Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China.
World J Gastroenterol. 2018 Dec 14;24(46):5280-5287. doi: 10.3748/wjg.v24.i46.5280.
To evaluate a 3D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer.
A retrospective analysis of our database was performed, and a total of 25 patients with pancreatic cancer who underwent iodine-125 seed implantation between January 2014 and November 2017 were analyzed. Of these, 12 implantations were assisted by a 3D-printed coplanar template (group A), and 13 implantations performed freehand were selected as a control group (group B). A 3D coplanar template was designed and printed according to a preoperative CT scan and treatment planning system. The iodine-125 seeds were then implanted using the template as a guide. Dosimetric verification was performed after implantation. Pre- and postoperative D90, V100, and V150 were calculated. The success rate of iodine-125 seed implantation, dosimetric parameters, and complications were analyzed and compared between the two groups.
Iodine-125 seed implantation was successfully performed in both groups. In group A, the median pre- and postoperative D90 values were 155.32 ± 8.05 Gy and 154.82 ± 16.43 Gy, respectively; the difference between these values was minimal and not statistically significant ( > 0.05). Postoperative V100 and V150 were 91.05% ± 4.06% and 64.54% ± 13.40%, respectively, which met the treatment requirement. A better dosimetric parameter was observed in group A than in group B, and the difference was statistically significant (V100: 91.05% ± 4.06% 72.91% ± 13.78%, < 0.05). No major procedure-related complications were observed in either group. For group A, mild hemorrhage was observed in 1 patient with a peritoneal local hematoma due to mesenteric vein damage from the iodine-125 seed implantation needle. The hematoma resolved spontaneously without treatment. Postoperative blood amylase levels remained within the normal range for all patients.
A 3D-printed coplanar template appears to be a safe and effective iodine-125 seed implantation guidance tool to improve implantation accuracy and optimize dosimetric distribution.
评估一种用于胰腺癌碘-125 种子植入治疗的 3D 打印共面模板。
对我们的数据库进行回顾性分析，分析了 2014 年 1 月至 2017 年 11 月期间接受碘-125 种子植入的 25 例胰腺癌患者。其中，12 例植入术采用 3D 打印共面模板辅助（A 组），另 13 例徒手植入作为对照组（B 组）。根据术前 CT 扫描和治疗计划系统设计并打印 3D 共面模板。然后，使用模板作为引导进行碘-125 种子植入。植入后进行剂量验证。计算术前和术后 D90、V100 和 V150。分析比较两组碘-125 种子植入成功率、剂量学参数和并发症。
两组均成功进行了碘-125 种子植入。A 组中，术前和术后 D90 值中位数分别为 155.32±8.05 Gy 和 154.82±16.43 Gy，差异极小且无统计学意义（>0.05）。术后 V100 和 V150 分别为 91.05%±4.06%和 64.54%±13.40%，符合治疗要求。A 组的剂量学参数优于 B 组，差异有统计学意义（V100：91.05%±4.06% 72.91%±13.78%，<0.05）。两组均无主要与手术相关的并发症。A 组中，1 例患者因肠系膜静脉损伤导致碘-125 种子植入针引起腹膜局部血肿，出现轻度出血。血肿未经治疗自发消退。所有患者术后血淀粉酶水平均在正常范围内。
3D 打印共面模板似乎是一种安全有效的碘-125 种子植入引导工具，可提高植入准确性并优化剂量分布。
