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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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vol. 11
Original paper

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Elizabeth Watt, Matthew Skarsgard, Michael Roumeliotis, Siraj Husain, Tyler Meyer

J Contemp Brachytherapy 2019; 11, 1: 61–68
Online publish date: 2019/02/28
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Post-implant analysis in permanent breast seed implant (PBSI) brachytherapy is an important component of the quality assurance process that indicates dosimetric quality relevant to patient outcome, indicating salvage therapy if inadequate, as well as providing feedback to the brachytherapy team to improve future treatments. To measure geometric indices on implant quality, plan reconstruction must be performed to correlate each planned and post-implant seed location. In this work, a simulated-annealing-based algorithm is developed to perform this plan reconstruction automatically.

Material and methods
The plan reconstruction algorithm was developed in MATLAB, taking the patient pre-treatment and post-implant (Day 0) plan and associated contours as inputs. For 19 treated patients, a reconstruction was obtained that defined the correspondence between each planned and post-implant seed. The simulated-annealing algorithm was used to reconstruct each patient 10 times to assess the variability in convergence. Manual reconstructions performed by at least two independent observers to obtain consensus were defined as the ground truth; these were compared to the automatic reconstructions obtained by the algorithm. Metrics on seed placement accuracy and needle strand angulation were calculated for the patients.

The algorithm performed reconstructions on 19 patients (1235 seeds) with ground-truth reconstructions, obtaining 97 ± 8% correct matches. This strong performance indicates the ability to incorporate this algorithm into the clinical quality assurance workflow.

The plan reconstruction algorithm developed herein performed very well in a 19-patient cohort. This algorithm can be incorporated into the clinical process to assist in the assessment of center-specific seed placement accuracy and can be used to gather implant metrics in an automated, standardized fashion for future PBSI trials.


permanent breast seed implant, post-implant analysis, plan reconstruction, simulated annealing

Vicini FA, Kestin L, Chen P et al. Limited-field radiation therapy in the management of early-stage breast cancer. J Natl Cancer Inst 2003; 95: 1205-1210.
Smith BD, Arthur DW, Buchholz TA et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys 2009; 74: 987-1001.
Polgár C, Van Limbergen E, Pötter R et al. Patient selection for accelerated partial-breast irradiation (APBI) after breast-conserving surgery: Recommendations of the Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) breast cancer working group. Radiother Oncol 2010; 94: 264-273.
Shah C, Vicini F, Wazer DE et al. The American Brachytherapy Society consensus statement for accelerated partial breast irradiation. Brachytherapy 2013; 12: 267-277.
Correa C, Harris EE, Leonardi MC et al. Accelerated partial breast irradiation: executive summary for the update of an ASTRO evidence-based consensus statement. Pract Radiat Oncol 2017; 7: 73-79.
Shah C, Vicini F, Shaitelman SF et al. The American Brachytherapy Society consensus statement for accelerated partial-breast irradiation. Brachytherapy 2018; 17: 154-170.
Pignol JP, Keller B, Rakovitch E et al. First report of a permanent breast 103Pd seed implant as adjuvant radiation treatment for early-stage breast cancer. Int J Radiat Oncol Biol Phys 2006; 64: 176-181.
Pignol JP, Caudrelier JM, Crook J et al. Report on the clinical outcomes of permanent breast seed implant for early-stage breast cancers. Int J Radiat Oncol Biol Phys 2015; 93: 614-621.
Keller BM, Ravi A, Sankreacha R, Pignol JP. Permanent breast seed implant dosimetry quality assurance. Int J Radiat Oncol Biol Phys 2012; 83: 84-92.
Morton D, Batchelar D, Hilts M et al. Incorporating three-dimensional ultrasound into permanent breast seed implant brachytherapy treatment planning. Brachytherapy 2017; 16: 167-173.
Frederick A, Meyer T, Roumeliotis M. Treatment planning considerations for permanent breast seed implant. Brachytherapy 2018; 17: 456-464.
Roumeliotis M, Yates B, Watt E et al. Demonstration of simulated annealing optimization for permanent breast seed implant treatment planning. Brachytherapy 2018; 17: 615-620.
Long K, Karchewski-Welter R, Roumeliotis M et al. 115: Proposal for a Permanent Breast Seed Implant (PBSI) Training Program. Radiother Oncol 2016; 120: S43.
Roumeliotis M, Quirk S, Skarsgard M et al. Development and characterization of an anthropomorphic breast phantom for permanent breast seed implant brachytherapy credentialing. Brachytherapy 2018; 17: 506-513.
Batchelar D, Hilts M, Rose T et al. Simulation and intraoperative checks for improved standardization and reproducibility of partial breast seed implant technique. Brachytherapy 2014; 13: S84.
Karchewski-Welter R, Long K, Watt E et al. 114: Patient positioning and mark-up optimization for permanent breast seed implant (PBSI). Radiother Oncol 2016; 120: S43.
Hilts M, Batchelar D, Rose J, Crook J. Deformable image registration for defining the postimplant seroma in permanent breast seed implant brachytherapy. Brachytherapy 2015; 14: 409-418.
Watt E, Husain S, Sia M et al. Dosimetric variations in permanent breast seed implant due to patient arm position. Brachytherapy 2015; 14: 979-985.
Hilts M, Halperin H, Morton D et al. Skin dose in breast brachytherapy: Defining a robust metric. Brachytherapy 2015; 14: 970-978.
Morton D, Hilts M, Batchelar D, Crook J. Seed placement in permanent breast seed implant brachytherapy: are concerns over accuracy valid? Int J Radiat Oncol Biol Phys 2016; 95: 1050-1057.
Watt E, Conroy L, Peacock M et al. Appropriate timing for postimplant imaging in permanent breast seed implant: Results from a serial CT study. Brachytherapy 2018; 17: 609-614.
Archambault L, Beaulieu L, Tubic D. Automatic post-implant needle reconstruction algorithm to characterize and improve implant robustness analyses. Med Phys 2003; 30: 2897-2903.
Chng N, Spadinger I, Morris WJ et al. Prostate brachytherapy postimplant dosimetry: Automatic plan reconstruction of stranded implants. Med Phys 2011; 38: 327-342.
Taschereau R, Roy J, Pouliot J. Monte Carlo simulations of prostate implants to improve dosimetry and compare planning methods. Med Phys 1999; 26: 1952-1959.
Kaplan ID, Meskell PM, Lieberfarb M et al. A comparison of the precision of seeds deposited as loose seeds versus suture embedded seeds: a randomized trial. Brachytherapy 2004; 3: 7-9.
Podder TK, Beaulieu L, Caldwell B et al. AAPM and GEC-ESTRO guidelines for image-guided robotic brachytherapy: Report of Task Group 192. Med Phys 2014; 41: 101501.
Jamaluddin MF, Ghosh S, Waine MP et al. Intraoperative factors associated with stranded source placement accuracy in low-dose-rate prostate brachytherapy. Brachytherapy 2017; 16: 497-502.
Sloboda RS. Optimization of brachytherapy dose distributions by simulated annealing. Med Phys 1992; 19: 955-964.
Pouliot J, Tremblay D, Roy J, Filice S. Optimization of permanent 125I prostate implants using fast simulated annealing. Int J Radiat Oncol Biol Phys 1996; 36: 711-720. Lessard E, Pouliot J. Inverse planning anatomy-based dose optimization for HDR-brachytherapy of the prostate using fast simulated annealing algorithm and dedicated objective function. Med Phys 2001; 28: 773-779.
Kirkpatrick S, Gelatt CD, Vecchi MP. Optimization by simulated annealing. Science 1983; 220: 671-680.
Frederick A, Watt E, Peacock M et al. Sci-Thur PM – Brachytherapy 02: Positional accuracy in Pd-103 permanent breast seed implant (PBSI) brachytherapy at the Tom Baker Cancer Centre (TBCC). Med Phys 2016; 43: 4933-4934.
Rivard MJ, Coursey BM, DeWerd LA et al. Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations. Med Phys 2004; 31: 633-674.
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