A system for nonradiographic source localization and real-time planning of intraoperative high dose rate brachytherapy Journal Article


Authors: Watanabe, Y.; Anderson, L. L.
Article Title: A system for nonradiographic source localization and real-time planning of intraoperative high dose rate brachytherapy
Abstract: We have developed a system for source localization and real-time planning of interstitial volume implants for intraoperative radiation therapy (IORT) using high dose rate remote afterloading techniques. Source localization is realized by using an electromagnetic tracking device, which consists of a transmitter coil, a receiver coil, and a signal processing unit, to generate the coordinates and orientation of the receiver. A drawback of the device is its sensitivity to adjacent metallic objects. Localization accuracy was evaluated in an operating room environment, where the metallic objects closest to the receiver are surgical retractors (that, incidentally, preclude radiographic localization). For achievable separation distances, we found an rms error of 0.7 mm in determining the distance between points 2 cm apart, thereby demonstrating the feasibility of the method. The receiver is mounted on a plastic block from which projects a long stylet and the transmitter is located at about 50 cm from the receiver. The styler is inserted sequentially into source catheters to obtain the location and orientation data that serve as input to treatment planning software. The planning program optimizes source dwell time to make calculated dose conform to the dose prescribed on an ellipsoidal surface to an extent consistent with a certain level of dose uniformity inside the target volume. A least squares method is used that involves minimizing the objective function by a matrix method (nonnegative least squares). We have demonstrated that dwell time optimization can be performed in a short time and that the approach is adequate for the IORT application.
Keywords: treatment planning; radiation dose; neoplasms; radiotherapy dosage; tomography, x-ray computed; medical instrumentation; intraoperative period; brachytherapy; radiotherapy planning, computer-assisted; phantoms, imaging; computer program; software; radiotherapy, high-energy; iridium radioisotopes; operating room; optimization; localization; high dose rate brachytherapy; radiotherapy, computer-assisted; intraoperative radiation therapy; humans; priority journal; article; volume implants; remote sensing
Journal Title: Medical Physics
Volume: 24
Issue: 12
ISSN: 0094-2405
Publisher: American Association of Physicists in Medicine  
Date Published: 1997-12-01
Start Page: 2014
End Page: 2023
Language: English
DOI: 10.1118/1.598115
PUBMED: 9434985
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 17 March 2017 -- Source: Scopus
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