Intra-operative 3D guidance in prostate brachytherapy using a non-isocentric C-arm.
Intra-operative 3D guidance in prostate brachytherapy using a non-isocentric C-arm.
复制标题
使用非等中心 C 形臂对前列腺近距离放射治疗进行术中 3D 引导。
DOI：
10.1007/978-3-540-75759-7_2
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Fichtinger,G
中科院分区：
文献类型：
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作者：
Jain,A;Deguet,A;Iordachita,I;Chintalapani,G;Blevins,J;Le,Y;Armour,E;Burdette,C;Song,D;Fichtinger,G
术中引导经直肠超声（TRUS）引导前列腺近距离治疗需要定位插入的放射性粒子相对于前列腺。使用典型的c型臂重建种子，并输出到商业近距离治疗系统进行剂量学分析。在非等心c臂上进行三维重建的技术障碍包括基于姿态的c臂校准；畸变校正;c臂图像的姿态估计；种子重建;c臂到TRUS注册。在具有40-100颗种子的精密加工硬影中，我们正确重建了99.8%的种子，平均3D精度为0.68 mm。在具有45-87颗种子和临床真实的15℃手臂运动的软组织幻影中，我们正确地重建了100%的种子，精度为1.3 mm。然后将重建的三维种子位置注册到由TRUS分割的前列腺上。在一项1期临床试验中，我们对4例患者进行了66-84粒种子的术中监测和剂量测定。我们通过平均插入3.75颗额外的粒子来优化100%规定的等剂量轮廓，使得在典型的c型臂上进行术中剂量测定成为可能，而现有临床装置的额外费用可以忽略不计。
Intra-operative guidance in Transrectal Ultrasound (TRUS) guided prostate brachytherapy requires localization of inserted radioactive seeds relative to the prostate. Seeds were reconstructed using a typical C-arm, and exported to a commercial brachytherapy system for dosimetry analysis. Technical obstacles for 3D reconstruction on a non-isocentric C-arm included pose-dependent C-arm calibration; distortion correction; pose estimation of C-arm images; seed reconstruction; and C-arm to TRUS registration. In precision-machined hard phantoms with 40-100 seeds, we correctly reconstructed 99.8% seeds with a mean 3D accuracy of 0.68 mm. In soft tissue phantoms with 45-87 seeds and clinically realistic 15oC-arm motion, we correctly reconstructed 100% seeds with an accuracy of 1.3 mm. The reconstructed 3D seed positions were then registered to the prostate segmented from TRUS. In a Phase-1 clinical trial, so far on 4 patients with 66-84 seeds, we achieved intra-operative monitoring of seed distribution and dosimetry. We optimized the 100% prescribed iso-dose contour by inserting an average of 3.75 additional seeds, making intra-operative dosimetry possible on a typical C-arm, at negligible additional cost to the existing clinical installation.