Print Email Facebook Twitter Dosimetric benefits and preclinical performance of steerable needles in HDR prostate brachytherapy Title Dosimetric benefits and preclinical performance of steerable needles in HDR prostate brachytherapy Author de Vries, M. (TU Delft Medical Instruments & Bio-Inspired Technology) Christianen, M. E.M.C. (Erasmus MC) Luthart, L. (Erasmus MC) de Vries, K. C. (Erasmus MC) Kolkman-Deurloo, I. K.K. (Erasmus MC) van den Dobbelsteen, J.J. (TU Delft Medical Instruments & Bio-Inspired Technology) Date 2024 Abstract Prostate cancer patients with an enlarged prostate and/or excessive pubic arch interference (PAI) are generally considered non-eligible for high-dose-rate (HDR) brachytherapy (BT). Steerable needles have been developed to make these patients eligible again. This study aims to validate the dosimetric impact and performance of steerable needles within the conventional clinical setting. HDR BT treatment plans were generated, needle implantations were performed in a prostate phantom, with prostate volume > 55 cm3 and excessive PAI of 10 mm, and pre- and post-implant dosimetry were compared considering the dosimetric constraints: prostate V100 > 95 % (13.50 Gy), urethra D0.1cm3 < 115 % (15.53 Gy) and rectum D1cm3 < 75 % (10.13 Gy). The inclusion of steerable needles resulted in a notable enhancement of the dose distribution and prostate V100 compared to treatment plans exclusively employing rigid needles to address PAI. Furthermore, the steerable needle plan demonstrated better agreement between pre- and post-implant dosimetry (prostate V100: 96.24 % vs. 93.74 %) compared to the rigid needle plans (79.13 % vs. 72.86 % and 87.70 % vs. 81.76 %), with no major changes in the clinical workflow and no changes in the clinical set-up. The steerable needle approach allows for more flexibility in needle positioning, ensuring a highly conformal dose distribution, and hence, HDR BT is a feasible treatment option again for prostate cancer patients with an enlarged prostate and/or excessive PAI. Subject BrachytherapyHDRProstate cancerPubic arch interferenceSteerable needle To reference this document use: http://resolver.tudelft.nl/uuid:2d89ca5b-77cf-402b-8d2b-01aa4e34fd55 DOI https://doi.org/10.1016/j.medengphy.2024.104177 ISSN 1350-4533 Source Medical Engineering & Physics, 128 Part of collection Institutional Repository Document type journal article Rights © 2024 M. de Vries, M. E.M.C. Christianen, L. Luthart, K. C. de Vries, I. K.K. Kolkman-Deurloo, J.J. van den Dobbelsteen Files PDF 1-s2.0-S135045332400078X-main.pdf 5.51 MB Close viewer /islandora/object/uuid:2d89ca5b-77cf-402b-8d2b-01aa4e34fd55/datastream/OBJ/view