Otal Antonio, Richart Jose, Rodriguez Silvia, Santos Manuel, Perez-Calatayud Jose
Radiotherapy Department, Clínica Benidorm, Benidorm.
Radiotherapy Department, Clínica Benidorm, Benidorm; Radiotherapy Department, La Fe University Hospital, Valencia, Spain.
J Contemp Brachytherapy. 2017 Feb;9(1):59-65. doi: 10.5114/jcb.2017.65290. Epub 2017 Jan 20.
T2 magnetic resonance imaging (MRI) is recommended as the imaging modality for image-guided brachytherapy. In locally advanced cervical carcinoma, combined endocavitary and interstitial applicators are appropriate (Vienna or Utrecht). To cover extensive disease, Template Benidorm (TB) was developed. Treatment planning system applicator libraries are currently unavailable for the Utrecht applicator or the TB. The purpose of this work is to develop an applicator library for both applicators.
The library developed in this work has been used in the Oncentra Brachytherapy TPS, version 4.3.0, which has a brachytherapy module that includes a library of rigid applicators. To add the needles of the Utrecht applicator and to model the TB, we used FreeCAD and MeshLab. The reconstruction process was based on the points that the rigid section and the interstitial part have in common. This, together with the free length, allowed us to ascertain the position of the tip.
In case of the Utrecht applicator, one of the sources of uncertainty in the reconstruction was determining the distance of the tip of needle from the ovoid. In case of the TB, the large number of needles involved made their identification time consuming. The developed library resolved both issues.
The developed library for the Utrecht and TB is feasible and efficient improving accuracy. It allows all the required treatment planning to proceed using just a T2 MRI sequence. The additional use of specific free available software applications makes it possible to add this information to the already existing library of the Oncentra Brachytherapy TPS. Specific details not included on this manuscript will be available under request. This library is also currently being implemented also into the Sagiplan v 2.0 TPS.
推荐使用T2磁共振成像（MRI）作为图像引导近距离放射治疗的成像方式。在局部晚期宫颈癌中，腔内和组织间联合施源器是合适的（维也纳或乌得勒支式）。为了覆盖广泛的病变，开发了贝尼多姆模板（TB）。目前，乌得勒支施源器或TB的治疗计划系统施源器库尚不可用。本研究的目的是为这两种施源器开发施源器库。
本研究开发的库已用于Oncentra Brachytherapy TPS 4.3.0版本，该版本有一个近距离放射治疗模块，其中包括一个刚性施源器库。为了添加乌得勒支施源器的针并对TB进行建模，我们使用了FreeCAD和MeshLab。重建过程基于刚性部分和组织间部分的公共点。这与自由长度一起，使我们能够确定尖端的位置。
对于乌得勒支施源器，重建中不确定性的来源之一是确定针尖端与卵形体的距离。对于TB，由于涉及大量的针，其识别耗时。开发的库解决了这两个问题。
为乌得勒支施源器和TB开发的库是可行且高效的，提高了准确性。它允许仅使用T2 MRI序列进行所有所需的治疗计划。额外使用特定的免费软件应用程序使得将此信息添加到Oncentra Brachytherapy TPS的现有库中成为可能。本手稿未包含的具体细节可根据要求提供。该库目前也正在被纳入Sagiplan v 2.0 TPS中。
