Inter-observer effects in needle reconstruction for temporary prostate brachytherapy: Dosimetric implications and adaptive CBCT-TRUS registration solutions

Karius A, Kreppner S, Strnad V, Schweizer C, Lotter M, Fietkau R, Bert C (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Brachytherapy Elsevier

DOI: 10.1016/j.brachy.2024.05.002

Abstract

PURPOSE: To investigate geometric and dosimetric inter-observer variability in needle reconstruction for temporary prostate brachytherapy. To assess the potential of registrations between transrectal ultrasound (TRUS) and cone-beam computed tomography (CBCT) to support implant reconstructions. METHODS AND MATERIALS: The needles implanted in 28 patients were reconstructed on TRUS by three physicists. Corresponding geometric deviations and associated dosimetric variations to prostate and organs at risk (urethra, bladder, rectum) were analyzed. To account for the found inter-observer variability, various approaches (template-based, probe-based, marker-based) for registrations of CBCT to TRUS were investigated regarding the respective needle transfer accuracy in a phantom study. Three patient cases were examined to assess registration accuracy in-vivo. RESULTS: Geometric inter-observer deviations >1 mm and >3 mm were found for 34.9% and 3.5% of all needles, respectively. Prostate dose coverage (changes up to 7.2%) and urethra dose (partly exceeding given dose constraints) were most affected by associated dosimetric changes. Marker-based and probe-based registrations resulted in the phantom study in high mean needle transfer accuracies of 0.73 mm and 0.12 mm, respectively. In the patient cases, the marker-based approach was the superior technique for CBCT-TRUS fusions. CONCLUSION: Inter-observer variability in needle reconstruction can substantially affect dosimetry for individual patients. Especially marker-based CBCT-TRUS registrations can help to ensure accurate reconstructions for improved treatment planning.

Authors with CRIS profile

Andre Karius Department of Radiation Oncology Stephan Kreppner Department of Radiation Oncology Vratislav Strnad Department of Radiation Oncology Claudia Schweizer Department of Radiation Oncology Rainer Fietkau Lehrstuhl für Strahlentherapie Christoph Bert Professur für Med. Strahlenphysik

How to cite

APA:

Karius, A., Kreppner, S., Strnad, V., Schweizer, C., Lotter, M., Fietkau, R., & Bert, C. (2024). Inter-observer effects in needle reconstruction for temporary prostate brachytherapy: Dosimetric implications and adaptive CBCT-TRUS registration solutions. Brachytherapy. https://doi.org/10.1016/j.brachy.2024.05.002

MLA:

Karius, Andre, et al. "Inter-observer effects in needle reconstruction for temporary prostate brachytherapy: Dosimetric implications and adaptive CBCT-TRUS registration solutions." Brachytherapy (2024).

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