Dynamic Brachytherapy of the Prostate Under Active Image Guidance

Image-guided brachytherapy is a promising treatment for early stage prostate cancer. Current research emphasizes methods for intraoperative optimized planning and precise implantation of radioactive seeds. Some new technologies for these purposes are descnbed in this paper. A morphological template will overcome pubic arch interference and achieve better-optimized dose coverage under the real-time dynamic dosimetry technique. Autosegmentation of the prostate anatomy has been implemented for clinical use to reduce operative time. Just-in-time planning and procedure tracking under active image guidance can now be performed in the operating room. Interactive planning and dynamic dosimetry can be achieved based on seed recognition in the live ultrasound images, which permit real-time replannmg to eliminate under-dosage. As a result of these advances, prostate brachytherapy of the future will increasingly be practised as a precision procedure rather than an art form.

[1]  R G Aarnink,et al.  Edge detection in prostatic ultrasound images using integrated edge maps. , 1998, Ultrasonics.

[2]  J. Roy,et al.  CT-based optimized planning for transperineal prostate implant with customized template. , 1991, International journal of radiation oncology, biology, physics.

[3]  R G Aarnink,et al.  A practical clinical method for contour determination in ultrasonographic prostate images. , 1994, Ultrasound in medicine & biology.

[4]  Y Yu,et al.  A genetic algorithm for the optimization of prostate implants. , 1996, Medical physics.

[5]  P. Okunieff,et al.  Automated treatment planning engine for prostate seed implant brachytherapy. , 1999, International journal of radiation oncology, biology, physics.

[6]  Y. Yu,et al.  Multiobjective decision theory for computational optimization in radiation therapy. , 1997, Medical physics.

[7]  P. Okunieff,et al.  Intraoperative optimized inverse planning for prostate brachytherapy: early experience. , 1999, International journal of radiation oncology, biology, physics.

[8]  F M Waterman,et al.  Limitations of the minimum peripheral dose as a parameter for dose specification in permanent 125I prostate implants. , 1996, International journal of radiation oncology, biology, physics.