Abstract
PURPOSE
To investigate the consistency between preoperative and postoperative dosimetry when
125I brachytherapy for brain tumors is performed with magnetic resonance (MR) guidance
and a three-dimensional non co-planar template (3DNPT).
METHODS AND MATERIALS
Thirty patients with brain tumors (metastatic or gliomas) underwent radioactive 125I seed implantation. A preoperative treatment plan was determined with MR imaging,
and the operation was done under 3DNPT assistance and MR guidance. The dosimetry was
verified postoperatively based on postoperative CT–MR fusion images. Postoperative
dosimetric parameters and implant quality indices were defined and compared with those
in the preoperative treatment plan. Furthermore, a comparison of preoperative and
postoperative doses to normal brain tissues and organs at risk was also performed.
RESULTS
All mean postoperative dosimetries were calculated. Target coverage parameters D90,
D100, %CTV100, %CTV150, and %CTV200 were 143.6 cGy, 76.6 cGy, 88.2%, 63.1%, and 41.4%,
respectively. The values of implant quality indices CI, EI, and HI were 0.75, 0.14,
and 0.28, respectively. No significant differences between most preoperative and postoperative
dosimetric parameters were found (p > 0.05). The differences were also insignificant for organs at risk. Postoperative
%CTV150 and %CTV200 were higher than the preoperative, whereas postoperative HI was
significantly lower than in the treatment plan.
CONCLUSIONS
Magnetic resonance guidance combined with 3DNPT allows accurate positioning and direction
in 125I brachytherapy for brain tumors. However, seed distribution and dose homogeneity
require further improvement.
Keywords
Abbreviations:
CI (coverage index), D (dose), EI (external volume index), HI (relative dose homogeneity index), V (target or tumor volume)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 09, 2023
Accepted:
November 21,
2022
Received in revised form:
November 13,
2022
Received:
April 29,
2022
Publication stage
In Press Corrected ProofFootnotes
Disclosures: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The Doctoral Research Initiation Project of Ganzhou People's Hospital (No. Bsqd2020002) supported this work.
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© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
