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Virtual modelling of novel applicator prototypes for cervical cancer brachytherapy

Primoz Petric

Primoz Petric

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Petric, Primoz
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Robert Hudej

Robert Hudej

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Hudej, Robert
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Noora Al-Hammadi

Noora Al-Hammadi

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Al-Hammadi, Noora
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Barbara Segedin

Barbara Segedin

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Segedin, Barbara
  
Nov 09, 2016
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Article Category: Research Article
Published Online: Nov 09, 2016
Page range: 433 - 441
Received: Jul 01, 2016
Accepted: Aug 29, 2016
DOI: https://doi.org/10.1515/raon-2016-0048
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© 2016 Radiol Oncol
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Principles of Target-volume Density Map (TDM) generation and postprocessing on an example of 6 cervical cancer cases. (A) Contours of high risk clinical target volumes (CTVHR – thin white lines) are shown on mid-coronal T2 weighted MRI with the applicator in place. Source channels are depicted as thick white lines. (B) CAT 2 generates the TDM by rigid co-registration of individual CTVHRs on a reference applicator. TDM voxels are assigned target density values, corresponding to the number of encompassing CTVHRs. These values are transformed to grey levels. (C) Resulting TDM DICOM image is exported to treatment planning system where isodensity contours (IDC) are auto-segmented (white dotted lines).
Principles of Target-volume Density Map (TDM) generation and postprocessing on an example of 6 cervical cancer cases. (A) Contours of high risk clinical target volumes (CTVHR – thin white lines) are shown on mid-coronal T2 weighted MRI with the applicator in place. Source channels are depicted as thick white lines. (B) CAT 2 generates the TDM by rigid co-registration of individual CTVHRs on a reference applicator. TDM voxels are assigned target density values, corresponding to the number of encompassing CTVHRs. These values are transformed to grey levels. (C) Resulting TDM DICOM image is exported to treatment planning system where isodensity contours (IDC) are auto-segmented (white dotted lines).
Schematic representation of applicator modelling based on our theoretical example of Target-volume Density Map (TDM). Above: Three virtual applicators are reconstructed on the TDM. Dose distribution is optimized based on a set of specific planning aims for the isodensity contours (IDC) and for residual volumes at risk (RVR). The optimized prescription isodoses for individual applicators are shown as thick dotted lines. (A) Standard intracavitary applicator: limited possibility for optimization. The planning aim is achieved for ≈70% IDC. (B) Combined intracavitary and interstitial applicator with parallel parametrial needles (Vienna-type): planning aim is achieved for ≈95% IDC. (C) Combined intracavitary and interstitial applicator with parallel and oblique parametrial needles: planning aim as achieved for ≈100 % IDC. (D) Characteristic curves for the IDC of the three applicator types. RVR curves are not shown. Shaded areas under characteristic curves represents IDC ranges in which certain applicator is able to achieve the planning aim. Arbitrary planning aim and applicator thresholds are marked by dotted lines.
Schematic representation of applicator modelling based on our theoretical example of Target-volume Density Map (TDM). Above: Three virtual applicators are reconstructed on the TDM. Dose distribution is optimized based on a set of specific planning aims for the isodensity contours (IDC) and for residual volumes at risk (RVR). The optimized prescription isodoses for individual applicators are shown as thick dotted lines. (A) Standard intracavitary applicator: limited possibility for optimization. The planning aim is achieved for ≈70% IDC. (B) Combined intracavitary and interstitial applicator with parallel parametrial needles (Vienna-type): planning aim is achieved for ≈95% IDC. (C) Combined intracavitary and interstitial applicator with parallel and oblique parametrial needles: planning aim as achieved for ≈100 % IDC. (D) Characteristic curves for the IDC of the three applicator types. RVR curves are not shown. Shaded areas under characteristic curves represents IDC ranges in which certain applicator is able to achieve the planning aim. Arbitrary planning aim and applicator thresholds are marked by dotted lines.
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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