Usmani Nawaid, Chng Nick, Spadinger Ingrid, Morris W James
Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
Brachytherapy. 2011 Jul-Aug;10(4):275-85. doi: 10.1016/j.brachy.2010.10.001. Epub 2010 Nov 18.
Quantify the migration of iodine-125 RAPIDStrands ("strands") from Day 0 to Day 30 postoperatively in patients treated with prostate brachytherapy.
Gold fiducial markers were inserted into the prostate before implants to serve as a fixed reference point within the prostate. Study patients underwent CT scans of the pelvis on Day 0 and Day 30 postimplant to image the prostate. In-house MATLAB software reconstructed each strand and determined its location relative to the center of mass of the fiducial markers. The recorded migration was taken to be the difference in these locations between Day 0 and Day 30.
A total of 232 strands containing 1069 sources were implanted in 10 patients. Overall, 84% of strands migrated by less than 5mm in any direction. The collection of strands were displaced a mean distance of +0.22mm laterally (95% confidence interval [CI]: +0.08 to +0.37mm), -0.22mm posteriorly (95% CI: -0.51 to +0.06mm), and +0.41mm superiorly (95% CI: +0.03 to +0.79mm). Strands located in the anterior prostate demonstrated the greatest degree of migration in any direction, moving a mean of +1.55mm superiorly. These strands also moved a mean distance of 0.84mm posteriorly, whereas posteriorly located strands moved by a mean distance of 0.82mm anteriorly, consistent with movement because of the resolution of edema.
This study did not identify any clinically significant patterns of mean migration of iodine-125 RAPIDStrands from Day 0 to Day 30 postimplant.
对接受前列腺近距离放射治疗的患者术后第0天至第30天期间碘-125快速线源(“线源”)的迁移情况进行量化。
在植入前将金基准标记物插入前列腺,作为前列腺内的固定参考点。研究患者在植入后第0天和第30天接受骨盆CT扫描以对前列腺成像。使用内部MATLAB软件重建每条线源,并确定其相对于基准标记物质心的位置。记录的迁移情况为第0天和第30天这些位置的差异。
10例患者共植入了232条含有1069个源的线源。总体而言,84%的线源在任何方向上的迁移距离小于5mm。线源集合在横向平均位移为+0.22mm(95%置信区间[CI]:+0.08至+0.37mm),向后为-0.22mm(95%CI:-0.51至+0.06mm),向上为+0.41mm(95%CI:+0.03至+0.79mm)。位于前列腺前部的线源在任何方向上的迁移程度最大,向上平均移动1.55mm。这些线源向后平均移动距离为0.84mm,而位于后部的线源向前平均移动距离为0.82mm,这与因水肿消退导致的移动一致。
本研究未发现碘-125快速线源在植入后第0天至第30天期间平均迁移的任何具有临床意义的模式。