Inverse treatment planning based on MRI for HDR prostate brachytherapy

Deborah Citrin, Holly Ning, Peter Guion, Guang Li, Robert C. Susil, Robert W. Miller, Etienne Lessard, Jean Pouliot, Xie Huchen, Jacek Capala, C. Norman Coleman, Kevin Camphausen, Cynthia Ménard

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To develop and optimize a technique for inverse treatment planning based solely on magnetic resonance imaging (MRI) during high-dose-rate brachytherapy for prostate cancer. Methods and Materials: Phantom studies were performed to verify the spatial integrity of treatment planning based on MRI. Data were evaluated from 10 patients with clinically localized prostate cancer who had undergone two high-dose-rate prostate brachytherapy boosts under MRI guidance before and after pelvic radiotherapy. Treatment planning MRI scans were systematically evaluated to derive a class solution for inverse planning constraints that would reproducibly result in acceptable target and normal tissue dosimetry. Results: We verified the spatial integrity of MRI for treatment planning. MRI anatomic evaluation revealed no significant displacement of the prostate in the left lateral decubitus position, a mean distance of 14.47 mm from the prostatic apex to the penile bulb, and clear demarcation of the neurovascular bundles on postcontrast imaging. Derivation of a class solution for inverse planning constraints resulted in a mean target volume receiving 100% of the prescribed dose of 95.69%, while maintaining a rectal volume receiving 75% of the prescribed dose of <5% (mean 1.36%) and urethral volume receiving 125% of the prescribed dose of <2% (mean 0.54%). Conclusion: Systematic evaluation of image spatial integrity, delineation uncertainty, and inverse planning constraints in our procedure reduced uncertainty in planning and treatment.

Original languageEnglish (US)
Pages (from-to)1267-1275
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume61
Issue number4
DOIs
StatePublished - Mar 15 2005

Keywords

  • Brachytherapy
  • High dose rate
  • Inverse planning
  • MRI
  • Prostate

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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