MRI-guided HDR prostate brachytherapy in standard 1.5T scanner

Cynthia Ménard, Robert C. Susil, Peter Choyke, Gary S. Gustafson, William Kammerer, Holly Ning, Robert W. Miller, Karen L. Ullman, Nancy Sears Crouse, Sharon Smith, Etienne Lessard, Jean Pouliot, Victor Wright, Elliot McVeigh, C. Norman Coleman, Kevin Camphausen

Research output: Contribution to journalArticle

Abstract

Purpose Magnetic resonance imaging (MRI) provides superior visualization of the prostate and surrounding anatomy, making it the modality of choice for imaging the prostate gland. This pilot study was performed to determine the feasibility and dosimetric quality achieved when placing high-dose-rate prostate brachytherapy catheters under MRI guidance in a standard "closed- bore" 1.5T scanner. Methods and materials Patients with intermediate-risk and high-risk localized prostate cancer received MRI-guided high-dose-rate brachytherapy boosts before and after a course of external beam radiotherapy. Using a custom visualization and targeting program, the brachytherapy catheters were placed and adjusted under MRI guidance until satisfactory implant geometry was achieved. Inverse treatment planning was performed using high-resolution T 2-weighted MRI. Results Ten brachytherapy procedures were performed on 5 patients. The median percentage of volume receiving 100% of prescribed minimal peripheral dose (V 100) achieved was 94% (mean, 92%; 95% confidence interval, 89-95%). The urethral V 125 ranged from 0% to 18% (median, 5%), and the rectal V 75 ranged from 0% to 3.1% (median, 0.3%). In all cases, lesions highly suspicious for malignancy could be visualized on the procedural MRI, and extracapsular disease was identified in 2 patients. Conclusion High-dose-rate prostate brachytherapy in a standard 1.5T MRI scanner is feasible and achieves favorable dosimetry within a reasonable period with high-quality image guidance. Although the procedure was well tolerated in the acute setting, additional follow-up is required to determine the long-term safety and efficacy of this approach.

Original languageEnglish (US)
Pages (from-to)1414-1423
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume59
Issue number5
DOIs
StatePublished - Aug 1 2004

Keywords

  • Brachytherapy
  • Image guidance
  • MRI
  • Prostate cancer

ASJC Scopus subject areas

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

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    Ménard, C., Susil, R. C., Choyke, P., Gustafson, G. S., Kammerer, W., Ning, H., Miller, R. W., Ullman, K. L., Sears Crouse, N., Smith, S., Lessard, E., Pouliot, J., Wright, V., McVeigh, E., Coleman, C. N., & Camphausen, K. (2004). MRI-guided HDR prostate brachytherapy in standard 1.5T scanner. International Journal of Radiation Oncology Biology Physics, 59(5), 1414-1423. https://doi.org/10.1016/j.ijrobp.2004.01.016