First clinical experience with a novel, mobile cone-beam CT system for treatment quality assurance in brachytherapy

Background and purpose On-site cone-beam computed tomography (CBCT) has gained in importance in adaptive brachytherapy during recent years. Besides treatment planning, there is increased need particularly for image-guidance during interventional procedures and for image-guided treatment quality assu...

Full description

Saved in:
Bibliographic Details
Published in:Strahlentherapie und Onkologie 2022-06, Vol.198 (6), p.573-581
Main Authors: Karius, Andre, Strnad, Vratislav, Lotter, Michael, Kreppner, Stephan, Bert, Christoph
Format: Article
Language:English
Subjects:
Catheters
Computed tomography
Diameters
Genital cancers
Image quality
Maneuverability
Medical imaging
Medicine
Medicine & Public Health
Oncology
Original
Original Article
Quality assurance
Quality control
Radiation therapy
Radiotherapy
Remote control
Soft tissues
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background and purpose On-site cone-beam computed tomography (CBCT) has gained in importance in adaptive brachytherapy during recent years. Besides treatment planning, there is increased need particularly for image-guidance during interventional procedures and for image-guided treatment quality assurance (QA). For this purpose, an innovative CBCT device was rolled out at our hospital as the first site worldwide. We present the first clinical images and experiences. Materials and methods The novel CBCT system is constructed of a 121 cm diameter ring gantry, and features a 43.2 × 43.2 cm 2 flat-panel detector, wireless remote-control via tablet-PC, and battery-powered maneuverability. Within the first months of clinical operation, we performed CBCT-based treatment QA for a total of 26 patients (8 with breast, 16 with cervix, and 2 with vaginal cancer). CBCT scans were analyzed regarding potential movements of implanted applicators in-situ during the brachytherapy course. Results With the presented device, treatment QA was feasible for the majority of patients. The CBCT scans of breast patients showed sufficient contrast between implanted catheters and tissue. For gynecologic patients, a distinct visualization of applicators was achieved in general. However, reasonable differentiations of organic soft tissues were not feasible. Conclusion The CBCT system allowed basic treatment QA measures for breast and gynecologic patients. For image-guidance during interventional brachytherapy procedures, the current image quality is not adequate. Substantial performance enhancements are required for intraoperative image-guidance.
ISSN:0179-7158
1439-099X
DOI:10.1007/s00066-022-01912-7