Schmidt-Ullrich P N, Todor D A, Cuttino L W, Arthur D W
Department of Radiation Oncology, Medical College of Virginia, University of Virginia, Charlottesville, VA, USA.
Conf Proc IEEE Eng Med Biol Soc. 2004;2004:3124-7. doi: 10.1109/IEMBS.2004.1403882.
Over the last decade, increasing numbers of breast cancer patients are being treated using interstitial radioactive implants (brachytherapy). Multiple catheters are placed in the breast using a free-hand or template-guided approach. The configuration of the catheters and their relation to the tumor target volume are crucial to effective treatment. Catheter insertion requires a high level of experience to produce an implant of excellent quality. Construction of optimal catheter configuration prior to the procedure (virtual planning) would reduce the dependence of implant quality on the skill of the physician. Currently available commercial planning systems do not allow for virtual planning. We have developed software which inputs the target anatomy for a prospective patient and matches it to a previously-delivered catheter configuration from an institutional implant library. The archived catheter arrangement is then customized to fit the new target volume. The user can actually explore the implications of variations in catheter number and spatial arrangement. This may significantly improve the quality of implants that would otherwise be designed strictly based on a physician's prior experience. In an academic environment, this new resource could lead to better, faster results in the treatment of breast cancer.
在过去十年中，越来越多的乳腺癌患者正在接受组织间放射性植入物治疗（近距离放射疗法）。使用徒手或模板引导的方法将多个导管放置在乳房中。导管的配置及其与肿瘤靶体积的关系对于有效治疗至关重要。导管插入需要高水平的经验才能产生高质量的植入物。在手术前构建最佳导管配置（虚拟规划）将减少植入物质量对医生技能的依赖。目前可用的商业规划系统不允许进行虚拟规划。我们已经开发了一种软件，该软件输入预期患者的目标解剖结构，并将其与机构植入物库中先前交付的导管配置进行匹配。然后对存档的导管排列进行定制以适应新的靶体积。用户实际上可以探索导管数量和空间排列变化的影响。这可能会显著提高植入物的质量，否则这些植入物将严格基于医生的先前经验进行设计。在学术环境中，这种新资源可能会在乳腺癌治疗中带来更好、更快的结果。
