Nattagh Khashayar, Siauw Timmy, Pouliot Jean, Hsu I-Chow, Cunha J Adam
Department of Radiation Oncology, University of California, San Francisco, CA; Department of Physics, University of California, Berkeley, CA.
Department of Radiation Oncology, University of California, San Francisco, CA.
Brachytherapy. 2014 Jul-Aug;13(4):413-9. doi: 10.1016/j.brachy.2014.01.003. Epub 2014 Feb 12.
During gynecologic brachytherapy (BT), suturing and image-guided needle insertions are highly skill-dependent tasks. Medical residents often have to practice these techniques in the operating room; this is sub-optimal for many reasons. We present a fast and low-cost method of building realistic and disposable gynecologic phantoms, which can be used to train physicians new to gynecologic BT.
Phantoms comprised a rectal cavity large enough to accommodate a standard transrectal ultrasound (US) probe, a vaginal cavity, a uterus, a uterine canal, and a cervix, all embedded in a gelatin matrix. The uterus was made of gelatin and coated with rubber to mimic the texture of soft tissue and for computed tomography (CT) and US image contrast. The phantom's durability, longevity, construction times, materials costs, CT, and US image quality were recorded. The speed of sound in the gelatin was measured using pulse echo measurements.
Anatomic structures were distinguishable using CT and US. For the first phantom, material costs were under $200, curing time was approximately 48 hours, and active participation time was 3 hours. Reusable parts allowed for reduction in time and cost for subsequent phantoms: under $20, 24 hours curing time, and 1 hour active participation time. The speed of sound in the gelatin ranged from 1495 to 1506 m/s.
A method for constructing gelatin gynecologic phantoms was developed. It can be used for training in image-guided BT needle insertion, placing a suture on the vaginal wall, and suturing the cervical lip.
在妇科近距离放射治疗（BT）中，缝合和图像引导下的针插入是高度依赖技能的任务。医学住院医师常常必须在手术室练习这些技术；由于多种原因，这并非最佳选择。我们提出一种快速且低成本的方法来构建逼真的一次性妇科模型，可用于培训初涉妇科BT的医生。
模型包括一个足够大以容纳标准经直肠超声（US）探头的直肠腔、一个阴道腔、一个子宫、一个子宫管和一个宫颈，所有这些都嵌入明胶基质中。子宫由明胶制成并涂有橡胶，以模拟软组织的质地并用于计算机断层扫描（CT）和超声图像对比。记录模型的耐用性、寿命、构建时间、材料成本、CT和超声图像质量。使用脉冲回波测量法测量明胶中的声速。
使用CT和超声可区分解剖结构。对于第一个模型，材料成本低于200美元，固化时间约为48小时，实际参与时间为3小时。可重复使用的部件使后续模型的时间和成本得以降低：低于20美元，固化时间24小时，实际参与时间1小时。明胶中的声速范围为1495至1506米/秒。
开发了一种构建明胶妇科模型的方法。它可用于培训图像引导下的BT针插入、在阴道壁上放置缝线以及缝合宫颈唇。
