Top

Radiation Oncology

Published in:

Open Access 01-12-2014 | Research

Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: limited effect of oedema

Authors: Anna M Dinkla, Bradley R Pieters, Kees Koedooder, Niek van Wieringen, Rob van der Laarse, Arjan Bel

Published in: Radiation Oncology | Issue 1/2014

Abstract

Background

In pulsed-dose rate prostate brachytherapy the dose is delivered during 48 hours after implantation, making the treatment sensitive to oedematic effects possibly affecting dose delivery. The aim was to study changes in prostate volume during treatment by analysing catheter configurations on three subsequent scans.

Methods

Prostate expansion was determined for 19 patients from the change in spatial distribution of the implanted catheters, using three CT-scans: a planning CT (CT1) and two CTs after 24 and 48 hours (CT2, CT3). An additional 4 patients only received one repeat CT (after 24 hours). The mean radial distance (MRD) of all dwell positions to the geometric centre of all dwell positions used was calculated to evaluate volume changes. From three implanted markers changes in inter-marker distances were assessed. The relative shifts of all dwell positions were determined using catheter- and marker-based registrations. Wilcoxon signed-rank tests were performed to compare the results from the different time points.

Results

The MRDs measured on the two repeat CTs were significantly different from CT1. The mean prostate volume change derived from the difference in MRD was +4.3% (range −9.3% to +15.6%) for CT1-CT2 (p < .05) and +4.4% (range −7.5% to +16.3%) for CT1-CT3 (p < .05). These values represented a mean increase of 1.2 cm³ in the first 24 hours and 1.5 cm³ in the subsequent 24 hours. There was no clear sign of prostate expansion from the change in inter-marker distance (CT1-CT2: 0.2 ± 1.8 mm; CT1-CT3: 0.6 ± 2.2 mm). Catheter configuration remained stable; shifts in catheter positions were largest in the C-C direction: 0 ± 1.8 mm for CT1-CT2 and 0 ± 1.4 mm for CT2-CT3.

Conclusions

The volume changes derived from catheter displacements were small and therefore considered clinically insignificant. Implant configuration remains stable during 2 days of treatment, confirming the safety of this technique.

Available only for authorised users

Hoskin PJ, Rojas AM, Bownes PJ, Lowe GJ, Ostler PJ, Bryant L: Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer. Radiother Oncol 2012, 103: 217-222. 10.1016/j.radonc.2012.01.007CrossRefPubMed

Pieters BR, Geijsen ED, Koedooder C, Blank LE, Rezaie E, van der Grient JN, de Reijke TM, Koning CC: Treatment results of PDR brachytherapy combined with external beam radiotherapy in 106 patients with intermediate- to high-risk prostate cancer. Int J Radiat Oncol Biol Phys 2011, 79: 1037-1042. 10.1016/j.ijrobp.2009.12.044CrossRefPubMed

Lettmaier S, Lotter M, Kreppner S, Strnad A, Fietkau R, Strnad V: Long term results of a prospective dose escalation phase-II trial: interstitial pulsed-dose-rate brachytherapy as boost for intermediate- and high-risk prostate cancer. Radiother Oncol 2012, 104: 181-186. 10.1016/j.radonc.2012.07.003CrossRefPubMed

Pieters BR, Rezaie E, Geijsen ED, Koedooder C, van der Grient JN, Blank LE, de Reijke TM, Koning CC: Development of late toxicity and international prostate symptom score resolution after external-beam radiotherapy combined with pulsed dose rate brachytherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2011, 81: 758-764. 10.1016/j.ijrobp.2010.05.044CrossRefPubMed

Kirisits C, Rivard MJ, Baltas D, Ballester F, De Brabandere M, van der Laarse R, Niatsetski Y, Papagiannis P, Hellebust TP, Perez-Calatayud J, Tanderup K, Venselaar JL, Siebert FA: Review of clinical brachytherapy uncertainties: analysis guidelines of GEC-ESTRO and the AAPM. Radiother Oncol 2013, 110: 199-212. 10.1016/j.radonc.2013.11.002CrossRefPubMed

Pinkawa M, Asadpour B, Gagel B, Piroth MD, Borchers H, Jakse G, Eble MJ: Evaluation of source displacement and dose–volume changes after permanent prostate brachytherapy with stranded seeds. Radiother Oncol 2007, 84: 190-196. 10.1016/j.radonc.2007.07.014CrossRefPubMed

Tanaka O, Hayashi S, Matsuo M, Nakano M, Uno H, Ohtakara K, Miyoshi T, Deguchi T, Hiroaki H: Effect of edema on postimplant dosimetry in prostate brachytherapy using CT/MRI fusion. Int J Radiat Oncol Biol Phys 2007, 69: 614-618. 10.1016/j.ijrobp.2007.05.082CrossRefPubMed

Sloboda RS, Usmani N, Pedersen J, Murtha A, Pervez N, Yee D: Time course of prostatic edema post permanent seed implant determined by magnetic resonance imaging. Brachytherapy 2010, 9: 354-361. 10.1016/j.brachy.2009.09.008CrossRefPubMed

Waterman FM, Yue N, Corn BW, Dicker AP: Edema associated with I-125 or Pd-103 prostate brachytherapy and its impact on post-implant dosimetry: an analysis based on serial CT acquisition. Int J Radiat Oncol Biol Phys 1998, 41: 1069-1077. 10.1016/S0360-3016(98)00152-7CrossRefPubMed

10.

Ghilezan M: Role of high dose rate brachytherapy in the treatment of prostate cancer. Cancer Radiother 2012, 16: 418-422. 10.1016/j.canrad.2012.08.001CrossRefPubMed

11.

Vicini F, Vargas C, Gustafson G, Edmundson G, Martinez A: High dose rate brachytherapy in the treatment of prostate cancer. World J Urol 2003, 21: 220-228. 10.1007/s00345-003-0358-8CrossRefPubMed

12.

Martinez AA, Pataki I, Edmundson G, Sebastian E, Brabbins D, Gustafson G: Phase II prospective study of the use of conformal high-dose-rate brachytherapy as monotherapy for the treatment of favorable stage prostate cancer: a feasibility report. Int J Radiat Oncol Biol Phys 2001, 49: 61-69. 10.1016/S0360-3016(00)01463-2CrossRefPubMed

13.

Kiffer JD, Schumer WA, Mantle CA, McKenzie BJ, Feigen M, Quong GG: Impact of oedema on implant geometry and dosimetry for temporary high dose rate brachytherapy of the prostate. Australas Radiol 2003, 47: 172-176. 10.1046/j.0004-8461.2003.01146.xCrossRefPubMed

14.

Cury FL, Duclos M, Aprikian A, Patrocinio H, Souhami L: Prostate gland edema after single-fraction high-dose rate brachytherapy before external beam radiation therapy. Brachytherapy 2010, 9: 208-212. 10.1016/j.brachy.2009.09.003CrossRefPubMed

15.

Smith WL, Lewis C, Bauman G, Rodrigues G, D’Souza D, Ash R, Ho D, Venkatesan V, Downey D, Fenster A: Prostate volume contouring: a 3D analysis of segmentation using 3DTRUS, CT, and MR. Int J Radiat Oncol Biol Phys 2007, 67: 1238-1247. 10.1016/j.ijrobp.2006.11.027CrossRefPubMed

16.

Kim Y, Hsu IC, Lessard E, Vujic J, Pouliot J: Dosimetric impact of prostate volume change between CT-based HDR brachytherapy fractions. Int J Radiat Oncol Biol Phys 2004, 59: 1208-1216. 10.1016/j.ijrobp.2004.02.053CrossRefPubMed

17.

Kovalchuk N, Furutani KM, Macdonald OK, Pisansky TM: Dosimetric effect of interfractional needle displacement in prostate high-dose-rate brachytherapy. Brachytherapy 2011, 11: 111-118. 10.1016/j.brachy.2011.05.006CrossRef

18.

Huang Y, Miller B, Doemer A, Babij D, Kumar S, Frontera R, Nurushev T, Chetty IJ, Aref I: Online correction of catheter movement using CT in high-dose-rate prostate brachytherapy. Brachytherapy 2013, 12: 260-266. 10.1016/j.brachy.2012.08.008CrossRefPubMed

19.

Whitaker M, Hruby G, Lovett A, Patanjali N: Prostate HDR brachytherapy catheter displacement between planning and treatment delivery. Radiother Oncol 2011, 101: 490-494. 10.1016/j.radonc.2011.08.004CrossRefPubMed

20.

Milickovic N, Mavroidis P, Tselis N, Nikolova I, Katsilieri Z, Kefala V, Zamboglou N, Baltas D: 4D analysis of influence of patient movement and anatomy alteration on the quality of 3D U/S-based prostate HDR brachytherapy treatment delivery. Med Phys 2011, 38: 4982-4993. 10.1118/1.3618735CrossRefPubMed

21.

Dinkla AM, Pieters BR, Koedooder C, Meijnen P, van Wieringen N, van der Laarse R, van der Grient JN, Rasch CR, Bel A: Deviations from the planned dose during 48 hours of stepping source prostate brachytherapy caused by anatomical variations. Radiother Oncol 2013, 107: 106-111. 10.1016/j.radonc.2012.12.011CrossRefPubMed

22.

Dinkla AM, Pieters BR, Koedooder C, van Wieringen N, van der Laarse R, van der Grient JN, Rasch CR, Koning CC, Bel A: Improved tumour control probability with MRI-based prostate brachytherapy treatment planning. Acta Oncol 2013, 52: 658-665. 10.3109/0284186X.2012.744875CrossRefPubMed

23.

Yamada Y, Rogers L, Demanes DJ, Morton G, Prestidge BR, Pouliot J, Cohen GN, Zaider M, Ghilezan M, Hsu IC: American Brachytherapy Society consensus guidelines for high-dose-rate prostate brachytherapy. Brachytherapy 2012, 11: 20-32. 10.1016/j.brachy.2011.09.008CrossRefPubMed

24.

Kovacs G, Potter R, Loch T, Hammer J, Kolkman-Deurloo IK, de la Rosette JJ, Bertermann H: GEC/ESTRO-EAU recommendations on temporary brachytherapy using stepping sources for localised prostate cancer. Radiother Oncol 2005, 74: 137-148. 10.1016/j.radonc.2004.09.004CrossRefPubMed

25.

Hoskin PJ, Colombo A, Henry A, Niehoff P, Paulsen HT, Siebert FA, Kovacs G: GEC/ESTRO recommendations on high dose rate afterloading brachytherapy for localised prostate cancer: an update. Radiother Oncol 2013, 107: 325-332. 10.1016/j.radonc.2013.05.002CrossRefPubMed

26.

Pieters BR, van der Grient JN, Blank LE, Koedooder C, Hulshof MC, de Reijke TM: Minimal displacement of novel self-anchoring catheters suitable for temporary prostate implants. Radiother Oncol 2006, 80: 69-72. 10.1016/j.radonc.2006.06.014CrossRefPubMed

27.

Besl PJ, McKay N: A method for registration of 3-D shapes. IEEE PAMI 1992, 14: 239-256. 10.1109/34.121791CrossRef

28.

Horn BKP: Closed-form solution of absolute orientation using unit quaternions. J Opt Soc Am 1987, 4: 629-642. 10.1364/JOSAA.4.000629CrossRef

29.

Hoskin PJ, Bownes PJ, Ostler P, Walker K, Bryant L: High dose rate afterloading brachytherapy for prostate cancer: catheter and gland movement between fractions. Radiother Oncol 2003, 68: 285-288. 10.1016/S0167-8140(03)00203-2CrossRefPubMed

30.

Damore SJ, Syed AM, Puthawala AA: Needle displacement during HDR brachytherapy in the treatment of prostate cancer. Int J Radiat Oncol Biol Phys 2000, 46: 1205-1211. 10.1016/S0360-3016(99)00477-0CrossRefPubMed

31.

Kim Y, Hsu IC, Pouliot J: Measurement of craniocaudal catheter displacement between fractions in computed tomography-based high dose rate brachytherapy of prostate cancer. J Appl Clin Med Phys 2007, 8: 2415.PubMed

32.

Foster W, Cunha JA, Hsu IC, Weinberg V, Krishnamurthy D, Pouliot J: Dosimetric impact of interfraction catheter movement in high-dose rate prostate brachytherapy. Int J Radiat Oncol Biol Phys 2011, 80: 85-90. 10.1016/j.ijrobp.2010.01.016CrossRefPubMed

33.

Tsalpatouros A, Baltas D, Kolotas C, van der Laarse R, Koutsouris D, Uzunoglu NK, Zamboglou N: CT-based software for 3-D localization and reconstruction in stepping source brachytherapy. IEEE Trans Inf Technol Biomed 1997, 1: 229-242. 10.1109/4233.681165CrossRefPubMed

34.

Elfrink RJ, Kolkman-Deurloo IK, van Kleffens HJ, Rijnders A, Schaeken B, Aalbers TH, Dries WJ, Venselaar JL: Determination of the accuracy of implant reconstruction and dose delivery in brachytherapy in The Netherlands and Belgium. Radiother Oncol 2001, 59: 297-306. 10.1016/S0167-8140(01)00300-0CrossRefPubMed

35.

Pantelis E, Papagiannis P, Anagnostopoulos G, Baltas D, Karaiskos P, Sandilos P, Sakelliou L: Evaluation of a TG-43 compliant analytical dosimetry model in clinical 192Ir HDR brachytherapy treatment planning and assessment of the significance of source position and catheter reconstruction uncertainties. Phys Med Biol 2004, 49: 55-67. 10.1088/0031-9155/49/1/004CrossRefPubMed

Title: Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: limited effect of oedema
Authors: Anna M Dinkla
Bradley R Pieters
Kees Koedooder
Niek van Wieringen
Rob van der Laarse
Arjan Bel
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-014-0272-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: limited effect of oedema

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2014

Feasibility of constant dose rate VMAT in the treatment of nasopharyngeal cancer patients

The role of tumor volume in radiotherapy of patients with head and neck cancer

The effects of computed tomography image characteristics and knot spacing on the spatial accuracy of B-spline deformable image registration in the head and neck geometry

Carbon-ion scanning lung treatment planning with respiratory-gated phase-controlled rescanning: simulation study using 4-dimensional CT data

Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer

A treatment planning study comparing Elekta VMAT and fixed field IMRT using the varian treatment planning system eclipse