A comparison of permanent prostate brachytherapy techniques: Preplan vs. hybrid interactive planning with postimplant analysis
A comparison of permanent prostate brachytherapy techniques: Preplan vs. hybrid interactive planning with postimplant analysis
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DOI：
10.1016/s0360-3016(02)02757-8
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发表时间：
2002-06-01
影响因子：
7
通讯作者：
Maxey, PB
中科院分区：
文献类型：
--
作者：
Shanahan, TG;Nanavati, PJ;Maxey, PB
目的：为了比较准备时间，手术时间在手术室，设备需求，和0天postimplant剂量测定两个不同的米克植入技术在一个单一institution.Methods和材料：100个连续的单一治疗患者从1999年至2000年与I-125经会阴永久性植入前列腺使用后装米克喷头进行了评价。前40例患者采用预先计划的改良外周负荷Mick技术进行治疗。接下来的60例患者采用混合交互式图像引导Mick技术治疗。分析包括以下计划：超声体积、预先计划所需时间、第0天CT体积、粒子数量、针数量、每个粒子的活动、植入物的总活动和手术时间。剂量学参数包括D-90、V-100和V-150。平均计划超声体积（33与37 cc），第0天CT体积（49与47 cc），nCi/粒子（0.30与0.34 mCi/种子），种子数量（121 vs. 96）、植入物的总活性（36 vs. 32 mCi）、D-90（132 vs. 149戈伊）、V-100（86% vs. 91%）和V-150（51% vs. 38%）相当。在平均计划前时间（30 vs. 7 min）、针数（32 vs. 19）和手术时间（90 vs. 40 min）方面存在显著差异（p <0.01）。结论：混合互动Mick前列腺近距离放射治疗持续减少计划前时间、手术时间和使用的针数，减少患者治疗时间和成本，同时保持良好的剂量覆盖率。混合交互式米克前列腺近距离放射治疗的使用导致改善的治疗比率，即，维持第0天D-90> 140戈伊、V-100> 90%和V-150 <40%，而不需要复杂的三维术中计划技术。(C)2002年爱思唯尔科学公司
Purpose: To compare preparation time, procedure time in the operating room, equipment needs, and Day 0 postimplant dosimetry between two different Mick implant techniques performed at a single institution.Methods and Materials: One hundred consecutive monotherapy patients treated from 1999 to 2000 with I-125 transperineal permanent implantation of the prostate using an afterloading Mick applicator were evaluated. The first 40 patients were treated with a preplanned modified peripheral loading Mick technique. The next 60 were treated with a hybrid interactive image-guided Mick technique. The analysis included planning the following: ultrasound volume, time required of preplanning, Day 0 CT volume, number of seeds, number of needles, activity per seed, total activity of the implant, and procedure time. Dosimetric parameters included D-90, V-100, and V-150.Results: Mean planning ultrasound volume (33 vs. 37 cc), Day 0 CT volume (49 vs. 47 cc), niCi/seed (0.30 vs. 0.34 mCi/seed), number of seeds (121 vs. 96), total activity of the implant (36 vs. 32 mCi), D-90 (132 vs. 149 Gy), V-100 (86% vs. 91%), and V-150 (51% vs. 38%) were comparable. Significant differences (p < 0.01) were noted in mean preplan time (30 vs. 7 min), number of needles (32 vs. 19), and procedure time (90 vs. 40 min).Conclusions: Hybrid interactive Mick prostate brachytherapy consistently reduces preplanning time, procedure time, and number of needles used, reducing patient treatment time and costs while maintaining excellent dosimetric coverage. Use of hybrid interactive Mick prostate brachytherapy results in improved therapeutic ratios, i.e., maintains Day 0 D-90 >140 Gy V-100 > 90%, and V-150 < 40%, without the need for sophisticated three-dimensional intraoperative planning technology. (C) 2002 Elsevier Science Inc.