A CT-based computerized treatment planning system for I-125 stereotactic brain implants.

A computer program has been developed at the University of California, San Francisco, as an aid in planning and evaluating stereotactic brain implants made with 125I seeds. The program allows images of seeds and catheters to be positioned in the target volume revealed by CT. It then generates and displays the resulting isodose distributions. Catheters may be changed interactively until an optimum implant is achieved. From the geometry of a stereotactic implant frame as measured by CT, the program calculates the approach angles of the catheters in the frame coordinate system. After the seeds are implanted, films made with a fiducial marker box can be used to generate true seed positions and hence true isodoses. This paper describes mathematically the geometrical transformations used by the program, and also outlines its many features and options. In its first 2 years of use the program has proved to be a valuable contributor to improved patient care.

[1]  M P Heilbrun,et al.  Preliminary experience with Brown-Roberts-Wells (BRW) computerized tomography stereotaxic guidance system. , 1983, Journal of neurosurgery.

[2]  P. Gutin,et al.  Permanent and removable implants for the brachytherapy of brain tumors. , 1981, International journal of radiation oncology, biology, physics.

[3]  C. Ling,et al.  Dose distributions of model 6702 I-125 seeds in water. , 1987, International journal of radiation oncology, biology, physics.

[4]  P. Gutin,et al.  Survival and quality of life after interstitial implantation of removable high-activity iodine-125 sources for the treatment of patients with recurrent malignant gliomas. , 1989, International journal of radiation oncology, biology, physics.

[5]  A. Young,et al.  Implantation of brain tumors with Cf-252. Use of computed tomography and magnetic resonance imaging to guide insertion and evaluate response. , 1984, Radiology.

[6]  D. Groothuis,et al.  Experimental Data on Early and Late Morphologic Effects of Permanently Implanted Gamma and Beta Sources (Iridium-192, Iodine-125 and Yttrium-90) in the Brain , 1984 .

[7]  J. A. Marchosky,et al.  Dosimetry of CT-guided volumetric IR-192 brain implant. , 1986, International journal of radiation oncology, biology, physics.

[8]  W Schlegel,et al.  Computerized optimization of 125I implants in brain tumors. , 1988, International journal of radiation oncology, biology, physics.

[9]  R. Brown A stereotactic head frame for use with CT body scanners. , 1979, Investigative radiology.

[10]  U. Rosenow,et al.  125I interstitial brachytherapy for primary malignant brain tumors: technical aspects of treatment planning and implantation methods. , 1984, International journal of radiation oncology, biology, physics.

[11]  P. Gutin,et al.  Recurrent malignant gliomas: survival following interstitial brachytherapy with high-activity iodine-125 sources. , 1987, Journal of neurosurgery.

[12]  C. Ling,et al.  Two-dimensional dose distribution of 125I seeds. , 1985, Medical physics.

[13]  P. Gutin,et al.  Brachytherapy of recurrent malignant brain tumors with removable high-activity iodine-125 sources. , 1984, Journal of neurosurgery.

[14]  F. Mundinger,et al.  Long-term Results of Stereotactic Interstitial Curietherapy , 1984 .

[15]  Iridium-192 brachytherapy in combination with interstitial microwave-induced hyperthermia for malignant glioma. , 1987, Applied neurophysiology.

[16]  C. Daumas-Duport,et al.  Interstitial and Combined Interstitial and External Irradiation of Supratentorial Gliomas. Results in 61 Cases Treated 1973–1981 , 1984 .

[17]  R L Siddon,et al.  Stereotaxic localization of intracranial targets. , 1987, International journal of radiation oncology, biology, physics.

[18]  S. Leibel,et al.  Stereotaxic interstitial implantation for the treatment of malignant brain tumors , 1986 .

[19]  M. Apuzzo,et al.  Interstitial radiobrachytherapy of malignant cerebral neoplasms: rationale, methodology, prospects. , 1987, Neurological research.