefferson University, Philadelphia, Pennsylvania 19107 (United States)

    2011-01-15

    Purpose: Recently, several robotic systems have been developed to perform accurate and consistent image-guided brachytherapy. Before introducing a new device into clinical operations, it is important to assess the reliability and mean time before failure (MTBF) of the system. In this article, the authors present the preclinical evaluation and analysis of the reliability and MTBF of an autonomous robotic system, which is developed for prostate seed implantation. Methods: The authors have considered three steps that are important in reliability growth analysis. These steps are: Identification and isolation of failures, classification of failures, and trend analysis. For any one-of-a-kind product, the reliability enhancement is accomplished through test-fix-test. The authors have used failure mode and effect analysis for collection and analysis of reliability data by identifying and categorizing the failure modes. Failures were classified according to severity. Failures that occurred during the operation of this robotic system were considered as nonhomogenous Poisson process. The failure occurrence trend was analyzed using Laplace test. For analyzing and predicting reliability growth, commonly used and widely accepted models, Duane's model and the Army Material Systems Analysis Activity, i.e., Crow's model, were applied. The MTBF was used as an important measure for assessing the system's reliability. Results: During preclinical testing, 3196 seeds (in 53 test cases) were deposited autonomously by the robot and 14 critical failures were encountered. The majority of the failures occurred during the first few cases. The distribution of failures followed Duane's postulation as well as Crow's postulation of reliability growth. The Laplace test index was -3.82 (<0), indicating a significant trend in failure data, and the failure intervals lengthened gradually. The continuous increase in the failure occurrence interval suggested a trend toward

  17. Transurethral ultrasound of the prostrate for applications in prostrate brachytherapy: analysis of phantom and in-vivo data

    Science.gov (United States)

    Holmes, David R., III; Davis, Brian J.; Bruce, Charles; Wilson, Torrence; Robb, Richard A.

    2001-05-01

    3D Trans-Urethral Ultrasound (TUUS) imaging is a new imaging technique for the diagnosis and treatment of prostate disease. Our current research focuses on the potential of TUUS in therapy guidance during tansperineal interstitial permanent prostate brachytherapy (TIPPB). TUUS may complement of potentially replace x-ray fluoroscopy and TRUS in providing data for determining the prostate boundary and radiation source locations. Prostate boundary detection and source localization using TUUS were tested on an ultrasound- equivalent prostate phantom and ina patient during TIPPB. Data collection was conducted with a 10 French, 10 MHz ultrasound catheter controlled by an Acuson SequoiaTM workstation. 2D and 3D TUUS scans were acquired after radioactive seeds were placed in the phantom and in the patient. Data was reconstructed, processed, and analyzed using Analyze software. Segmentation of the prostate boundary was performed semi-automatically, and seed segmentation was performed manually. Image artifacts in TUUS data resulted in incorrect reconstruction of the seeds. Intelligent processing of the seed data improved reconstruction. Comparison to the CT data suggests that TUUS dat provides: 1) greater spatial resolution, 2) greater temporal resolution and 3) better contrast for soft tissue differentiation. The reconstructed source sizes and locations were measured and found accurate. Placement of the TUUS catheter into the urethra provides excellent 2D sections which can be used to acquire volumetric data for 3D analysis of the prostate and radioactive sources. Preliminary results suggest that TUUS will be useful for guidance of seed placement, post-implant seed localization, and intra-operative dosimetry.

  18. In vivo dosimetry: trends and prospects for brachytherapy

    DEFF Research Database (Denmark)

    Kertzscher, Gustavo; Rosenfeld, A.; Beddar, S.

    2014-01-01

    The error types during brachytherapy (BT) treatments and their occurrence rates are not well known. The limited knowledge is partly attributed to the lack of independent verification systems of the treatment progression in the clinical workflow routine. Within the field of in vivo dosimetry (IVD)...

  19. Electromagnetic tracking for treatment verification in interstitial brachytherapy

    DEFF Research Database (Denmark)

    Bert, Christoph; Kellermeier, Markus; Tanderup, Kari

    2016-01-01

    Electromagnetic tracking (EMT) is used in several medical fields to determine the position and orientation of dedicated sensors, e.g., attached to surgical tools. Recently, EMT has been introduced to brachytherapy for implant reconstruction and error detection. The manuscript briefly summarizes...

  20. Electromagnetic tracking for treatment verification in interstitial brachytherapy

    DEFF Research Database (Denmark)

    Bert, Christoph; Kellermeier, Markus; Tanderup, Kari

    2016-01-01

    Electromagnetic tracking (EMT) is used in several medical fields to determine the position and orientation of dedicated sensors, e.g., attached to surgical tools. Recently, EMT has been introduced to brachytherapy for implant reconstruction and error detection. The manuscript briefly summarizes...

  1. Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES

    Energy Technology Data Exchange (ETDEWEB)

    Park, Su Gyong; Chang, Hye Sook; Choi, Eun Kyong; Yi, Byong Yong [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    1992-12-15

    Remote afterloading high dose rate brachytherapy(HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures performed at Asan Medical Center for 3 years. From Sep. 1985 to Aug 1992, 471 procedures of intracavitary radiation in 55 patients of cervical cancer and 26 of nasopharyngeal cancer, 79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range 1-31 months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, 80% achieves palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

  2. Assessment of effective dose to staff in brachytherapy.

    Science.gov (United States)

    Faulkner, K; James, H V; Chapple, C L; Rawlings, D J

    1996-11-01

    The aim of this paper is to investigate the problem of monitoring effective dose to hospital staff who are involved in the treatment of tumors using sealed sources placed inside the body (brachytherapy). In addition, the use of an unsealed source to treat the thyroid was also considered. Radiation distributions produced by both sealed sources commonly used in brachytherapy (192I, 137Cs, 226Ra) and an unsealed source used in the treatment of the thyroid (131I) were used to irradiate a Rando phantom. The brachytherapy treatments of esophageal and gynecological carcinoma were simulated. The Rando phantom was loaded with lithium fluoride thermoluminescent dosimeters at positions corresponding to a number of radiosensitive organs. Film badges and electronic personal dosimeters were attached to the Rando phantom at various anatomical sites. The Rando phantom was positioned adjacent to the patient at an angle of 90 degrees to the longitudinal axis of the patient. Irradiations were performed with and without a portable lead screen used on the radiotherapy wards. Effective dose was estimated for each simulated radiotherapy treatment and compared with the personal monitor readings. The data were used as a basis for the provision of advice on the wearing of the film badge dosimeters and the design of portable lead screens. The data also permitted a comparison between the two types of dosimeter when used for personal monitoring in brachytherapy.

  3. Verification of Oncentra brachytherapy planning using independent calculation

    Science.gov (United States)

    Safian, N. A. M.; Abdullah, N. H.; Abdullah, R.; Chiang, C. S.

    2016-03-01

    This study was done to investigate the verification technique of treatment plan quality assurance for brachytherapy. It is aimed to verify the point doses in 192Ir high dose rate (HDR) brachytherapy between Oncentra Masterplan brachytherapy treatment planning system and independent calculation software at a region of rectum, bladder and prescription points for both pair ovoids and full catheter set ups. The Oncentra TPS output text files were automatically loaded into the verification programme that has been developed based on spreadsheets. The output consists of source coordinates, desired calculation point coordinates and the dwell time of a patient plan. The source strength and reference dates were entered into the programme and then dose point calculations were independently performed. The programme shows its results in a comparison of its calculated point doses with the corresponding Oncentra TPS outcome. From the total of 40 clinical cases that consisted of two fractions for 20 patients, the results that were given in term of percentage difference, it shows an agreement between TPS and independent calculation are in the range of 2%. This programme only takes a few minutes to be used is preferably recommended to be implemented as the verification technique in clinical brachytherapy dosimetry.

  4. Initial application of digital tomosynthesis to improve brachytherapy treatment planning

    Science.gov (United States)

    Baydush, Alan H.; Mirzaei McKee, Mahta; King, June; Godfrey, Devon J.

    2007-03-01

    We present preliminary investigations that examine the feasibility of incorporating volumetric images generated using digital tomosynthesis into brachytherapy treatment planning. The Integrated Brachytherapy Unit (IBU) at our facility consists of an L-arm, C-arm isocentric motion system with an x-ray tube and fluoroscopic imager attached. Clinically, this unit is used to generate oblique, anterior-posterior, and lateral images for simple treatment planning and dose prescriptions. Oncologists would strongly prefer to have volumetric data to better determine three dimensional dose distributions (dose-volume histograms) to the target area and organs at risk. Moving the patient back and forth to CT causes undo stress on the patient, allows extensive motion of organs and treatment applicators, and adds additional time to patient treatment. We propose to use the IBU imaging system with digital tomosynthesis to generate volumetric patient data, which can be used for improving treatment planning and overall reducing treatment time. Initial image data sets will be acquired over a limited arc of a human-like phantom composed of real bones and tissue equivalent material. A brachytherapy applicator will be incorporated into one of the phantoms for visualization purposes. Digital tomosynthesis will be used to generate a volumetric image of this phantom setup. This volumetric image set will be visually inspected to determine the feasibility of future incorporation of these types of images into brachytherapy treatment planning. We conclude that initial images using the tomosynthesis reconstruction technique show much promise and bode well for future work.

  5. Stepping source prostate brachytherapy: From target definition to dose delivery

    NARCIS (Netherlands)

    Dinkla, A.M.

    2015-01-01

    Brachytherapy is an effective way to treat tumours locally and conformally, and is widely used in the treatment of prostate cancer. Prior to the treatment, a CT or MRI scan is acquired. The use of MRI led to a mean increase of 3% in dose coverage of the target volume (chapter 2). Although this seems

  6. Brachytherapy treatment planning algorithm applied to prostate cancer

    Science.gov (United States)

    Herrera-Rodríguez, M. R.; Martínez-Dávalos, A.

    2000-10-01

    An application of Genetic Algorithms (GAs) for treatment planning optimization in prostate brachytherapy is presented. The importance of multi-objective selection criteria based on the contour of the volume of interest and radiosensitive structures such as the rectum and urethra is discussed. First results are obtained for a simple test case which presents radial symmetry.

  7. Patient effective dose from endovascular brachytherapy with 192Ir sources.

    Science.gov (United States)

    Perma, L; Bianchi, C; Nicolini, G; Novario, R; Tanzi, F; Conte, L

    2002-01-01

    The growing use of endovascular brachytherapy has been accompanied by the publication of a large number of studies in several fields, but few studies on patient dose have been found in the literature. Moreover, these studies were carried out on the basis of Monte Carlo simulation. The aim of the present study was to estimate the effective dose to the patient undergoing endovascular brachytherapy treatment with 112Ir sources, by means of experimental measurements. Two standard treatments were taken into account: an endovascular brachytherapy of the coronary artery corresponding to the activity x time product of 184 GBq.min and an endovascular brachytherapy of the renal artery (898 GBq.min). Experimental assessment was accomplished by thermoluminescence dosemeters positioned in more than 300 measurement points in a properly adapted Rqndo phantom. A method has been developed to estimate the mean organ doses for all tissues and organs concerned in order to calculate the effective dose associated with intravascular brachytherapy. The normalised organ doses resulting from cronary treatment were 2.4 x 10(-2) mSv.GBq(-1).min(-1) for lung, 0.9 x 10(-2) mSv.GBSq(-1).min(-1) for oesophagus and 0.48 x 10(-2) mS.GBq(-1).min(-1) for bone marrow. During brachytherapy of the renal artery, the corresponding normalised doses were 4.2 x 10(-2) mS.GBq(-1).min(-1) for colon, 7.8 x 10(-2) mSv.GBq(-1).min(-1) for stomach and 1.7 x 10(-2) mSv.GBq(-1).min(-1) for liver. Coronary treatment iJnvlled an efl'fective dose of (0.046 mSv.GBq(-1).min(-1), whereas the treatment of the renal artery resulted in an effective dose of 0.15 mSv.GBq(-1).min(-1); there were many similarities with data from former studies. Based on these results it can be concluded that the dose level of patients exposed during brachytherapy treatment is low.

  8. Permanent interstitial low-dose-rate brachytherapy for patients with low risk prostate cancer. An interim analysis of 312 cases

    Energy Technology Data Exchange (ETDEWEB)

    Badakhshi, Harun; Graf, Reinhold; Budach, Volker; Wust, Peter [University Hospital Berlin, Department for Radiation Oncology of Charite School of Medicine, Berlin (Germany)

    2015-04-01

    The biochemical relapse-free survival (bRFS) rate after treatment with permanent iodine-125 seed implantation (PSI) or combined seeds and external beam radiotherapy (COMB) for clinical stage T1-T2 localized prostate cancer is a clinically relevant endpoint. The goal of this work was to evaluate the influence of relevant patient- and treatment-related factors. The study population comprised 312 consecutive patients treated with permanent seed implantation. All patients were evaluable for analysis of overall survival (OS) and disease-specific survival (DSS), 230 for bRFS, of which 192 were in the PSI group and 38 in the COMB group. The prescribed minimum peripheral dose was 145 Gy for PSI, for COMB 110 Gy implant and external beam radiotherapy of 45 Gy. The median follow-up time was 33 months (range 8-66 months). bRFS was defined as a serum prostate-specific antigen (PSA) level ≤ 0.2 ng/ml at last follow-up. Overall, the actuarial bRFS at 50 months was 88.4 %. The 50-month bRFS rate for PSI and COMB was 90.9 %, and 77.2 %, respectively. In the univariate analysis, age in the categories ≤ 63 and > 63 years (p < 0.00), PSA nadir (≤ 0.5 ng/ml and > 0.5 ng/ml) and PSA bounce (yes/no) were the significant predicting factors for bRFS. None of the other patient and treatment variables (treatment modality, stage, PSA, Gleason score, risk group, number of risk factors, D90 and various other dose parameters) were found to be a statistically significant predictor of 50-month bRFS. The biochemical failure rates were low in this study. As a proof of principle, our large monocenteric analysis shows that low-dose-rate brachytherapy is an effective and safe procedure for patients with early stage prostate cancer. (orig.) [German] Das biochemisch rezidivfreie Ueberleben (bRFS) nach der Brachytherapie mit permanenter Iod-125-Seed-Implantation (PSI) oder in Kombination mit externer Radiotherapie (COMB) ist beim Patienten mit fruehem Prostatakarzinom (T1/T2) ein relevanter

  9. Epimacular brachytherapy for wet AMD: current perspectives

    Directory of Open Access Journals (Sweden)

    Casaroli-Marano RP

    2014-08-01

    Full Text Available Ricardo P Casaroli-Marano,1,2 Socorro Alforja,1 Joan Giralt,1 Michel E Farah2 1Instituto Clínic de Oftalmología (Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; 2Department of Ophthalmology and Visual Sciences, Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil Abstract: Age-related macular degeneration (AMD is considered the most common cause of blindness in the over-60 age group in developed countries. There are basically two forms of presentation: geographic (dry or atrophic and wet (neovascular or exudative. Geographic atrophy accounts for approximately 85%–90% of ophthalmic frames and leads to a progressive degeneration of the retinal pigment epithelium and the photoreceptors. Wet AMD causes the highest percentage of central vision loss secondary to disease. This neovascular form involves an angiogenic process in which newly formed choroidal vessels invade the macular area. Today, intravitreal anti-angiogenic drugs attempt to block the angiogenic events and represent a major advance in the treatment of wet AMD. Currently, combination therapy for wet AMD includes different forms of radiation delivery. Epimacular brachytherapy (EMBT seems to be a useful approach to be associated with current anti-vascular endothelial growth factor agents, presenting an acceptable efficacy and safety profile. However, at the present stage of research, the results of the clinical trials carried out to date are insufficient to justify extending routine use of EMBT for the treatment of wet AMD. Keywords: macular degeneration, radiation, vascular endothelial growth factor, combined therapy, intravitreal therapy, vitrectomy

  10. Brachytherapy dose measurements in heterogeneous tissues

    Energy Technology Data Exchange (ETDEWEB)

    Paiva F, G.; Luvizotto, J.; Salles C, T.; Guimaraes A, P. C.; Dalledone S, P. de T.; Yoriyaz, H. [Instituto de Pesquisas Energeticas e Nucleares / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Rubo, R., E-mail: gabrielpaivafonseca@gmail.com [Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, 05403-900 Sao Paulo (Brazil)

    2014-08-15

    Recently, Beau lieu et al. published an article providing guidance for Model-Based Dose Calculation Algorithms (MBDCAs), where tissue heterogeneity considerations are addressed. It is well-known that T G-43 formalism which considers only water medium is limited and significant dose differences have been found comparing both methodologies. The aim of the present work is to experimentally quantify dose values in heterogeneous medium using different dose measurement methods and techniques and compare them with those obtained with Monte Carlo simulations. Experiments have been performed using a Nucletron micro Selectron-Hdr Ir-192 brachytherapy source and a heterogeneous phantom composed by PMMA and different tissue equivalent cylinders like bone, lungs and muscle. Several dose measurements were obtained using tissue equivalent materials with height 1.8 cm and 4.3 cm positioned between the radiation source and the detectors. Radiochromic films, TLDs and MOSFET S have been used for the dose measurements. Film dosimetry has been performed using two methodologies: a) linearization for dose-response curve based on calibration curves to create a functional form that linearize s the dose response and b) 177 multichannel analysis dosimetry where the multiple color channels are analyzed allowing to address not only disturbances in the measurements caused by thickness variation in the film layer, but also, separate other external influences in the film response. All experiments have been simulated using the MCNP5 Monte Carlo radiation transport code. Comparison of experimental results are in good agreement with calculated dose values with differences less than 6% for almost all cases. (Author)

  11. SU-E-T-477: An Efficient Dose Correction Algorithm Accounting for Tissue Heterogeneities in LDR Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mashouf, S; Lai, P [University of Toronto, Medical Biophysics Dept., Toronto, ON (Canada); Karotki, A; Keller, B; Beachey, D; Pignol, J [Sunnybrook Health Sciences Centre, Toronto, ON (Canada)

    2014-06-01

    Purpose: Seed brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose surrounding the brachytherapy seeds is based on American Association of Physicist in Medicine Task Group No. 43 (TG-43 formalism) which generates the dose in homogeneous water medium. Recently, AAPM Task Group No. 186 emphasized the importance of accounting for tissue heterogeneities. This can be done using Monte Carlo (MC) methods, but it requires knowing the source structure and tissue atomic composition accurately. In this work we describe an efficient analytical dose inhomogeneity correction algorithm implemented using MIM Symphony treatment planning platform to calculate dose distributions in heterogeneous media. Methods: An Inhomogeneity Correction Factor (ICF) is introduced as the ratio of absorbed dose in tissue to that in water medium. ICF is a function of tissue properties and independent of source structure. The ICF is extracted using CT images and the absorbed dose in tissue can then be calculated by multiplying the dose as calculated by the TG-43 formalism times ICF. To evaluate the methodology, we compared our results with Monte Carlo simulations as well as experiments in phantoms with known density and atomic compositions. Results: The dose distributions obtained through applying ICF to TG-43 protocol agreed very well with those of Monte Carlo simulations as well as experiments in all phantoms. In all cases, the mean relative error was reduced by at least 50% when ICF correction factor was applied to the TG-43 protocol. Conclusion: We have developed a new analytical dose calculation method which enables personalized dose calculations in heterogeneous media. The advantages over stochastic methods are computational efficiency and the ease of integration into clinical setting as detailed source structure and tissue segmentation are not needed. University of Toronto, Natural Sciences and

  12. SU-E-T-546: Use of Implant Volume for Quality Assurance of Low Dose Rate Brachytherapy Treatment Plans

    Energy Technology Data Exchange (ETDEWEB)

    Wilkinson, D; Kolar, M [Radiation Oncology, Cleveland Clinic Foundation, Cleveland, OH (United States)

    2014-06-01

    Purpose: To analyze the application of volume implant (V100) data as a method for a global check of low dose rate (LDR) brachytherapy plans. Methods: Treatment plans for 335 consecutive patients undergoing permanent seed implants for prostate cancer and for 113 patients treated with plaque therapy for ocular melanoma were analyzed. Plaques used were 54 COMS (10 to 20 mm, notched and regular) and 59 Eye Physics EP917s with variable loading. Plots of treatment time x implanted activity per unit dose versus v100 ^.667 were made. V100 values were obtained using dose volume histograms calculated by the treatment planning systems (Variseed 8.02 and Plaque Simulator 5.4). Four different physicists were involved in planning the prostate seed cases; two physicists for the eye plaques. Results: Since the time and dose for the prostate cases did not vary, a plot of implanted activity vs V100 ^.667 was made. A linear fit with no intercept had an r{sup 2} = 0.978; more than 94% of the actual activities fell within 5% of the activities calculated from the linear fit. The greatest deviations were in cases where the implant volumes were large (> 100 cc). Both COMS and EP917 plaque linear fits were good (r{sup 2} = .967 and .957); the largest deviations were seen for large volumes. Conclusions: The method outlined here is effective for checking planning consistency and quality assurance of two types of LDR brachytherapy treatment plans (temporary and permanent). A spreadsheet for the calculations enables a quick check of the plan in situations were time is short (e.g. OR-based prostate planning)

  13. Accuracy evaluation of a 3D-printed individual template for needle guidance in head and neck brachytherapy

    Science.gov (United States)

    Huang, Ming-Wei; Zhang, Jian-Guo; Zheng, Lei; Liu, Shu-Ming; Yu, Guang-Yan

    2016-01-01

    To transfer the preplan for the head and neck brachytherapy to the clinical implantation procedure, a preplan-based 3D-printed individual template for needle insertion guidance had previously been designed and used. The accuracy of needle insertion using this kind template was assessed in vivo. In the study, 25 patients with head and neck tumors were implanted with 125I radioactive seeds under the guidance of the 3D-printed individual template. Patients were divided into four groups based on the site of needle insertion: the parotid and masseter region group (nine patients); the maxillary and paranasal region group (eight patients); the submandibular and upper neck area group (five patients); and the retromandibular region group (six patients). The distance and angular deviations between the preplanned and placed needles were compared, and the complications and time required for needle insertion were assessed. The mean entrance point distance deviation for all 619 needles was 1.18 ± 0.81 mm, varying from 0.857 ± 0.545 to 1.930 ± 0.843 mm at different sites. The mean angular deviation was 2.08 ± 1.07 degrees, varying from 1.85 ± 0.93 to 2.73 ± 1.18 degrees at different sites. All needles were manually inserted to their preplanned positions in a single attempt, and the mean time to insert one needle was 7.5 s. No anatomical complications related to inaccurately placed implants were observed. Using the 3D-printed individual template for the implantation of 125I radioactive seeds in the head and neck region can accurately transfer a CT-based preplan to the brachytherapy needle insertion procedure. Moreover, the addition of individual template guidance can reduce the time required for implantation and minimize the damage to normal tissues. PMID:27422928

  14. An algorithm for efficient metal artifact reductions in permanent seed implants

    Energy Technology Data Exchange (ETDEWEB)

    Xu Chen; Verhaegen, Frank; Laurendeau, Denis; Enger, Shirin A.; Beaulieu, Luc [Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada) and Departement de Genie Electrique et Genie Informatique, Laboratoire de Vision et Systemes Numeriques, Universite Laval, Quebec, Quebec G1K 7P4 (Canada); Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands) and Oncology Department, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4 (Canada); Departement de Genie Electrique et Genie Informatique, Laboratoire de Vision et Systemes Numeriques, Universite Laval, Quebec, Quebec G1K 7P4 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Co circumflex te du Palais, Quebec, Quebec G1R 2J6 (Canada); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Universite Laval, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada) and Departement de Physique, de Genie Physique et d' Optique, Universite Laval, Quebec, Quebec G1K 7P4 (Canada)

    2011-01-15

    Purpose: In permanent seed implants, 60 to more than 100 small metal capsules are inserted in the prostate, creating artifacts in x-ray computed tomography (CT) imaging. The goal of this work is to develop an automatic method for metal artifact reduction (MAR) from small objects such as brachytherapy seeds for clinical applications. Methods: The approach for MAR is based on the interpolation of missing projections by directly using raw helical CT data (sinogram). First, an initial image is reconstructed from the raw CT data. Then, the metal objects segmented from the reconstructed image are reprojected back into the sinogram space to produce a metal-only sinogram. The Steger method is used to determine precisely the position and edges of the seed traces in the raw CT data. By combining the use of Steger detection and reprojections, the missing projections are detected and replaced by interpolation of non-missing neighboring projections. Results: In both phantom experiments and patient studies, the missing projections have been detected successfully and the artifacts caused by metallic objects have been substantially reduced. The performance of the algorithm has been quantified by comparing the uniformity between the uncorrected and the corrected phantom images. The results of the artifact reduction algorithm are indistinguishable from the true background value. Conclusions: An efficient algorithm for MAR in seed brachytherapy was developed. The test results obtained using raw helical CT data for both phantom and clinical cases have demonstrated that the proposed MAR method is capable of accurately detecting and correcting artifacts caused by a large number of very small metal objects (seeds) in sinogram space. This should enable a more accurate use of advanced brachytherapy dose calculations, such as Monte Carlo simulations.

  15. A radiobiology-based inverse treatment planning method for optimisation of permanent l-125 prostate implants in focal brachytherapy

    Science.gov (United States)

    Haworth, Annette; Mears, Christopher; Betts, John M.; Reynolds, Hayley M.; Tack, Guido; Leo, Kevin; Williams, Scott; Ebert, Martin A.

    2016-01-01

    Treatment plans for ten patients, initially treated with a conventional approach to low dose-rate brachytherapy (LDR, 145 Gy to entire prostate), were compared with plans for the same patients created with an inverse-optimisation planning process utilising a biologically-based objective. The ‘biological optimisation’ considered a non-uniform distribution of tumour cell density through the prostate based on known and expected locations of the tumour. Using dose planning-objectives derived from our previous biological-model validation study, the volume of the urethra receiving 125% of the conventional prescription (145 Gy) was reduced from a median value of 64% to less than 8% whilst maintaining high values of TCP. On average, the number of planned seeds was reduced from 85 to less than 75. The robustness of plans to random seed displacements needs to be carefully considered when using contemporary seed placement techniques. We conclude that an inverse planning approach to LDR treatments, based on a biological objective, has the potential to maintain high rates of tumour control whilst minimising dose to healthy tissue. In future, the radiobiological model will be informed using multi-parametric MRI to provide a personalised medicine approach.

  16. Treatment planning for brachytherapy: an integer programming model, two computational approaches and experiments with permanent prostate implant planning.

    Science.gov (United States)

    Lee, E K; Gallagher, R J; Silvern, D; Wuu, C S; Zaider, M

    1999-01-01

    An integer linear programming model is proposed as a framework for optimizing seed placement and dose distribution in brachytherapy treatment planning. The basic model involves using 0/1 indicator variables to describe the placement or non-placement of seeds in a prespecified three-dimensional grid of potential locations. The dose delivered to each point in a discretized representation of the diseased organ and neighbouring healthy tissue can then be modelled as a linear combination of the indicator variables. A system of linear constraints is imposed to attempt to keep the dose level at each point to within specified target bounds. Since it is physically impossible to satisfy all constraints simultaneously, each constraint uses a variable to either record when the target dose level is achieved, or to record the deviation from the desired level. These additional variables are embedded into an objective function to be optimized. Variations on this model are discussed and two computational approaches--a branch-and-bound algorithm and a genetic algorithm--for finding 'optimal' seed placements are described. Results of computational experiments on a collection of prostate cancer cases are reported. The results indicate that both optimization algorithms are capable of producing good solutions within 5 to 15 min, and that small variations in model parameters can have a measurable effect on the dose distribution of the resulting plans.

  17. Flat-panel cone-beam CT on a mobile isocentric C-arm for image-guided brachytherapy

    Science.gov (United States)

    Jaffray, David A.; Siewerdsen, Jeffrey H.; Edmundson, Gregory K.; Wong, John W.; Martinez, Alvaro A.

    2002-05-01

    Flat-panel imager (FPI) based cone-beam computed tomography (CBCT) is a strong candidate technology for intraoperative imaging in image-guided procedures such as brachytherapy. The soft-tissue imaging performance and potential navigational utility have been investigated using a computer-controlled benchtop system. These early results have driven the development of an isocentric C-arm for intraoperative FPI-CBCT, capable of collecting 94 projections over 180 degrees in 110 seconds. The C-arm system employs a large-area FPI with 400 micron pixel pitch and Gd2O2S:Tb scintillator. Image acquisition, processing and reconstruction are orchestrated under a single Windows-based application. Reconstruction is performed by a modified Feldkamp algorithm implemented on a high-speed reconstruction engine. Non-idealities in the source and detector trajectories during orbital motion has been quantified and tested for stability. Cone-beam CT imaging performance was tested through both quantitative and qualitative methods. The system MTF was measured using a wire phantom and demonstrated frequency pass out to 0.6 mm-1. Voxel noise was measured at 2.7 percent in a uniform 12 cm diameter water bath. Anatomical phantoms were employed for qualitative evaluation of the imaging performance. Images of an anaesthetized rabbit demonstrated the capacity of the system to discern soft-tissue structures within a living subject while offering sub-millimeter spatial resolution. The dose delivered in each of the imaging procedures was estimated from in-air exposure measurements to be approximately 0.1 cGy. Imaging studies of an anthropomorphic prostate phantom were performed with and without radioactive seeds. Soft-tissue imaging performance and seed detection appear to satisfy the imaging and navigation requirements for image-guided brachytherapy. These investigations advance the development and evaluation of such technology for image-guided surgical procedures, including brachytherapy

  18. Image guided, adaptive, accelerated, high dose brachytherapy as model for advanced small volume radiotherapy.

    Science.gov (United States)

    Haie-Meder, Christine; Siebert, Frank-André; Pötter, Richard

    2011-09-01

    Brachytherapy has consistently provided a very conformal radiation therapy modality. Over the last two decades this has been associated with significant improvements in imaging for brachytherapy applications (prostate, gynecology), resulting in many positive advances in treatment planning, application techniques and clinical outcome. This is emphasized by the increased use of brachytherapy in Europe with gynecology as continuous basis and prostate and breast as more recently growing fields. Image guidance enables exact knowledge of the applicator together with improved visualization of tumor and target volumes as well as of organs at risk providing the basis for very individualized 3D and 4D treatment planning. In this commentary the most important recent developments in prostate, gynecological and breast brachytherapy are reviewed, with a focus on European recent and current research aiming at the definition of areas for important future research. Moreover the positive impact of GEC-ESTRO recommendations and the highlights of brachytherapy physics are discussed what altogether presents a full overview of modern image guided brachytherapy. An overview is finally provided on past and current international brachytherapy publications focusing on "Radiotherapy and Oncology". These data show tremendous increase in almost all research areas over the last three decades strongly influenced recently by translational research in regard to imaging and technology. In order to provide high level clinical evidence for future brachytherapy practice the strong need for comprehensive prospective clinical research addressing brachytherapy issues is high-lighted. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Standards, options and recommendations for brachytherapy of prostate cancer: efficacy and toxicity; Standards, options et recommandations pour la curietherapie des patients atteints de cancer de la prostate: efficacite et toxicite

    Energy Technology Data Exchange (ETDEWEB)

    Pommier, P. [Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France); Villers, A. [Centre Hospitalier Universitaire, Hopital Huriez, 59 - Lille (France); Bataillard, A. [Federation Nationale des Centres de Lutte Contre le Cancer, FNCLCC, 75 - Paris (France)] [and others

    2001-12-01

    Context. - The 'Standards, Options and Recommendations' (SOR) collaborative project was initiated in 1993 by the Federation of the French Cancer Centres (FNCLCC), with the 20 French Regional Cancer Centres, several French public university and general hospitals, as well as private clinics and medical specialty societies. Its main objective is the development of serviceable clinical practice guidelines in order to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review, followed by a critical appraisal by a multidisciplinary group of experts. Draft guidelines are produced, then validated by specialists in cancer care delivery. Objectives. - Produce technical practice guidelines for the brachytherapy of prostate cancer using the methodology developed by the Standards, Options and Recommendations project. Methods. - The FNCLCC and the French Urology Association (AFU) first designated the multidisciplinary group of experts. Available data were collected by a search of Medline and lists selected by experts in the group. A first draft of the guidelines was written, they validated by independent reviewers. Results. - The main recommendations are: 1/ Brachytherapy with permanent seeds alone is a possible curative treatment for prostate cancer patients with the following prognosis factors: tumour stage T1 or T2a (TNM 1992), Gleason score {<=} 6 and PSA < 10 {mu}g/L. 2/ Combined treatment with brachytherapy and hormonal therapy could be more efficient than brachytherapy alone for prostate cancer patients with Gleason score > 7 and/or PSA > 10. 3/ Combination of brachytherapy and external beam radiation therapy can be proposed to prostate cancer patients with intermediate prognosis. 4/ Before and after seed implantation, risks of infection must be prevented by appropriate antibiotic therapy (recommendation). 5/ Brachytherapy must not be performed within 2 months of trans-urethral prostate resection. 6

  20. dose in cervical cancer intracavitary brachytherapy

    Directory of Open Access Journals (Sweden)

    Zahra Siavashpour

    2016-04-01

    Full Text Available Purpose: To analyze the optimum organ filling point for organs at risk (OARs dose in cervical cancer high-dose-rate (HDR brachytherapy. Material and methods : In a retrospective study, 32 locally advanced cervical cancer patients (97 insertions who were treated with 3D conformal external beam radiation therapy (EBRT and concurrent chemotherapy during 2010-2013 were included. Rotterdam HDR tandem-ovoid applicators were used and computed tomography (CT scanning was performed after each insertion. The OARs delineation and GEC-ESTRO-based clinical target volumes (CTVs contouring was followed by 3D forward planning. Then, dose volume histogram (DVH parameters of organs were recorded and patients were classified based on their OARs volumes, as well as their inserted tandem length. Results : The absorbed dose to point A ranged between 6.5-7.5 Gy. D 0.1cm ³ and D 2cm ³ of the bladder significantly increased with the bladder volume enlargement (p value < 0.05. By increasing the bladder volume up to about 140 cm3, the rectum dose was also increased. For the cases with bladder volumes higher than 140 cm3, the rectum dose decreased. For bladder volumes lower than 75 cm3, the sigmoid dose decreased; however, for bladder volumes higher than 75 cm3, the sigmoid dose increased. The D 2cm ³ of the bladder and rectum were higher for longer tandems than for shorter ones, respectively. The divergence of the obtained results for different tandem lengths became wider by the extension of the bladder volume. The rectum and sigmoid volume had a direct impact on increasing their D 0.1cm ³ and D 2cm ³, as well as decreasing their D 10 , D 30 , and D 50 . Conclusions : There is a relationship between the volumes of OARs and their received doses. Selecting a bladder with a volume of about 70 cm3 or less proved to be better with regards to the dose to the bladder, rectum, and sigmoid.

  1. 125I brachytherapy of locally advanced non-small-cell lung cancer after one cycle of first-line chemotherapy:a comparison with best supportive care

    Directory of Open Access Journals (Sweden)

    Song J

    2017-03-01

    NSCLC and quality of life after one cycle of first-line chemotherapy compared with best supportive care. Keywords: non-small-cell lung cancer, CT-guided intervention, 125I seed, brachytherapy 

  2. Protocol-based image-guided salvage brachytherapy. Early results in patients with local failure of prostate cancer after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lahmer, G.; Lotter, M.; Kreppner, S.; Fietkau, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2013-08-15

    Purpose: To assess the overall clinical outcome of protocol-based image-guided salvage pulsed-dose-rate brachytherapy for locally recurrent prostate cancer after radiotherapy failure particularly regarding feasibility and side effects. Patients and methods: Eighteen consecutive patients with locally recurrent prostate cancer (median age, 69 years) were treated during 2005-2011 with interstitial PDR brachytherapy (PDR-BT) as salvage brachytherapy after radiotherapy failure. The treatment schedule was PDR-BT two times with 30 Gy (pulse dose 0.6 Gy/h, 24 h per day) corresponding to a total dose of 60 Gy. Dose volume adaptation was performed with the aim of optimal coverage of the whole prostate (V{sub 100} > 95 %) simultaneously respecting the protocol-based dose volume constraints for the urethra (D{sub 0.1} {sub cc} < 130 %) and the rectum (D{sub 2} {sub cc} < 50-60 %) taking into account the previous radiation therapy. Local relapse after radiotherapy (external beam irradiation, brachytherapy with J-125 seeds or combination) was confirmed mostly via choline-PET and increased PSA levels. The primary endpoint was treatment-related late toxicities - particularly proctitis, anal incontinence, cystitis, urinary incontinence, urinary frequency/urgency, and urinary retention according to the Common Toxicity Criteria. The secondary endpoint was PSA-recurrence-free survival. Results: We registered urinary toxicities only. Grade 2 and grade 3 toxicities were observed in up to 11.1 % (2/18) and 16.7 % (3/18) of patients, respectively. The most frequent late-event grade 3 toxicity was urinary retention in 17 % (3/18) of patients. No late gastrointestinal side effects occurred. The biochemical PSA-recurrence-free survival probability at 3 years was 57.1 %. The overall survival at 3 years was 88.9 %; 22 % (4/18) of patients developed metastases. The median follow-up time for all patients after salvage BT was 21 months (range, 8-77 months). Conclusion: Salvage PDR-brachytherapy

  3. SU-E-J-232: Feasibility of MRI-Based Preplan On Low Dose Rate Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Y; Tward, J; Rassiah-Szegedi, P; Zhao, H; Sarkar, V; Huang, L; Szegedi, M; Kokeny, K; Salter, B [University of Utah Huntsman Cancer Institute, Salt Lake City, UT (United States)

    2015-06-15

    Purpose: To investigate the feasibility of using MRI-based preplan for low dose rate prostate brachytherapy. Methods: 12 patients who received transrectal ultrasound (TRUS) guided prostate brachytherapy with Pd-103 were retrospectively studied. Our care-standard of the TRUS-based preplan served as the control. One or more prostate T2-weighted wide and/or narrow-field of view MRIs obtained within the 3 months prior to the implant were imported into the MIM Symphony software v6.3 (MIM Software Inc., Cleveland, OH) for each patient. In total, 37 MRI preplans (10 different image sequences with average thickness of 4.8mm) were generated. The contoured prostate volume and the seed counts required to achieve adequate dosimetric coverage from TRUS and MRI preplans were compared for each patient. The effects of different MRI sequences and image thicknesses were also investigated statistically using Student’s t-test. Lastly, the nomogram from the MRI preplan and TRUS preplan from our historical treatment data were compared. Results: The average prostate volume contoured on the TRUS and MRI were 26.6cc (range: 12.6∼41.3cc), and 27.4 cc (range: 14.3∼50.0cc), respectively. Axial MRI thicknesses (range: 3.5∼8.1mm) did not significantly affect the contoured volume or the number of seeds required on the preplan (R2 = 0.0002 and 0.0012, respectively). Four of the MRI sequences (AX-T2, AX-T2-Whole-Pelvis, AX-T2-FSE, and AXIALT2- Hi-Res) showed statistically significant better prostate volume agreement with TRUS than the other seven sequences (P <0.01). Nomogram overlay between the MRI and TRUS preplans showed good agreement; indicating volumes contoured on MRI preplan scan reliably predict how many seeds are needed for implant. Conclusion: Although MRI does not allow for determination of the actual implant geometry, it can give reliable volumes for seed ordering purposes. Our future work will investigate if MRI is sufficient to reliably replace TRUS preplanning in patients

  4. Dosimetric study of a new polymer encapsulated palladium-103 seed

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, S; Vynckier, S [Cliniques Universitaires Saint-Luc, Radiotherapy and Oncology Department, Catholic University of Louvain, Brussels (Belgium)

    2005-04-07

    The use of low-energy photon emitters for brachytherapy applications, as in the treatment of prostate or ocular tumours, has increased significantly over the last few years. Several new seed models utilizing {sup 103}Pd and {sup 125}I have recently been introduced. Following the TG43U1 recommendations of the AAPM (American Association of Physicists in Medicine) (Rivard et al 2004 Med. Phys. 31 633), dose distributions around these low-energy photon emitters are characterized by the dose rate constant, the radial dose function and the anisotropy function in water. These functions and constants can be measured for each new seed in a solid phantom (i.e. solid water such as WT1) using high spatial resolution detectors such as very small thermoluminescent detectors. These experimental results in solid water must then be converted into liquid water by using Monte Carlo simulations. This paper presents the dosimetric parameters of a new palladium seed, OptiSeed{sup TM} (produced by International Brachytherapy (IBt), Seneffe, Belgium), made with a biocompatible polymeric shell and with a design that differs from the hollow titanium encapsulated seed, InterSource{sup 103}, produced by the same company. A polymer encapsulation was chosen by the company IBt in order to reduce the quantity of radioactive material needed for a given dose rate, and to improve the symmetry of the radiation field around the seed. The necessary experimental data were obtained by measurements with LiF thermoluminescent dosimeters (1 mm{sup 3}) in a solid water phantom (WT1) and then converted to values in liquid water using Monte Carlo calculations (MCNP-4C). Comparison of the results with a previous study by Reniers et al (2002 Appl. Radiat. Isot. 57 805) shows very good agreement for the dose rate constant and for the radial dose function. In addition, the results also indicate an improvement in isotropy compared to a conventional titanium encapsulated seed. The relative dose (anisotropy value

  5. Dose optimization in simulated permanent interstitial implant of prostate brachytherapy; Otimizacao de dose em implantes intersticiais permanentes simulados de braquiterapia de prostata

    Energy Technology Data Exchange (ETDEWEB)

    Faria, Fernando Pereira de

    2006-07-01

    Any treatment of cancer that uses some modality of radiotherapy is planned before being executed. In general the goal in radiotherapy is to irradiate the target to be treated minimizing the incidence of radiation in healthy surrounding tissues. The planning differ among themselves according to the modality of radiotherapy, the type of cancer and where it is located. This work approaches the problem of dose optimization for the planning of prostate cancer treatment through the modality of low dose-rate brachytherapy with Iodine 125 or Palladium 103 seeds. An algorithm for dose calculation and optimization was constructed to find the seeds configuration that better fits the relevant clinical criteria such as as the tolerated dose by the urethra and rectum and the desired dose for prostate. The algorithm automatically finds this configuration from the prostate geometry established in two or three dimensions by using images of ultrasound, magnetic resonance or tomography and from the establishment of minimum restrictions to the positions of the seeds in the prostate and needles in a template. Six patterns of seeds distribution based on clinical criteria were suggested and tested in this work. Each one of these patterns generated a space of possible seeds configurations for the prostate tested by the dose calculation and optimization algorithm. The configurations that satisfied the clinical criteria were submitted to a test according to an optimization function suggested in this work. The configuration that produced maximum value for this function was considered the optimized one. (author)

  6. Seed Treatment. Bulletin 760.

    Science.gov (United States)

    Lowery, Harvey C.

    This manual gives a definition of seed treatment, the types of seeds normally treated, diseases and insects commonly associated with seeds, fungicides and insecticides used, types of equipment used for seed treatment, and information on labeling and coloring of treated seed, pesticide carriers, binders, stickers, and safety precautions. (BB)

  7. MO-E-BRD-03: Intra-Operative Breast Brachytherapy: Is One Stop Shopping Best? [Non-invasive Image-Guided Breast Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Libby, B. [University of Virginia (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  8. Brachytherapy for prostate cancer: Comparative characteristics of procedures

    Directory of Open Access Journals (Sweden)

    S. V. Kanaev

    2015-01-01

    Full Text Available The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC. The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT. Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary (HDR-BT and low-dose rate (permanent (LDR-BT brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.

  9. Cataract extraction after brachytherapy for malignant melanoma of the choroid

    Energy Technology Data Exchange (ETDEWEB)

    Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. (Texas Retina Associates, Dallas (USA))

    1991-05-01

    Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

  10. Compound dual radiation action theory for 252Cf brachytherapy.

    Science.gov (United States)

    Wang, C K; Zhang, X

    2004-01-01

    The existing dosimetry protocol that uses the concept of RBE for 252Cf brachytherapy contains large uncertainties. A new formula has been developed to correlate the biological effect (i.e. cell survival fraction) resulting from a mixed n + gamma radiation field with two physical quantities and two biological quantities. The formula is based on a pathway model evolved from that of the compound-dual-radiation-action (CDRA) theory, previously proposed by Rossi and Zaider. The new model employs the recently published data on radiation-induced DNA lesions. The new formula is capable of predicting quantitatively the synergistic effect caused by the interactions between neutron events and gamma ray events, and it is intended to be included into a new dosimetry protocol for future 252Cf brachytherapy.

  11. Dose volume analysis in brachytherapy and stereotactic radiosurgery

    CERN Document Server

    Tozer-Loft, S M

    2000-01-01

    compared with a range of figures of merit which express different aspects of the quality of each dose distributions. The results are analysed in an attempt to answer the question: What are the important features of the dose distribution (conformality, uniformity, etc) which show a definite relationship with the outcome of the treatment? Initial results show positively that, when Gamma Knife radiosurgery is used to treat acoustic neuroma, some measures of conformality seem to have a surprising, but significant association with outcome. A brief introduction to three branches of radiotherapy is given: interstitial brachytherapy, external beam megavoltage radiotherapy, and stereotactic radiosurgery. The current interest in issues around conformity, uniformity and optimisation is explained in the light of technical developments in these fields. A novel method of displaying dose-volume information, which mathematically suppresses the inverse-square law, as first suggested by L.L. Anderson for use in brachytherapy i...

  12. Review of advanced catheter technologies in radiation oncology brachytherapy procedures.

    Science.gov (United States)

    Zhou, Jun; Zamdborg, Leonid; Sebastian, Evelyn

    2015-01-01

    The development of new catheter and applicator technologies in recent years has significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. In this paper, we review these advances, focusing on the performance of catheter imaging and reconstruction techniques in brachytherapy procedures using magnetic resonance images and electromagnetic tracking. The accuracy of catheter reconstruction, imaging artifacts, and other notable properties of plastic and titanium applicators in gynecologic treatments are reviewed. The accuracy, noise performance, and limitations of electromagnetic tracking for catheter reconstruction are discussed. Several newly developed applicators for accelerated partial breast irradiation and gynecologic treatments are also reviewed. New hypofractionated high dose rate treatment schemes in prostate cancer and accelerated partial breast irradiation are presented.

  13. IMAGE-GUIDED RADIOTHERAPY AND -BRACHYTHERAPY FOR CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Suresh eDutta

    2015-03-01

    Full Text Available Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT, and 2-dimensional intracavitary brachytherapy.Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron emission tomography (PET and magnetic resonance imaging (MRI has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT, allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  14. 3T MR-Guided Brachytherapy for Gynecologic Malignancies

    CERN Document Server

    Kapur, Tina; Damato, Antonio; Schmidt, Ehud J; Viswanathan, Akila N; 10.1016/j.mri.2012.06.003

    2013-01-01

    Gynecologic malignancies are a leading cause of death in women worldwide. Standard treatment for many primary and recurrent gynecologic cancer cases includes a combination of external beam radiation, followed by brachytherapy. Magnetic Resonance Imaging (MRI) is benefitial in diagnostic evaluation, in mapping the tumor location to tailor radiation dose, and in monitoring the tumor response to treatment. Initial studies of MR-guidance in gynecologic brachtherapy demonstrate the ability to optimize tumor coverage and reduce radiation dose to normal tissues, resulting in improved outcomes for patients. In this article we describe a methodology to aid applicator placement and treatment planning for 3 Tesla (3T) MR-guided brachytherapy that was developed specifically for gynecologic cancers. This has been used in 18 cases to date in the Advanced Multimodality Image Guided Operating suite at Brigham and Women's Hospital. It is comprised of state of the art methods for MR imaging, image analysis, and treatment plann...

  15. Experimental iodine-125 seed irradiation of intracerebral brain tumors in nude mice

    Directory of Open Access Journals (Sweden)

    Haveman Jaap

    2007-09-01

    Full Text Available Abstract Background High-dose radiotherapy is standard treatment for patients with brain cancer. However, in preclinical research external beam radiotherapy is limited to heterotopic murine models– high-dose radiotherapy to the murine head is fatal due to radiation toxicity. Therefore, we developed a stereotactic brachytherapy mouse model for high-dose focal irradiation of experimental intracerebral (orthotopic brain tumors. Methods Twenty-one nude mice received a hollow guide-screw implanted in the skull. After three weeks, 5 × 105 U251-NG2 human glioblastoma cells were injected. Five days later, a 2 mCi iodine-125 brachytherapy seed was inserted through the guide-screw in 11 randomly selected mice; 10 mice received a sham seed. Mice were euthanized when severe neurological or physical symptoms occurred. The cumulative irradiation dose 5 mm below the active iodine-125 seeds was 23.0 Gy after 13 weeks (BEDtumor = 30.6 Gy. Results In the sham group, 9/10 animals (90% showed signs of lethal tumor progression within 6 weeks. In the experimental group, 2/11 mice (18% died of tumor progression within 13 weeks. Acute side effects in terms of weight loss or neurological symptoms were not observed in the irradiated animals. Conclusion The intracerebral implantation of an iodine-125 brachytherapy seed through a stereotactic guide-screw in the skull of mice with implanted brain tumors resulted in a significantly prolonged survival, caused by high-dose irradiation of the brain tumor that is biologically comparable to high-dose fractionated radiotherapy– without fatal irradiation toxicity. This is an excellent mouse model for testing orthotopic brain tumor therapies in combination with radiation therapy.

  16. Brachytherapy in Lip Carcinoma: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Guibert, Mireille, E-mail: mireilleguib@voila.fr [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); David, Isabelle [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Vergez, Sebastien [Department of Head and Neck Surgery, Larrey Hospital, Toulouse (France); Rives, Michel [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France); Filleron, Thomas [Department of Epidemiology, Claudius Regaud Institut, Toulouse (France); Bonnet, Jacques; Delannes, Martine [Department of Radiation Oncology, Claudius Regaud Institut, Toulouse (France)

    2011-12-01

    Purpose: The aim of this study was to evaluate the effectiveness of low-dose-rate brachytherapy for local control and relapse-free survival in squamous cell and basal cell carcinomas of the lips. We compared two groups: one with tumors on the skin and the other with tumors on the lip. Patients and methods: All patients had been treated at Claudius Regaud Cancer Centre from 1990 to 2008 for squamous cell or basal cell carcinoma. Low-dose-rate brachytherapy was performed with iridium 192 wires according to the Paris system rules. On average, the dose delivered was 65 Gy. Results: 172 consecutive patients were included in our study; 69 had skin carcinoma (squamous cell or basal cell), and 92 had squamous cell mucosal carcinoma. The average follow-up time was 5.4 years. In the skin cancer group, there were five local recurrences and one lymph node recurrence. In the mucosal cancer group, there were ten local recurrences and five lymph node recurrences. The 8-year relapse-free survival for the entire population was 80%. The 8-year relapse-free survival was 85% for skin carcinoma 75% for mucosal carcinoma, with no significant difference between groups. The functional results were satisfactory for 99% of patients, and the cosmetic results were satisfactory for 92%. Maximal toxicity observed was Grade 2. Conclusions: Low-dose-rate brachytherapy can be used to treat lip carcinomas at Stages T1 and T2 as the only treatment with excellent results for local control and relapse-free survival. The benefits of brachytherapy are also cosmetic and functional, with 91% of patients having no side effects.

  17. Surgical management of strabismus following choroidal melanoma plaque brachytherapy.

    Science.gov (United States)

    Alfreihi, Shatha H; Pineles, Stacy L; McCannel, Tara A; Prada, Angelica M; Velez, Federico G

    2017-08-01

    To characterize intraoperative findings, surgical approach, and postoperative outcomes in patients undergoing strabismus surgery following plaque brachytherapy for ocular melanoma. The records of all patients who underwent plaque brachytherapy for choroidal melanoma between May 2007 and June 2016 were reviewed retrospectively to identify those who subsequently required strabismus surgery. Of the 461 patients who underwent plaque brachytherapy during the study period, 13 (2.8%) met inclusion criteria. Visual acuity of the affected eye was 20/40 or better in 9 patients (69%). Preoperative horizontal deviation ranged from 0(Δ) to 52(Δ); vertical deviation, from 2(Δ) to 25(Δ). At final follow-up mean horizontal deviation ranged from 0 to 4(Δ); vertical deviation, from 0(Δ) to 12(Δ). Intraoperatively, all muscles directly adjacent to the treated area appeared macroscopically thicker than normal despite being functionally underacting. Magnetic resonance imaging showed enlarged muscles adjacent to the plaque radiotherapy. Microscopic examination of muscles in 2 patients showed reactive enlargement of the muscle fibers, granulation tissue, and inflammation. Persistent strabismus after plaque brachytherapy is rare. Typical findings include enlarged, underacting rectus muscles adjacent to the area of the plaque, restrictive connective tissue, and incomitant strabismus. Previously disinserted muscles may be found in abnormal locations. In this patient cohort scar tissue removal in conjunction with tightening procedures on the muscle adjacent to the plaque combined with recession of the antagonist muscle frequently resulted in good anatomical outcome. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  18. Ruby-based inorganic scintillation detectors for 192Ir brachytherapy

    Science.gov (United States)

    Kertzscher, Gustavo; Beddar, Sam

    2016-11-01

    We tested the potential of ruby inorganic scintillation detectors (ISDs) for use in brachytherapy and investigated various unwanted luminescence properties that may compromise their accuracy. The ISDs were composed of a ruby crystal coupled to a poly(methyl methacrylate) fiber-optic cable and a charge-coupled device camera. The ISD also included a long-pass filter that was sandwiched between the ruby crystal and the fiber-optic cable. The long-pass filter prevented the Cerenkov and fluorescence background light (stem signal) induced in the fiber-optic cable from striking the ruby crystal, which generates unwanted photoluminescence rather than the desired radioluminescence. The relative contributions of the radioluminescence signal and the stem signal were quantified by exposing the ruby detectors to a high-dose-rate brachytherapy source. The photoluminescence signal was quantified by irradiating the fiber-optic cable with the detector volume shielded. Other experiments addressed time-dependent luminescence properties and compared the ISDs to commonly used organic scintillator detectors (BCF-12, BCF-60). When the brachytherapy source dwelled 0.5 cm away from the fiber-optic cable, the unwanted photoluminescence was reduced from  >5% to  5% within 10 s from the onset of irradiation and after the source had retracted. The ruby-based ISDs generated signals of up to 20 times that of BCF-12-based detectors. The study presents solutions to unwanted luminescence properties of ruby-based ISDs for high-dose-rate brachytherapy. An optic filter should be sandwiched between the ruby crystal and the fiber-optic cable to suppress the photoluminescence. Furthermore, we recommend avoiding ruby crystals that exhibit significant time-dependent luminescence.

  19. Scintillating fiber optic dosimeters for breast and prostate brachytherapy

    Science.gov (United States)

    Moutinho, L. M.; Castro, I. F.; Freitas, H.; Melo, J.; Silva, P.; Gonçalves, A.; Peralta, L.; Rachinhas, P. J.; Simões, P. C. P. S.; Pinto, S.; Pereira, A.; Santos, J. A. M.; Costa, M.; Veloso, J. F. C. A.

    2017-02-01

    Brachytherapy is a radiotherapy modality where the radioactive material is placed close to the tumor, being a common treatment for skin, breast, gynecological and prostate cancers. These treatments can be of low-dose-rate, using isotopes with mean energy of 30 keV, or high-dose-rate, using isotopes such as 192Ir with a mean energy of 380 keV. Currently these treatments are performed in most cases without in-vivo dosimetry for quality control and quality assurance. We developed a dosimeter using small diameter probes that can be inserted into the patient's body using standard brachytherapy needles. By performing real-time dosimetry in breast and prostate brachytherapy it will be possible to perform real-time dose correction when deviations from the treatment plan are observed. The dosimeter presented in this work was evaluated in-vitro. The studies consisted in the characterization of the dosimeter with 500 μm diameter sensitive probes (with a BCF-12 scintillating optical fiber) using an inhouse made gelatin breast phantom with a volume of 566 cm3. A breast brachytherapy treatment was simulated considering a tumor volume of 27 cm3 and a prescribed absolute dose of 5 Gy. The dose distribution was determined by the Inverse Planning Simulated Annealing (IPSA) optimization algorithm (ELEKTA). The dwell times estimated from the experimental measurements are in agreement with the prescribed dwell times, with relative error below 3%. The measured signal-to-noise ratio (SNR) including the stem-effect contribution is below 3%.

  20. Stereolithographic modelling as an aid to orbital brachytherapy.

    Science.gov (United States)

    Poulsen, M; Lindsay, C; Sullivan, T; D'Urso, P

    1999-06-01

    This paper describes the technique of stereolithographic biomodelling and its application to a patient who was treated using orbital brachytherapy. The process uses a moving laser beam, directed by a computer, to draw cross-sections of the model onto the surface of photo-curable liquid plastic. Using a stereolithographic apparatus (SLA), solid or surface data is sliced by software into very thin cross-sections. A helium cadmium (HeCd) laser then generates a small intense spot of ultraviolet (UV) light that is moved across the top of a vat of liquid photo monomer by a computerised optical scanning system. The laser polymerises the liquid into a solid where it touches, precisely printing each cross-section. A vertical elevator lowers the newly formed layer, and a recoating and levelling system establishes the next layer's thickness. Successive cross-sections (0.25 mm thick), each one adhering to the one below, are built one on top of the other, to form the part from the bottom up. The biomodel allowed the implant to be planned in detail prior to the surgery. The accurate placement of brachytherapy catheters was assured, and the dosimetry could be determined and optimised prior to the definitive procedure. Stereolithography is a useful technique in the area of orbital brachytherapy. It allows the implant to to be carried out with greater accuracy and confidence. For the patient, it minimises the risk to the eye and provides them with a greater understanding of the procedure.

  1. Image-guided high dose rate endorectal brachytherapy.

    Science.gov (United States)

    Devic, Slobodan; Vuong, Té; Moftah, Belal; Evans, Michael; Podgorsak, Ervin B; Poon, Emily; Verhaegen, Frank

    2007-11-01

    Fractionated high dose rate endorectal brachytherapy (HDR-EBT) using CT-based treatment planning is an alternative method for preoperative down-sizing and down-staging of advanced rectal adeno-carcinomas. The authors present an image guidance procedure that was developed to ensure daily dose reproducibility for the four brachytherapy treatment fractions. Since the applicator might not be placed before each treatment fraction inside the rectal lumen in the same manner as it was placed during the 3D CT volume acquisition used for treatment planning, there is a shift along the catheter axis that may have to be performed. The required shift is determined by comparison of a daily radiograph with the treatment planning digitally-reconstructed radiograph (DRR). A procedure is developed for DRR reconstruction from the 3D data set used for the treatment planning, and two possible daily longitudinal shifts are illustrated: above and below the planning dose distribution. The authors also describe the procedure for rotational alignment illustrated on a clinical case. Reproduction of the treatment planned dose distribution on a daily basis is crucial for the success of fractionated 3D based brachytherapy treatments. Due to the cylindrical symmetry of the applicator used for preoperative HDR-EBT, two types of adjustments are necessary: applicator rotation and dwell position shift along the applicator's longitudinal axis. The impact of the longitudinal applicator shift prior to treatment delivery for 62 patients treated in our institution is also assessed.

  2. Fabrication of cesium-137 brachytherapy sources using vitrification technology.

    Science.gov (United States)

    Dash, Ashutosh; Varma, R N; Ram, Ramu; Saxena, S K; Mathakar, A R; Avhad, B G; Sastry, K V S; Sangurdekar, P R; Venkatesh, Meera

    2009-08-01

    137Cs source in solid matrix encapsulated in stainless-steel at MBq (mCi) levels are widely used as brachytherapy sources for the treatment of carcinoma of cervix uteri. This article describes the large-scale preparation of such sources. The process of fabrication includes vitrification of 137Cs-sodium borosilicate glass, its transformation into spheres of 5-6 mm diameter, casting of glass spheres into a cylinder of 1.5 mm (varphi) x 80 mm (l) in a platinum mould, cutting of the moulds into 5-mm-long pieces, silver coating on the sources, and finally, encapsulation in stainless steel capsules. Development of safety precautions used to trap 137Cs escaping during borosilicate glass preparation is also described. The leach rates of the radioactive sources prepared by the above technology were within permissible limits, and the sources could be used for encapsulation in stainless steel capsules and supplied for brachytherapy applications. This development was aimed at promoting the potential utility of 137Cs-brachytherapy sources in the country and reducing the user's reliance on imported sources. Since its development, more than 1000 such sources have been made by using 4.66 TBq(126 Ci) of 137Cs.

  3. A compilation of current regulations, standards and guidelines in remote afterloading brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tortorelli, J.P.; Simion, G.P.; Kozlowski, S.D. [Idaho National Engineering Lab., Idaho Falls, ID (United States)

    1994-10-01

    Over a dozen government and professional organizations in the United States and Europe have issued regulations and guidance concerning quality management in the practice of remote afterloading brachytherapy. Information from the publications of these organizations was collected and collated for this report. This report provides the brachytherapy licensee access to a broad field of quality management information in a single, topically organized document.

  4. Salvage high-dose-rate brachytherapy for isolated vaginal recurrence of endometrial cancer.

    Science.gov (United States)

    Baek, Sungjae; Isohashi, Fumiaki; Yamaguchi, Hiroko; Mabuchi, Seiji; Yoshida, Ken; Kotsuma, Tadayuki; Yamazaki, Hideya; Tanaka, Eiichi; Sumida, Iori; Tamari, Keisuke; Otani, Keisuke; Seo, Yuji; Suzuki, Osamu; Yoshioka, Yasuo; Kimura, Tadashi; Ogawa, Kazuhiko

    We have retrospectively analyzed the outcomes of high-dose-rate (HDR) brachytherapy as a salvage therapy for vaginal recurrence of endometrial cancer. From 1997 to 2012, salvage HDR brachytherapy was performed in 43 patients. The median age was 64 years (range, 41-88 years). HDR brachytherapy was performed by interstitial brachytherapy in 34 patients (79%) and by intracavity brachytherapy in nine patients (21%). Seventeen (40%) of the 43 patients were treated with external beam radiotherapy. The median followup period was 58 months (range, 6-179 months). The 5-year overall survival (OS), progression-free survival (PFS), and local control rates (LC) were 84%, 52%, and 78%, respectively. Patients who received brachytherapy with external beam radiotherapy experienced no nodal recurrence (0 of 17 patients), whereas 23% of the patients (6 of 26 patients) who received brachytherapy alone experienced nodal recurrence (p = 0.047). The pathologic grade at the time of initial surgery (G1-2 vs. G3) was found to be a significant prognostic factor for both OS and PFS. The respective 5-year OS was 96% vs. 40% (p endometrial cancer. Pathologic grade, age, and modality were significant prognostic factors. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Dose escalation in permanent brachytherapy for prostate cancer: dosimetric and biological considerations

    Energy Technology Data Exchange (ETDEWEB)

    Li, X Allen [Department of Radiation Oncology, University of Maryland, School of Medicine, 22 South Greene Street, Baltimore, MD 21201-1595 (United States); Wang, Jian Z [Department of Radiation Oncology, University of Maryland, School of Medicine, 22 South Greene Street, Baltimore, MD 21201-1595 (United States); Stewart, Robert D [School of Health Sciences, Purdue University, West Lafayette, IN 47907-1338 (United States); Di Biase, Steven J [Department of Radiation Oncology, University of Maryland, School of Medicine, 22 South Greene Street, Baltimore, MD 21201-1595 (United States)

    2003-09-07

    No prospective dose escalation study for prostate brachytherapy (PB) with permanent implants has been reported. In this work, we have performed a dosimetric and biological analysis to explore the implications of dose escalation in PB using {sup 125}I and {sup 103}Pd implants. The concept of equivalent uniform dose (EUD), proposed originally for external-beam radiotherapy (EBRT), is applied to low dose rate brachytherapy. For a given {sup 125}I or {sup 103}Pd PB, the EUD for tumour that corresponds to a dose distribution delivered by EBRT is calculated based on the linear quadratic model. The EUD calculation is based on the dose volume histogram (DVH) obtained retrospectively from representative actual patient data. Tumour control probabilities (TCPs) are also determined in order to compare the relative effectiveness of different dose levels. The EUD for normal tissue is computed using the Lyman model. A commercial inverse treatment planning algorithm is used to investigate the feasibility of escalating the dose to prostate with acceptable dose increases in the rectum and urethra. The dosimetric calculation is performed for five representative patients with different prostate sizes. A series of PB dose levels are considered for each patient using {sup 125}I and {sup 103}Pd seeds. It is found that the PB prescribed doses (minimum peripheral dose) that give an equivalent EBRT dose of 64.8, 70.2, 75.6 and 81 Gy with a fraction size of 1.8 Gy are 129, 139, 150 and 161 Gy for {sup 125}I and 103, 112, 122 and 132 Gy for {sup 103}Pd implants, respectively. Estimates of the EUD and TCP for a series of possible prescribed dose levels (e.g., 145, 160, 170 and 180 Gy for {sup 125}I and 125, 135, 145 and 155 for {sup 103}Pd implants) are tabulated. The EUD calculation was found to depend strongly on DVHs and radiobiological parameters. The dosimetric calculations suggest that the dose to prostate can be escalated without a substantial increase in both rectal and urethral dose

  6. Third-party brachytherapy source calibrations and physicist responsibilities: report of the AAPM Low Energy Brachytherapy Source Calibration Working Group.

    Science.gov (United States)

    Butler, Wayne M; Bice, William S; DeWerd, Larry A; Hevezi, James M; Huq, M Saiful; Ibbott, Geoffrey S; Palta, Jatinder R; Rivard, Mark J; Seuntjens, Jan P; Thomadsen, Bruce R

    2008-09-01

    The AAPM Low Energy Brachytherapy Source Calibration Working Group was formed to investigate and recommend quality control and quality assurance procedures for brachytherapy sources prior to clinical use. Compiling and clarifying recommendations established by previous AAPM Task Groups 40, 56, and 64 were among the working group's charges, which also included the role of third-party handlers to perform loading and assay of sources. This document presents the findings of the working group on the responsibilities of the institutional medical physicist and a clarification of the existing AAPM recommendations in the assay of brachytherapy sources. Responsibility for the performance and attestation of source assays rests with the institutional medical physicist, who must use calibration equipment appropriate for each source type used at the institution. Such equipment and calibration procedures shall ensure secondary traceability to a national standard. For each multi-source implant, 10% of the sources or ten sources, whichever is greater, are to be assayed. Procedures for presterilized source packaging are outlined. The mean source strength of the assayed sources must agree with the manufacturer's stated strength to within 3%, or action must be taken to resolve the difference. Third party assays do not absolve the institutional physicist from the responsibility to perform the institutional measurement and attest to the strength of the implanted sources. The AAPM leaves it to the discretion of the institutional medical physicist whether the manufacturer's or institutional physicist's measured value should be used in performing dosimetry calculations.

  7. Radiation protection in brachytherapic treatment of prostatic carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mannino, G.; Bona, R.; Occhipinti, A. [Catania Univ. Hospital, ' Vittorio Emanuele, Ferrarotto e Santo Bambino' (Italy); Testagrossa, B.; Vermiglio, G.; Tripepi, M.G. [Messina Univ., Dept. of Protezionistica Ambientale, Sanitaria, Sociale ed Industriale (Italy)

    2006-07-01

    Purpose: To evaluate absorbed doses for medical staff and general public deriving from prostate brachytherapy with I-125 seeds. Methods And Materials: Radiation exposure measurements were made for staff and on a subset of 64 patients of the 100 trans perineal I-125 implanted seeds implants at the Vittorio Emanuele, Ferrarotto e Santo Bambino Universitary Hospital. Results: Absorbed doses for operators are very low when using radiation safety devices. The exposure rate at the anterior skin surface due to I-125 implanted seeds ranged from 32 to 120 {mu}Sv/hour. Conclusions: The evaluation of dose measurements shows that radiation risk associated to this practice is very low, both for staff that for critical group of population, if they follow the specific radioprotection statements supplied by health physicists. (authors)

  8. Ocular Response of Choroidal Melanoma With Monosomy 3 Versus Disomy 3 After Iodine-125 Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Marathe, Omkar S. [David Geffen School of Medicine, University of Los Angeles, Los Angeles, CA (United States); Wu, Jeffrey; Lee, Steve P. [Department of Radiation Oncology, University of Los Angeles, Los Angeles, CA (United States); Yu Fei; Burgess, Barry L. [Department of Ophthalmology, The Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); Leu Min [Department of Radiation Oncology, University of Los Angeles, Los Angeles, CA (United States); Straatsma, Bradley R. [Department of Ophthalmology, The Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); McCannel, Tara A., E-mail: TMcCannel@jsei.ucla.edu [Department of Ophthalmology, Jules Stein Eye Institute, University of Los Angeles, Los Angeles, CA (United States); Jonsson Comprehensive Cancer Center, University of Los Angeles, Los Angeles, CA (United States)

    2011-11-15

    Purpose: To report the ocular response of choroidal melanoma with monosomy 3 vs. disomy 3 after {sup 125}I brachytherapy. Methods and Materials: We evaluated patients with ciliochoroidal melanoma managed with fine needle aspiration biopsy immediately before plaque application for {sup 125}I brachytherapy between January 1, 2005 and December 31, 2008. Patients with (1) cytopathologic diagnosis of melanoma, (2) melanoma chromosome 3 status identified by fluorescence in situ hybridization, and (3) 6 or more months of follow-up after brachytherapy were sorted by monosomy 3 vs. disomy 3 and compared by Kruskal-Wallis test. Results: Among 40 ciliochoroidal melanomas (40 patients), 15 had monosomy 3 and 25 had disomy 3. Monosomy 3 melanomas had a median greatest basal diameter of 12.00 mm and a median tumor thickness of 6.69 mm before brachytherapy; at a median of 1.75 years after brachytherapy, median thickness was 3.10 mm. Median percentage decrease in tumor thickness was 48.3%. Disomy 3 melanomas had a median greatest basal diameter of 10.00 mm and median tumor thickness of 3.19 mm before brachytherapy; at a median of 2.00 years after brachytherapy, median tumor thickness was 2.37 mm. The median percentage decrease in tumor thickness was 22.7%. Monosomy 3 melanomas were statistically greater in size than disomy 3 melanomas (p < 0.001) and showed a greater decrease in tumor thickness after brachytherapy (p = 0.006). Conclusion: In this study, ciliochoroidal melanomas with monosomy 3 were significantly greater in size than disomy 3 melanoma and showed a significantly greater decrease in thickness at a median of 1.75 years after brachytherapy. The greater decrease in monosomy 3 melanoma thickness after brachytherapy is consistent with other malignancies in which more aggressive pathology has been shown to be associated with a greater initial response to radiotherapy.

  9. Neurocognitive function and quality of life in patients with newly diagnosed brain metastasis after treatment with intra-operative cesium-131 brachytherapy: a prospective trial.

    Science.gov (United States)

    Pham, Anthony; Yondorf, Menachem Z; Parashar, Bhupesh; Scheff, Ronald J; Pannullo, Susan C; Ramakrishna, Rohan; Stieg, Philip E; Schwartz, Theodore H; Wernicke, A Gabriella

    2016-03-01

    Intraoperative permanent Cesium-131 (Cs-131) brachytherapy can provide a viable alternative to WBRT with excellent response rates and minimal toxicity. This study reports the results of the prospective trial of the impact of intraoperative Cs-131 on neurocognitive function and quality of life (QoL) in patients with resected brain metastases. Between 2010 and 2012, 24 patients with newly diagnosed metastasis to the brain were accrued on a prospective protocol and treated with Cs-131 brachytherapy seeds after surgical resection. Physicians administered the mini-mental status examination (MMSE) and functional assessment of cancer therapy-brain (FACT-Br) questionnaire to all patients before treatment and again every 2 months for the duration of 6 months with additional follow-up again at 12 months. Wilcoxon rank sum test was used to analyze statistically significant changes in MMSE over time and paired t test was used to analyze changes in FACT-BR. There was a statistical improvement in overall FACT-BR score at 4 and 6 months of follow-up when compared to baseline (162 vs. 143, P = 0.004; 164 vs. 143, P = 0.005 respectively) with a non-significant trend toward improvement at 2 and 12 months (154 vs. 143, P = 0.067; 159 vs. 149, P = 0.4). MMSE score was statistically improved at 4 and up to 12 months compared to pre-treatment MMSE (30 vs. 29, P = 0.017; 30 vs. 29, P = 0.001 respectively). Patients with brain metastasis who received intra-operative permanent Cs-131 brachytherapy implants saw an improvement of their neurocognitive status and self-assessment of QoL. In addition to the excellent local control of metastasis, this approach may contribute to the improvements in cognitive function and QOL.

  10. Organic Leek Seed Production - Securing Seed Quality

    DEFF Research Database (Denmark)

    Deleuran, L C; Boelt, B

    2011-01-01

    To maintain integrity in organic farming, availability of organically produced GM-free seed of varieties adapted to organic production systems is of vital impor-tance. Despite recent achievements, organic seed supply for a number of vegetable species is insufficient. Still, in many countries...... organic vegetable growers can get derogations to use non-organic seeds in their productions. Potentially, this could lead to the organic consumers’ loss of faith and interest in organic products. The pre-requisite for an organic vegetable production is the presence of organically produced high quality...... seeds. Tunnel production is a means of securing seed of high genetic purity and quality, and organic leek (Allium porrum L.) seed production was tested in tunnels in Denmark. The present trial focused on steckling size and in all years large stecklings had a positive effect on both seed yield...

  11. Organic Leek Seed Production - Securing Seed Quality

    DEFF Research Database (Denmark)

    Deleuran, L C; Boelt, B

    2011-01-01

    To maintain integrity in organic farming, availability of organically produced GM-free seed of varieties adapted to organic production systems is of vital impor-tance. Despite recent achievements, organic seed supply for a number of vegetable species is insufficient. Still, in many countries...... organic vegetable growers can get derogations to use non-organic seeds in their productions. Potentially, this could lead to the organic consumers’ loss of faith and interest in organic products. The pre-requisite for an organic vegetable production is the presence of organically produced high quality...... seeds. Tunnel production is a means of securing seed of high genetic purity and quality, and organic leek (Allium porrum L.) seed production was tested in tunnels in Denmark. The present trial focused on steckling size and in all years large stecklings had a positive effect on both seed yield...

  12. Organic leek seed production - securing seed quality

    DEFF Research Database (Denmark)

    Deleuran, Lise Christina; Boelt, Birte

    2011-01-01

    To maintain integrity in organic farming, availability of organically produced GM-free seed of varieties adapted to organic production systems is of vital impor-tance. Despite recent achievements, organic seed supply for a number of vegetable species is insufficient. Still, in many countries...... organic vegetable growers can get derogations to use non-organic seeds in their productions. Potentially, this could lead to the organic consumers’ loss of faith and interest in organic products. The pre-requisite for an organic vegetable production is the presence of organically produced high quality...... seeds. Tunnel production is a means of securing seed of high genetic purity and quality, and organic leek (Allium porrum L.) seed production was tested in tunnels in Denmark. The present trial focused on steckling size and in all years large stecklings had a positive effect on both seed yield...

  13. Barley seed aging

    NARCIS (Netherlands)

    Nagel, Manuela; Kodde, Jan; Pistrick, Sibylle; Mascher, Martin; Börner, Andreas; Groot, Steven P.C.

    2016-01-01

    Experimental seed aging approaches intend to mimic seed deterioration processes to achieve a storage interval reduction. Common methods apply higher seed moisture levels and temperatures. In contrast, the “elevated partial pressure of oxygen” (EPPO) approach treats dry seed stored at ambient temp

  14. Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

    Directory of Open Access Journals (Sweden)

    Kasper ME

    2015-11-01

    Full Text Available Michael E Kasper,1,2 Ahmed A Chaudhary3 1Department of Radiation Oncology, Lynn Cancer Institute at Boca Raton Regional Hospital, Boca Raton, 2Charles E. Schmidt College of Medicine, Florida Atlantic University, FL, 3North Main Radiation Oncology, Warren Alpert School of Medicine, Brown University, RI, USA Abstract: Nonmelanoma skin cancer (NMSC is an increasing health care issue in the United States, significantly affecting quality of life and impacting health care costs. Radiotherapy has a long history in the treatment of NMSC. Shortly after the discovery of X-rays and 226Radium, physicians cured patients with NMSC using these new treatments. Both X-ray therapy and brachytherapy have evolved over the years, ultimately delivering higher cure rates and lower toxicity. Electronic brachytherapy for NMSC is based on the technical and clinical data obtained from radionuclide skin surface brachytherapy and the small skin surface applicators developed over the past 25 years. The purpose of this review is to introduce electronic brachytherapy in the context of the history, data, and utilization of traditional radiotherapy and brachytherapy. Keywords: electronic brachytherapy, superficial radiotherapy, skin surface brachytherapy, electron beam therapy, nonmelanoma skin cancer, basal cell carcinoma, squamous cell carcinoma

  15. Electromagnetically navigated brachytherapy as a new treatment option for peripheral pulmonary tumors.

    Science.gov (United States)

    Harms, Wolfgang; Krempien, Robert; Grehn, Christian; Hensley, Frank; Debus, Jürgen; Becker, Heinrich D

    2006-02-01

    This technical note describes the principles of navigated brachytherapy for treatment of peripheral non-small cell lung cancer (NSCLC). In a prospective feasibility trial a first patient with medically inoperable NSCLC in the right upper lobe was treated with external-beam radiotherapy (50 Gy) and navigated endoluminal brachytherapy (15 Gy). Navigated bronchoscopy was performed with an electromagnetic navigation system for localization of a microsensor mounted on the tip of a dedicated catheter placed within the working channel of a bronchoscope. The probe can be actively guided by a steering mechanism to targeted lesions in the periphery of the lung. After successful localization of the NSCLC, endobronchial ultrasound (EBUS) was performed to confirm the exact position in the center of the lesion. A 6-F brachytherapy catheter was placed within the tumor. Primary 3-D-planned brachytherapy was performed on chest CTs acquired with the inserted catheter. High-dose-rate brachytherapy (370 GBq iridium-192) was applied as a boost three times a week (single dose 5 Gy) and provided highly conformal irradiations of the NSCLC including the draining bronchovascular bundle. The brachytherapy catheter was tolerated well during treatment (5 days) and alimentation was possible without any problems. Repeated CTs showed stable positioning of the catheter. During follow-up (12 months), endoluminal ultrasound and CT demonstrated a partial remission while histology showed a complete remission of the tumor. Navigated brachytherapy for peripheral pulmonary tumors not amenable to conventional bronchoscopy is feasible.

  16. Electromagnetically navigated brachytherapy as a new treatment option for peripheral pulmonary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Harms, W.; Krempien, R.; Grehn, C.; Hensley, F.; Debus, J. [Dept. of Radio-Oncology, Univ. of Heidelberg (Germany); Becker, H.D. [Dept. of Interdisciplinary Bronchoscopy, Thorax Clinic at Heidelberg Univ. Medical School, Heidelberg (Germany)

    2006-02-01

    Purpose: this technical note describes the principles of navigated brachytherapy for treatment of peripheral non-small cell lung cancer (NSCLC). Material and methods: in a prospective feasibility trial a first patient with medically inoperable NSCLC in the right upper lobe was treated with external-beam radiotherapy (50 Gy) and navigated endoluminal brachytherapy (15 Gy). Navigated bronchoscopy was performed with an electromagnetic navigation system for localization of a microsensor mounted on the tip of a dedicated catheter placed within the working channel of a bronchoscope. The probe can be actively guided by a steering mechanism to targeted lesions in the periphery of the lung. After successful localization of the NSCLC, endobronchial ultrasound (EBUS) was performed to confirm the exact position in the center of the lesion. A 6-F brachytherapy catheter was placed within the tumor. Primary 3-D-planned brachytherapy was performed on chest CTs acquired with the inserted catheter. High-dose-rate brachytherapy (370 GBq iridium-192) was applied as a boost three times a week (single dose 5 Gy) and provided highly conformal irradiations of the NSCLC including the draining bronchovascular bundle. Results: the brachytherapy catheter was tolerated well during treatment (5 days) and alimentation was possible without any problems. Repeated CTs showed stable positioning of the catheter. During follow-up (12 months), endoluminal ultrasound and CT demonstrated a partial remission while histology showed a complete remission of the tumor. Conclusion: navigated brachytherapy for peripheral pulmonary tumors not amenable to conventional bronchoscopy is feasible. (orig.)

  17. Comparison between real-time intra-operative ultrasound-based dosimetry and CT-based dosimetry for prostate brachytherapy using cesium-131.

    Science.gov (United States)

    Jacobs, B L; Gibbons, E P; Smith, R P; Beriwal, S; Komanduri, K; Benoit, R M

    2008-12-01

    The purpose of this study was to evaluate the correlation between real-time intra-operative ultrasound-based dosimetry (USD) and day 0 post-implant CT dosimetry (CTD) (131)Cs permanent prostate brachytherapy. Fifty-two consecutive patients who underwent prostate brachytherapy with (131)Cs were evaluated. Real time operating room planning was performed using VariSeed 7.1 software. Post-needle placement prostate volume was used for real-time planning. Targets for dosimetry were D(90) >110%, V(100) >90%, V(150) 15% difference between USD and CTD and 51.9% of patients had a >10% difference between these values. In contrast, the USD and CTD for V(100) were within 5% in 55.8% of patients and within 10% in 86.5% of patients. This study demonstrates a correlation between the mean intra-operative USD and post-implant day 0 CTD values only for V(200). Significant variation in D(90), V(150), and V(200) values existed for individual patients between USD and CTD. These results suggest that real-time intra-operative USD does not serve as a surrogate for post-operative CTD, and that post-operative CTD is still necessary.

  18. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    Energy Technology Data Exchange (ETDEWEB)

    Krengli, M.; Deantonio, L. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); University of ' ' Piemonte Orientale' ' , Department of Translational Medicine, Novara (Italy); Masini, L.; Filomeno, A.; Gambaro, G. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); Comoli, A.M. [University Hospital Maggiore della Carita, Ophthalmology, Novara (Italy); Negri, E. [University Hospital Maggiore della Carita, Medical Physics, Novara (Italy)

    2014-03-15

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium ({sup 192}Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.) [German] Das Karzinom des Augenlids stellt aufgrund der funktionellen und kosmetischen Beeintraechtigungen dieser anatomischen Region eine therapeutische Herausforderung dar. Ziele der Therapie sind sowohl die Tumorkontrolle als auch ein gutes funktionelles und kosmetisches Ergebnis. Lokale Kontrolle, Toxizitaet sowie funktionelle und kosmetische Ergebnisse bei Patienten mit Karzinom des Augenlids, die mit interstitieller Brachytherapie behandelt wurden, sollten analysiert werden. Sechzig Patienten mit Karzinom des Augenlids wurden mit interstitieller Brachytherapie mit Iridium-192-Draehten

  19. MO-E-BRD-00: Breast Brachytherapy: The Phoenix of Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  20. MO-E-BRD-01: Is Non-Invasive Image-Guided Breast Brachytherapy Good?

    Energy Technology Data Exchange (ETDEWEB)

    Hiatt, J. [Rhode Island Hospital (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  1. MO-E-BRD-02: Accelerated Partial Breast Irradiation in Brachytherapy: Is Shorter Better?

    Energy Technology Data Exchange (ETDEWEB)

    Todor, D. [Virginia Commonwealth University (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  2. High brachytherapy doses can counteract hypoxia in cervical cancer—a modelling study

    Science.gov (United States)

    Lindblom, Emely; Dasu, Alexandru; Beskow, Catharina; Toma-Dasu, Iuliana

    2017-01-01

    Tumour hypoxia is a well-known adverse factor for the outcome of radiotherapy. For cervical tumours in particular, several studies indicate large variability in tumour oxygenation. However, clinical evidence shows that the management of cervical cancer including brachytherapy leads to high rate of success. It was the purpose of this study to investigate whether the success of brachytherapy for cervical cancer, seemingly regardless of oxygenation status, could be explained by the characteristics of the brachytherapy dose distributions. To this end, a previously used in silico model of tumour oxygenation and radiation response was further developed to simulate the treatment of cervical cancer employing a combination of external beam radiotherapy and intracavitary brachytherapy. Using a clinically-derived brachytherapy dose distribution and assuming a homogeneous dose delivered by external radiotherapy, cell survival was assessed on voxel level by taking into account the variation of sensitivity with oxygenation as well as the effects of repair, repopulation and reoxygenation during treatment. Various scenarios were considered for the conformity of the brachytherapy dose distribution to the hypoxic region in the target. By using the clinically-prescribed brachytherapy dose distribution and varying the total dose delivered with external beam radiotherapy in 25 fractions, the resulting values of the dose for 50% tumour control, D 50, were in agreement with clinically-observed values for high cure rates if fast reoxygenation was assumed. The D 50 was furthermore similar for the different degrees of conformity of the brachytherapy dose distribution to the tumour, regardless of whether the hypoxic fraction was 10%, 25%, or 40%. To achieve 50% control with external RT only, a total dose of more than 70 Gy in 25 fractions would be required for all cases considered. It can thus be concluded that the high doses delivered in brachytherapy can counteract the increased

  3. Practical considerations for maximizing heat production in a novel thermobrachytherapy seed prototype

    Energy Technology Data Exchange (ETDEWEB)

    Gautam, Bhoj; Warrell, Gregory; Shvydka, Diana; Ishmael Parsai, E., E-mail: e.parsai@utoledo.edu [University of Toledo Medical Center, 3000 Arlington Avenue, MS1151, Toledo, Ohio 43614 (United States); Subramanian, Manny [BEST Medical International, Inc., 7643 Fullerton Road, Springfield, Virginia 22153 (United States)

    2014-02-15

    Purpose: A combination of hyperthermia and radiation in the treatment of cancer has been proven to provide better tumor control than radiation administered as a monomodality, without an increase in complications or serious toxicities. Moreover, concurrent administration of hyperthermia and radiation displays synergistic enhancement, resulting in greater tumor cell killing than hyperthermia and radiation delivered separately. The authors have designed a new thermobrachytherapy (TB) seed, which serves as a source of both radiation and heat for concurrent brachytherapy and hyperthermia treatments when implanted in solid tumors. This innovative seed, similar in size and geometry to conventional seeds, will have self-regulating thermal properties. Methods: The new seed's geometry is based on the standard BEST Model 2301{sup 125}I seed, resulting in very similar dosimetric properties. The TB seed generates heat when placed in an oscillating magnetic field via induction heating of a ferromagnetic Ni–Cu alloy core that replaces the tungsten radiographic marker of the standard Model 2301. The alloy composition is selected to undergo a Curie transition near 50 °C, drastically decreasing power production at higher temperatures and providing for temperature self-regulation. Here, the authors present experimental studies of the magnetic properties of Ni–Cu alloy material, the visibility of TB seeds in radiographic imaging, and the ability of seed prototypes to uniformly heat tissue to a desirable temperature. Moreover, analyses are presented of magnetic shielding and thermal expansion of the TB seed, as well as matching of radiation dose to temperature distributions for a short interseed distance in a given treatment volume. Results: Annealing the Ni–Cu alloy has a significant effect on its magnetization properties, increasing the sharpness of the Curie transition. The TB seed preserves the radiographic properties of the BEST 2301 seed in both plain x rays and CT

  4. Dose volume analysis in brachytherapy and stereotactic radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Tozer-Loft, S.M

    2000-12-01

    A brief introduction to three branches of radiotherapy is given: interstitial brachytherapy, external beam megavoltage radiotherapy, and stereotactic radiosurgery. The current interest in issues around conformity, uniformity and optimisation is explained in the light of technical developments in these fields. A novel method of displaying dose-volume information, which mathematically suppresses the inverse-square law, as first suggested by L.L. Anderson for use in brachytherapy is explained in detail, and some improvements proposed. These 'natural' histograms are extended to show the effects of real point sources which do not exactly follow the inverse-square law, and to demonstrate the in-target dose-volume distribution, previously unpublished. The histograms are used as a way of mathematically analysing the properties of theoretical mono-energetic radionuclides, and for demonstrating the dosimetric properties of a potential new brachytherapy source (Ytterbium-169). A new modification of the Anderson formalism is then described for producing Anderson Inverse-Square Shifted (AISS) histograms for the Gamma Knife, which are shown to be useful for demonstrating the quality of stereotactic radiosurgery dose distributions. A study is performed analysing the results of Gamma Knife treatments on 44 patients suffering from a benign brain tumour (acoustic neuroma). Follow-up data is used to estimate the volume shrinkage or growth of each tumour, and this measure of outcome is compared with a range of figures of merit which express different aspects of the quality of each dose distributions. The results are analysed in an attempt to answer the question: What are the important features of the dose distribution (conformality, uniformity, etc) which show a definite relationship with the outcome of the treatment? Initial results show positively that, when Gamma Knife radiosurgery is used to treat acoustic neuroma, some measures of conformality seem to have a surprising

  5. [Endobronchial brachytherapy: state of the art in 2013].

    Science.gov (United States)

    Derhem, N; Sabila, H; Mornex, F

    2013-04-01

    Endobronchial brachytherapy is an invasive technique, which allows localizing radioactive sources at the tumour contact. Therefore, high doses are administered to tumour while healthy tissues can be spared. Initially dedicated to a palliative setting, improvements helped reaching 60 to 88% symptoms alleviation and 30 to 100% of endoscopic macroscopic response. New diagnostic techniques and early diagnosis extended the indications to a curative intent: endoluminal primitive tumour, post radiation endobronchial recurrence, inoperable patients. CT-based dosimetry is a keypoint to optimize treatment quality and to minimize potential side effects, making this treatment a safe and efficient technique for specific indications.

  6. Survival following interstitial brachytherapy for recurrent malignant glioma.

    Science.gov (United States)

    Kitchen, N D; Hughes, S W; Taub, N A; Sofat, A; Beaney, R P; Thomas, D G

    1994-01-01

    The treatment of recurrent malignant glioma is difficult and at present largely disappointing. Furthermore the results of any treatment modality need to be interpreted with knowledge regarding patient selection and timing of treatment. The results of interstitial brachytherapy using iodine-125 in 23 patients are presented. There were no operative complications. Median survival time from tumour recurrence and implantation was 36 and 25 weeks respectively. Karnofsky Performance Status (KPS) was significantly associated with survival, though patient age, original tumour histology, prior chemotherapy, and time to recurrence were not. Treatment does confer modest survival benefit as compared to controls, but our results are not as impressive as others. Reasons for this finding are discussed.

  7. Salvage robot-assisted radical prostatectomy after brachytherapy: our experience

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2014-01-01

    Full Text Available In case of recurrence of prostate cancer after radiation therapy patient may be offered salvage radical prostatectomy (both open and laparoscopic/robotic, hormone therapy, and a number of alternative techniques such as salvage cryoablation, HIFU-therapy and brachytherapy. Results of monitoring of patients for 10 years after salvage treatment of prostate cancer are known only after salvage prostatectomy. Technically radical prostatectomy after radiation therapy is associated with a large number of complications if compared with primary radical prostatectomy. The most frequent complications after salvage prostatectomy include incontinence, stricture formation of urethrovesical anastomosis, rectal injury, acute urinary retention and infectious complications.

  8. Pulsed-Dose Rate Brachytherapy for the Treatment of Endometrial Cancer.

    Science.gov (United States)

    De Felice, Francesca; Caiazzo, Rossella; Benevento, Ilaria; Musio, Daniela; Rubini, Filippo; Tombolini, Vincenzo

    2017-01-01

    Endometrial cancer (EC) is the most frequent gynecologic malignancy. The aim of this review is to outline clinical practice recommendations, to suggest a technical solution, and to advise doses selection for pulsed-dose rate (PDR) brachytherapy in EC. Electronic bibliographic databases, including PubMed, clinicaltrials.gov, and the American Society of Clinical Oncology (ASCO) Meeting Library, were searched for articles in English. Clinical guidelines and systematic reviews were also considered. The appropriate therapeutic approach should consider risk factors for tumor relapse and PDR brachytherapy and have a convincing role in this multidisciplinary scenario. Performing PDR brachytherapy in EC requires robust training and experience. © 2017 S. Karger AG, Basel.

  9. High dose brachytherapy in pediatric oncology; Braquiterapia com alta taxa de dose em oncologia pediatrica

    Energy Technology Data Exchange (ETDEWEB)

    Ferrigno, Robson; Codjaian, Osanna Esther; Novaes, Paulo Eduardo R.S.; Trippe, Nivaldo [Fundacao Antonio Prudente, Sao Paulo, SP (Brazil). Hospital A.C. Camargo. Dept. de Radioterapia

    1995-05-01

    Brachytherapy is a kind of radiotherapy that has been used in the multidisciplinary approach of some pediatric tumors, such as soft tissue sarcomas of the extremities, head and neck and urogenital tract. Recent technological advances in this area lead to development of computerized high dose rate remote afterloading brachytherapy. This type of treatment has some advantages compared to low dose rate brachytherapy traditionally used. This article describes not only the characteristics and advantages of this kind of treatment, but also the preliminary results of the first seven children treated with high dose rate at the Hospital A.C.Camargo. (author) 10 refs., 8 figs.

  10. A case of percutaneous high dose rate brachytherapy for superior pulmonary sulcus tumor

    Energy Technology Data Exchange (ETDEWEB)

    Asakura, Tamaki; Imamura, Masahiro; Murata, Takashi [Kansai Medical Univ., Moriguchi, Osaka (Japan)] [and others

    1996-07-01

    A 64-year-old man with advanced superior pulmonary sulcus tumor suffered severe unrelieved pain even after chemotherapy, external irradiation and hyperthermia. So we planned to introduce a percutaneous high dose rate brachytherapy using the microselectron HDR {sup 192}Ir. With the estimation using the Pain Score, satisfying pain relief was attainable with a combination of the percutaneous high dose rate brachytherapy and conventional treatment. So the percutaneous high dose rate brachytherapy had the possibility to contribute to the alleviation of the pain. (author)

  11. Study of factors influencing dose distribution of brachytherapy in cervical cancer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To study the factors which influence the dose distribution of brachytherapy in cervical cancer.Methods Ninety-five patients with cervical cancer Ⅱ-Ⅲb received fundamental radiation therapy including brachytherapy in our department from Aug.2004 to Nov.2005.The deviation of isodose curve of brachytherapy was based on A-B reference system,and the deviation of dose was defined by measuring in a practical standard body model.Results The factors influencing isodose offset significantly were parametrial...

  12. LOW-DOSE RATE BRACHYTHERAPY FOR PROSTATE CANCER: DIFFERENT INDICATIONS – DIFFERENT RESULTS

    Directory of Open Access Journals (Sweden)

    V. A. Biryukov

    2014-07-01

    Full Text Available In Russia, there is presently a growing interest in low-dose intratissue radiotherapy (brachytherapy for locally advanced prostate cancer (PC. Since its inception, current brachytherapy has undergone a number of significant changes in terms of improved visualization and better treatment planning and monitoring, which is sure to have affected the higher quality of their performance and better long-term results. The main purpose of the given paper is to generalize the data of foreign investigators who have the greatest experience with brachytherapy for its further use in the treatment of patients with locally advanced PC under the conditions of Russian clinics.

  13. Use of Monte Carlo Methods in brachytherapy; Uso del metodo de Monte Carlo en braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Granero Cabanero, D.

    2015-07-01

    The Monte Carlo method has become a fundamental tool for brachytherapy dosimetry mainly because no difficulties associated with experimental dosimetry. In brachytherapy the main handicap of experimental dosimetry is the high dose gradient near the present sources making small uncertainties in the positioning of the detectors lead to large uncertainties in the dose. This presentation will review mainly the procedure for calculating dose distributions around a fountain using the Monte Carlo method showing the difficulties inherent in these calculations. In addition we will briefly review other applications of the method of Monte Carlo in brachytherapy dosimetry, as its use in advanced calculation algorithms, calculating barriers or obtaining dose applicators around. (Author)

  14. A simple percutaneous inserter for radiopaque gold seeds used in radiotherapy treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Hay, K.D.; Hindley, A.; Sharp, I. [Auckland Hospital and medimec, Auckland (New Zealand). Departments of Oral Health and Radiation Oncology

    1998-05-01

    Percutaneous insertion of a radiopaque marker is an important technique used in radiotherapy planning for both external-beam and brachytherapy. It is of particular importance in the oral cavity. We describe the construction and use of a simple inserter for `cold` gold seeds manufactured from a commercialiy available Becton Dickinson Brand 5-mL disposable syrinqe and a Becton Dickinson Brand 18 G 11/2 TW (1.25 x 38 mm) hypodermic needle. Copyright (1998) Blackwell Science Pty Ltd 6 refs., 5 figs.

  15. Dosimetry of IRIDIUM-192 and CESIUM-137 Seed Sources.

    Science.gov (United States)

    Thomason, Cynthia

    The use of ^{192}Ir in brachytherapy implants both alone and in conjunction with other modalities for the treatment of various types of cancer has greatly increased in recent years. This increased usage has led to a greater need for detailed information concerning the dose distribution surrounding commerically available ^{192} Ir seed sources. This is especially truce since improvements in computer technology along with their increased availability and utilization have enabled more precise calculation of dose distributions. The radiation does distribution in water was measured using LiF thermoluminescent dosimeters for an ^{192}Ir seed source with platinum encapsulation, for an ^{192}Ir seed source with stainless steel encapsulation and for a ^{137}Cs seed source intended as a substitute for ^{192 }Ir. The Electron-Gamma-Shower (EGS) computer code, which is a package for doing Monte Carlo simulation of the transport of photons and electrons in any medium or geometry specified by the user, also was used to study the dose distribution around these seed sources. In addition, the exposure rate constant, exposure rate at 1 meter, transmission through the source capsule, f-factor, and energy distribution exiting the source capsule were evaluated by Monte Carlo simulation of these three sources. Good agreement was seen between the measured data and the Monte Carlo generated data. In addition to producing valuable dosimetric data, this study has demonstrated that Monte Carlo modeling of ^{192} Ir and ^{137}Cs seed sources using the EGS Monte Carlo code can provide an accurate means of evaluating these data.

  16. Seed vigour and seed lot quality

    Directory of Open Access Journals (Sweden)

    Lekić Slavoljub S.

    2001-01-01

    Full Text Available This paper discusses seed vigour as the most important seed characteristic the seed lot quality depends on. In Serbian, the terms such as vigor, viability and germ inability are used in various ways, depending on the author, which leaves room to possible misunderstanding in interpretation of research results and misuse of expert terminology. The modest lexical fund, compared to that of the English language, for instance, greatly contributes to the problem, and so does the absence of terminological standardization. Since the current technology and research level in seed science and technology requires appropriate terminology, this article offers an outline of basic seed traits related expert terminology as a foundation of future seed research and technology development. .

  17. Pathological impairments induced by interstitial implantation of 125I Seeds in spinal canal of banna mini-pigs

    Directory of Open Access Journals (Sweden)

    Yang Zuozhang

    2012-03-01

    Full Text Available Abstract Background Use a banna mini-pig to set up 125I implantation model, and investigate the consequence of radiation-related impairments. Methods In present study, 125I seeds were implanted into spinal canal of T13 level of spine in banna mini-pigs. After operation, the pigs were raised up to 8 months, behavior changes were recorded within this period. After 8 months, spinal cords were collected for pathological analysis. Results In this study, a 125I brachytherapy animal model had been successfully established, in the model group, the banna pigs' Tarlov scale decreased from 5 to 2.57 ± 0.36, significant cellular impairments were noted by pathological analysis. Conclusions Without any protection and operation improvement, 125I implantation can cause serious histological impairments and moving difficulty for banna mini-pigs; this present research provides an alternative tool to study spinal 125I brachytherapy.

  18. American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review.

    Science.gov (United States)

    Harkenrider, Matthew M; Block, Alec M; Alektiar, Kaled M; Gaffney, David K; Jones, Ellen; Klopp, Ann; Viswanathan, Akila N; Small, William

    This article aims to review the risk stratification of endometrial cancer, treatment rationale, outcomes, treatment planning, and treatment recommendations of vaginal brachytherapy (VBT) in the postoperative management of endometrial cancer patients. The authors performed a thorough review of the literature and reference pertinent articles pertaining to the aims of this review. Adjuvant VBT for early-stage endometrial cancer patients results in very low rates of vaginal recurrence (0-3.1%) with low rates of late toxicity which are primarily vaginal in nature. Post-Operative Radiation Therapy in Endometrial Cancer 2 (PORTEC-2) supports that VBT results in noninferior rates of vaginal recurrence compared to external beam radiotherapy for the treatment of high-intermediate risk patients. VBT as a boost after external beam radiotherapy, in combination with chemotherapy, and for high-risk histologies have shown excellent results as well though randomized data do not exist supporting VBT boost. There are many different applicators, dose-fractionation schedules, and treatment planning techniques which all result in favorable clinical outcomes and low rates of toxicity. Recommendations have been published by the American Brachytherapy Society and the American Society of Radiation Oncology to help guide practitioners in the use of VBT. Data support that patients and physicians prefer joint decision making regarding the use of VBT, and patients often desire additional treatment for a marginal benefit in risk of recurrence. Discussions regarding adjuvant therapy for endometrial cancer