Doyle Andrea Jane, King Deirdre M, Browne Jacinta E
School of Physics & Clinical & Optometric Sciences, Medical Ultrasound Physics and Technology Group, Centre of Industrial Engineering Optics, FOCAS Institute, Dublin Institute of Technology, Ireland.
Hermitage Medical Clinic, Dublin, Ireland.
Phys Med. 2017 Dec;44:51-57. doi: 10.1016/j.ejmp.2017.11.011. Epub 2017 Nov 20.
Ultrasound guided brachytherapy for the treatment of prostate cancer has become a routine treatment option, due to many benefits including patient recovery and dose localisation [1]; however it is not clear whether the standards which govern the image quality for these systems are adequate. Upon review of the recommended standards for ultrasound systems used in prostate brachytherapy procedures, the recommended tests do not appear to be specific to the clinical application of ultrasound guided prostate brachytherapy. Rather they are generic and similar to those recommended for other clinical applications such as general abdominal scanning [2]. Furthermore, there is growing evidence that these tests should be specific to the clinical application [3,4] in order to gain meaningful data about the performance of the system for the application, and also to detect clinically relevant changes in quality control results. An additional problem is that there are no clinically relevant test phantom recommended for the quality assurance of ultrasound systems used in prostate brachytherapy. The image quality for this application of ultrasound needs to be monitored to ensure consistent levels of confidence in the procedure. This paper reviews the currently recommended test guidelines and test phantoms for ultrasound systems used in prostate brachytherapy from the different standard bodies and professional organisations. A critical analysis of those tests which are most reflective of the imaging and guidance tasks undertaken in an ultrasound guided prostate brachytherapy procedure will also be presented to inform the design of a TRUS quality assurance protocol.
超声引导下近距离放射治疗前列腺癌已成为一种常规治疗选择，这得益于诸多益处，包括患者恢复和剂量定位[1]；然而，这些系统的图像质量控制标准是否足够尚不清楚。在审查前列腺近距离放射治疗程序中使用的超声系统的推荐标准时，推荐的测试似乎并非针对超声引导下前列腺近距离放射治疗的临床应用。相反，它们是通用的，与其他临床应用（如一般腹部扫描）推荐的测试相似[2]。此外，越来越多的证据表明，这些测试应针对临床应用[3,4]，以便获得有关该系统在该应用中的性能的有意义数据，并检测质量控制结果中与临床相关的变化。另一个问题是，没有针对前列腺近距离放射治疗中使用的超声系统的质量保证推荐临床相关的测试体模。需要监测超声在该应用中的图像质量，以确保对该程序的信心水平一致。本文回顾了不同标准机构和专业组织目前推荐的用于前列腺近距离放射治疗的超声系统的测试指南和测试体模。还将对那些最能反映超声引导下前列腺近距离放射治疗程序中成像和引导任务的测试进行批判性分析，以为经直肠超声质量保证方案的设计提供参考。
