eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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5/2022
vol. 14
 
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abstract:
Original paper

A comparative study of dosimetric parameters of 3D-printed non-coplanar template-assisted CT-guided iodine-125 seed implantation brachytherapy in patients with inguinal lymph node metastatic carcinomas

Yanhao Liu
1
,
Zongyan Shen
1
,
Ang Qu
1
,
Ping Jiang
1
,
Yuliang Jiang
1
,
Junjie Wang
1

  1. Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
J Contemp Brachytherapy 2022; 14, 5: 452–461
Online publish date: 2022/11/30
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Purpose
To compare the pre-plan and post-plan dosimetric parameter differences of 3D-printed non-coplanar templates (3D-PNCT)-assisted computed tomography (CT)-guided iodine-125 (125I) radioactive seed implantation brachytherapy (RISI) in patients with inguinal lymph node metastasis (ILNM).

Material and methods
This was a retrospective study of 15 patients with ILNM carcinomas treated with 3D-PNCT-assisted CT-guided RISI between May, 2015 and April, 2018. All patients underwent prior external beam radiotherapy (EBRT) or surgery. Dosimetric parameters included D90, D100 (dose delivered to 90% and 100% of the volume, respectively), V100, V150, V200 (percentage of target volume receiving 100%, 150%, and 200% of the prescribed dose, respectively). Quality parameters included conformal index (CI), external index (EI), and homogeneity index (HI). Paired t-test and Bland-Altman analysis were applied to compared pre-plan and post-plan parameters.

Results
The median gross tumor volume (GTV) in the pre-plan was 8.7 ml (range, 0.8-185.1 ml). There were statistically significant differences in V100, V150, CI, and EI (p < 0.05). Bland-Altman analysis indicated that accidental error of RISI was small. In 1 of the 15 cases, D90 and D100 exceeded the prescribed therapeutic accuracy. In 1 of the 15 cases, V150, EI, and GTV were outside the specified accuracy range (95% confidence interval).

Conclusions
3D-PNCT-assisted CT-guided RISI is a safe, accurate, and feasible choice in ILNM treatment. The procedure of RISI has significantly improved. The pre-plan can be accurately executed by 3D-PNCT-assisted CT-guided RISI.

keywords:

interstitial permanent brachytherapy, inguinal lymph node metastasis, 3D printing non-coplanar template, 125I radioactive seed implantation

 
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