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首页> 外文期刊>Brachytherapy >Impact of transrectal ultrasound- and computed tomography-based seed localization on postimplant dosimetry in prostate brachytherapy.
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Impact of transrectal ultrasound- and computed tomography-based seed localization on postimplant dosimetry in prostate brachytherapy.

机译：经直肠超声和计算机断层扫描的种子定位对前列腺近距离放射治疗植入后剂量的影响。

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PURPOSE: To study the impact of seed localization, as performed by different observers using linked (125)I seeds, on postimplant dosimetry in prostate brachytherapy and, to compare transrectal ultrasound (TRUS)-based with CT-based approach for the dosimetric outcomes. METHODS AND MATERIALS: Nineteen permanent prostate implants were conducted using linked (125)I seeds. Postimplant TRUS and CT images were acquired and prostate glands were, after implantation, delineated on all images by a single oncologist, who had performed all 19 seeding procedures. Six observers independently localized the seeds on both TRUS and CT images, from which the principle dosimetric parameters V(100) (volume of prostate that received the prescribed dose), V(150) (volume of prostate that received 150% of the prescribed dose), and D(90) (minimal dose delivered to 90% of the prostate) were directly calculated for each patient. A single-factor analysis of variance was first applied to determine interobserver variability in seed localization. A nonparametric comparison of the approach using TRUS and CT was then carried out by the Wilcoxon paired-sample test. RESULTS: Analysis from the analysis of variance for TRUS showed that the null hypothesis for equal means, could not be rejected for all six observers based on a significance level alpha=0.05. TRUS-based and CT-based approaches were then cross compared by the Wilcoxon paired-sample test, which suggested that the null hypothesis was insignificant for V(100) and D(90), but was significant for V(150). CONCLUSIONS: Both TRUS- and CT-imaging modalities provided indistinguishable postimplant dosimetry results as far as V(100) and D(90) were concerned. There was comparable observer independence between TRUS- and CT-based seed localization for linked-seed implant procedures. With other advantages that TRUS-imaging modality had over CT in the evaluation of postimplant dosimetry, TRUS would be a preferred choice in conjunction with linked seeds for intraoperative procedures in prostate brachytherapy.
机译：目的：研究不同位置的观察者使用链接的（125）I种子对前列腺近距离放射治疗中种子定位的影响，并比较基于经直肠超声（TRUS）和基于CT的方法的剂量结果。方法和材料：使用链接的（125）I种子进行19个永久性前列腺植入物。采集植入后的TRUS和CT图像，并在植入后由一名肿瘤学家在所有图像上描绘出前列腺，该肿瘤专家完成了全部19种播种步骤。六名观察员分别在TRUS和CT图像上定位了种子，从中可以得出主要的剂量学参数V（100）（接受处方剂量的前列腺体积），V（150）（接受处方剂量的150％前列腺体积） ）和D（90）（递送至90％的前列腺的最小剂量）直接为每位患者计算。首先使用单因素方差分析来确定种子定位中观察者间的差异。然后通过Wilcoxon配对样本测试对使用TRUS和CT的方法进行非参数比较。结果：TRUS的方差分析表明，基于均值显着性水平α= 0.05，所有六个观察者均不能拒绝均值的零假设。然后，通过Wilcoxon配对样本检验对基于TRUS的方法和基于CT的方法进行了交叉比较，这表明零假设对于V（100）和D（90）无关紧要，而对于V（150）则很重要。结论：就V（100）和D（90）而言，TRUS和CT成像方式均提供了难以区分的植入后剂量学结果。对于链接种子植入程序，在基于TRUS和CT的种子定位之间观察者的独立性相当。在评估植入后剂量测定时，TRUS成像方式优于CT的其他优势，在前列腺近距离放射治疗的术中过程中，TRUS结合链接的种子将成为首选。

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