eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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4/2021
vol. 13
 
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abstract:
Original paper

3D-printed template and optical needle navigation in CT-guided iodine-125 permanent seed implantation

Zhe Ji
1
,
Yuliang Jiang
1
,
Haitao Sun
1
,
Yi Chen
1
,
Fuxin Guo
1
,
Jinghong Fan
1
,
Junjie Wang
1

1.
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
J Contemp Brachytherapy 2021; 13, 4: 410–418
Online publish date: 2021/08/24
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Introduction
To preliminarily verify the accuracy of navigation-assisted seed implantation by comparing pre-operative and actual differences in puncture characteristics and dosimetry in computed tomography (CT)-guided, navigation-assisted radioactive iodine-125 seed implantation, using 3D-printed templates for malignant tumors’ treatment.

Material and methods
A total of 27 tumor patients, who were treated with seed implantation under combination guidance in our hospital between December 2019 and December 2020 were enrolled in this study. Navigation needles (n = 1-3) were placed in each patient to obtain pre-operative and intra-operative puncture information, such as angle, depth, insertion point, and tip position. Moreover, dosimetry parameters in pre-operative and post-operative plans, including D90, V100, V150, V200, minimum peripheral dose (MPD), conformal index, external index, and homogeneity index of target area were investigated.

Results
Mean errors of the angle, depth, insertion point, and tip position were 0.5 ±0.5°, 4.0 ±2.0 mm, 1.7 ±1 mm, and 3.1 ±1.8 mm, respectively. There were no significant differences between intra-operative and pre-operative angles (p = 0.271), but there was a significant difference in the depth (p = 0.002). Errors of the angle, depth, and insertion point were larger for the pelvic/retroperitoneal area than for the head and neck/chest wall (p < 0.05). With the exception of MPD, there was no significant difference in dosimetry indices between post-operative and preoperative plans (p > 0.05).

Conclusions
Seed implantation under combination guidance showed good accuracy, and the actual intra-operative puncture information and post-operative doses were in agreement with those in the pre-operative plan, thereby demonstrating promising prospects for further development.

keywords:

brachytherapy, iodine-125, optical navigation, 3D-printed template, accuracy

 
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