用于鼻前庭癌磁共振成像引导近距离放射治疗的个性化 3D 打印涂抹器

IF 3.4 Q2 ONCOLOGY Physics and Imaging in Radiation Oncology Pub Date : 2024-07-01 DOI:10.1016/j.phro.2024.100629

Mischa de Ridder , Milena Smolic , Maarten Kastelijns , Samantha Kloosterman , Stefan van der Vegt , Johannes A. Rijken , Ina M. Jürgenliemk-Schulz , Homan Dehnad , Petra S. Kroon , Marinus A. Moerland

{"title":"用于鼻前庭癌磁共振成像引导近距离放射治疗的个性化 3D 打印涂抹器","authors":"Mischa de Ridder , Milena Smolic , Maarten Kastelijns , Samantha Kloosterman , Stefan van der Vegt , Johannes A. Rijken , Ina M. Jürgenliemk-Schulz , Homan Dehnad , Petra S. Kroon , Marinus A. Moerland","doi":"10.1016/j.phro.2024.100629","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and purpose</h3><p>Brachytherapy is treatment of choice for early stage nasal vestibule cancer. Over the years improvements were achieved by means of image guided target definition, interstitial implant techniques and also individual mold techniques. The aim of this study was to improve the technique of the implant so that the need for interstitial catheters can be limited by making use of patient individualized 3D-printed applicators.</p></div><div><h3>Materials and Methods</h3><p>In 19 patients 3D-printed applicators were used to deliver pulse dose rate (PDR) brachytherapy. All patients underwent computed tomography (CT) and magnetic resonance imaging (MRI). A pre-plan with tumor delineation and manually optimized catheter positions to achieve tumor coverage was made. Based on the pre-plan a 3D-printed applicator was manufactured. Dose was evaluated by several indices: Conformity Index, Healthy Tissues Conformity Index, Dose Homogeneity Index, Dose non-uniformity ratio, Conformal index and high dose (HD) index.</p></div><div><h3>Results</h3><p>A high target coverage was achieved, with a median V100%<sub>CTV</sub> of 99.1 % (range, 81.8–100 %) and median CI of 0.99 (range, 0.82–1.00), as well as a median V0.7Gy<sub>GTV</sub> of 100 % (range, 93.0–100 %). The median HD was 0.39 (range, 0.20–0.83). Interstitial catheters were needed in 12 patients. None of the patients developed grade ≥ II toxicity within the median follow up of 18 months.</p></div><div><h3>Conclusions</h3><p>This study shows that using 3D-printed applicators limits the need for interstitial catheters and also limits the high doses in normal tissue.</p></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240563162400099X/pdfft?md5=e60301b7e39f906cb6252499405c2c3b&pid=1-s2.0-S240563162400099X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Individualized 3D-printed applicators for magnetic resonance imaging-guided brachytherapy in nasal vestibule cancer\",\"authors\":\"Mischa de Ridder , Milena Smolic , Maarten Kastelijns , Samantha Kloosterman , Stefan van der Vegt , Johannes A. Rijken , Ina M. Jürgenliemk-Schulz , Homan Dehnad , Petra S. Kroon , Marinus A. Moerland\",\"doi\":\"10.1016/j.phro.2024.100629\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and purpose</h3><p>Brachytherapy is treatment of choice for early stage nasal vestibule cancer. Over the years improvements were achieved by means of image guided target definition, interstitial implant techniques and also individual mold techniques. The aim of this study was to improve the technique of the implant so that the need for interstitial catheters can be limited by making use of patient individualized 3D-printed applicators.</p></div><div><h3>Materials and Methods</h3><p>In 19 patients 3D-printed applicators were used to deliver pulse dose rate (PDR) brachytherapy. All patients underwent computed tomography (CT) and magnetic resonance imaging (MRI). A pre-plan with tumor delineation and manually optimized catheter positions to achieve tumor coverage was made. Based on the pre-plan a 3D-printed applicator was manufactured. Dose was evaluated by several indices: Conformity Index, Healthy Tissues Conformity Index, Dose Homogeneity Index, Dose non-uniformity ratio, Conformal index and high dose (HD) index.</p></div><div><h3>Results</h3><p>A high target coverage was achieved, with a median V100%<sub>CTV</sub> of 99.1 % (range, 81.8–100 %) and median CI of 0.99 (range, 0.82–1.00), as well as a median V0.7Gy<sub>GTV</sub> of 100 % (range, 93.0–100 %). The median HD was 0.39 (range, 0.20–0.83). Interstitial catheters were needed in 12 patients. None of the patients developed grade ≥ II toxicity within the median follow up of 18 months.</p></div><div><h3>Conclusions</h3><p>This study shows that using 3D-printed applicators limits the need for interstitial catheters and also limits the high doses in normal tissue.</p></div>\",\"PeriodicalId\":36850,\"journal\":{\"name\":\"Physics and Imaging in Radiation Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S240563162400099X/pdfft?md5=e60301b7e39f906cb6252499405c2c3b&pid=1-s2.0-S240563162400099X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physics and Imaging in Radiation Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S240563162400099X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physics and Imaging in Radiation Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S240563162400099X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景和目的近距离放射治疗是早期鼻前庭癌的首选治疗方法。多年来，通过图像引导下的目标界定、间质植入技术和个体模具技术等手段，鼻前庭近距离放射治疗技术得到了改进。这项研究的目的是改进植入技术，以便通过使用患者个性化的 3D 打印涂抹器来限制对间质导管的需求。材料和方法在 19 名患者中，使用 3D 打印涂抹器进行脉冲剂量率 (PDR) 近距离放射治疗。所有患者均接受了计算机断层扫描（CT）和磁共振成像（MRI）检查。预计划包括肿瘤划界和手动优化导管位置，以实现肿瘤覆盖。根据预规划制造了 3D 打印涂抹器。剂量通过几个指数进行评估：结果实现了高目标覆盖率，中位 V100%CTV 为 99.1%（范围为 81.8-100%），中位 CI 为 0.99（范围为 0.82-1.00），中位 V0.7GyGTV 为 100%（范围为 93.0-100%）。HD 中位数为 0.39（范围为 0.20-0.83）。12 名患者需要使用间质导管。中位随访 18 个月，没有一名患者出现≥II 级毒性。结论这项研究表明，使用 3D 打印涂抹器可减少对间质导管的需求，同时也可限制正常组织中的高剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Individualized 3D-printed applicators for magnetic resonance imaging-guided brachytherapy in nasal vestibule cancer

Background and purpose

Brachytherapy is treatment of choice for early stage nasal vestibule cancer. Over the years improvements were achieved by means of image guided target definition, interstitial implant techniques and also individual mold techniques. The aim of this study was to improve the technique of the implant so that the need for interstitial catheters can be limited by making use of patient individualized 3D-printed applicators.

Materials and Methods

In 19 patients 3D-printed applicators were used to deliver pulse dose rate (PDR) brachytherapy. All patients underwent computed tomography (CT) and magnetic resonance imaging (MRI). A pre-plan with tumor delineation and manually optimized catheter positions to achieve tumor coverage was made. Based on the pre-plan a 3D-printed applicator was manufactured. Dose was evaluated by several indices: Conformity Index, Healthy Tissues Conformity Index, Dose Homogeneity Index, Dose non-uniformity ratio, Conformal index and high dose (HD) index.

Results

A high target coverage was achieved, with a median V100%_CTV of 99.1 % (range, 81.8–100 %) and median CI of 0.99 (range, 0.82–1.00), as well as a median V0.7Gy_GTV of 100 % (range, 93.0–100 %). The median HD was 0.39 (range, 0.20–0.83). Interstitial catheters were needed in 12 patients. None of the patients developed grade ≥ II toxicity within the median follow up of 18 months.