Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: Limited effect of oedema

Anna M. Dinkla, Bradley R. Pieters, Kees Koedooder, Niek Wieringen, Rob Laarse, Arjan Bel

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: In pulsed-dose rate prostate brachytherapy the dose is delivered during 48 hours after implantation, making the treatment sensitive to oedematic effects possibly affecting dose delivery. The aim was to study changes in prostate volume during treatment by analysing catheter configurations on three subsequent scans. Methods: Prostate expansion was determined for 19 patients from the change in spatial distribution of the implanted catheters, using three CT-scans: a planning CT (CT1) and two CTs after 24 and 48 hours (CT2, CT3). An additional 4 patients only received one repeat CT (after 24 hours). The mean radial distance (MRD) of all dwell positions to the geometric centre of all dwell positions used was calculated to evaluate volume changes. From three implanted markers changes in inter-marker distances were assessed. The relative shifts of all dwell positions were determined using catheter- and marker-based registrations. Wilcoxon signed-rank tests were performed to compare the results from the different time points. Results: The MRDs measured on the two repeat CTs were significantly different from CT1. The mean prostate volume change derived from the difference in MRD was +4.3% (range -9.3% to +15.6%) for CT1-CT2 (p < .05) and +4.4% (range -7.5% to +16.3%) for CT1-CT3 (p < .05). These values represented a mean increase of 1.2 cm3 in the first 24 hours and 1.5 cm3 in the subsequent 24 hours. There was no clear sign of prostate expansion from the change in inter-marker distance (CT1-CT2: 0.2 ± 1.8 mm; CT1-CT3: 0.6 ± 2.2 mm). Catheter configuration remained stable; shifts in catheter positions were largest in the C-C direction: 0 ± 1.8 mm for CT1-CT2 and 0 ± 1.4 mm for CT2-CT3. Conclusions: The volume changes derived from catheter displacements were small and therefore considered clinically insignificant. Implant configuration remains stable during 2 days of treatment, confirming the safety of this technique.
Original languageEnglish
Article number210
JournalRadiation Oncology
Volume9
Issue number1
DOIs
Publication statusPublished - 2014
Externally publishedYes

Cite this

Dinkla, Anna M. ; Pieters, Bradley R. ; Koedooder, Kees ; Wieringen, Niek ; Laarse, Rob ; Bel, Arjan. / Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: Limited effect of oedema. In: Radiation Oncology. 2014 ; Vol. 9, No. 1.
@article{ea2298d32d0846018be2452afe9a3872,
title = "Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: Limited effect of oedema",
abstract = "Background: In pulsed-dose rate prostate brachytherapy the dose is delivered during 48 hours after implantation, making the treatment sensitive to oedematic effects possibly affecting dose delivery. The aim was to study changes in prostate volume during treatment by analysing catheter configurations on three subsequent scans. Methods: Prostate expansion was determined for 19 patients from the change in spatial distribution of the implanted catheters, using three CT-scans: a planning CT (CT1) and two CTs after 24 and 48 hours (CT2, CT3). An additional 4 patients only received one repeat CT (after 24 hours). The mean radial distance (MRD) of all dwell positions to the geometric centre of all dwell positions used was calculated to evaluate volume changes. From three implanted markers changes in inter-marker distances were assessed. The relative shifts of all dwell positions were determined using catheter- and marker-based registrations. Wilcoxon signed-rank tests were performed to compare the results from the different time points. Results: The MRDs measured on the two repeat CTs were significantly different from CT1. The mean prostate volume change derived from the difference in MRD was +4.3{\%} (range -9.3{\%} to +15.6{\%}) for CT1-CT2 (p < .05) and +4.4{\%} (range -7.5{\%} to +16.3{\%}) for CT1-CT3 (p < .05). These values represented a mean increase of 1.2 cm3 in the first 24 hours and 1.5 cm3 in the subsequent 24 hours. There was no clear sign of prostate expansion from the change in inter-marker distance (CT1-CT2: 0.2 ± 1.8 mm; CT1-CT3: 0.6 ± 2.2 mm). Catheter configuration remained stable; shifts in catheter positions were largest in the C-C direction: 0 ± 1.8 mm for CT1-CT2 and 0 ± 1.4 mm for CT2-CT3. Conclusions: The volume changes derived from catheter displacements were small and therefore considered clinically insignificant. Implant configuration remains stable during 2 days of treatment, confirming the safety of this technique.",
author = "Dinkla, {Anna M.} and Pieters, {Bradley R.} and Kees Koedooder and Niek Wieringen and Rob Laarse and Arjan Bel",
year = "2014",
doi = "10.1186/s13014-014-0272-9",
language = "English",
volume = "9",
journal = "Radiation Oncology",
issn = "1748-717X",
publisher = "BioMed Central",
number = "1",

}

Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: Limited effect of oedema. / Dinkla, Anna M.; Pieters, Bradley R.; Koedooder, Kees; Wieringen, Niek; Laarse, Rob; Bel, Arjan.

In: Radiation Oncology, Vol. 9, No. 1, 210, 2014.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: Limited effect of oedema

AU - Dinkla, Anna M.

AU - Pieters, Bradley R.

AU - Koedooder, Kees

AU - Wieringen, Niek

AU - Laarse, Rob

AU - Bel, Arjan

PY - 2014

Y1 - 2014

N2 - Background: In pulsed-dose rate prostate brachytherapy the dose is delivered during 48 hours after implantation, making the treatment sensitive to oedematic effects possibly affecting dose delivery. The aim was to study changes in prostate volume during treatment by analysing catheter configurations on three subsequent scans. Methods: Prostate expansion was determined for 19 patients from the change in spatial distribution of the implanted catheters, using three CT-scans: a planning CT (CT1) and two CTs after 24 and 48 hours (CT2, CT3). An additional 4 patients only received one repeat CT (after 24 hours). The mean radial distance (MRD) of all dwell positions to the geometric centre of all dwell positions used was calculated to evaluate volume changes. From three implanted markers changes in inter-marker distances were assessed. The relative shifts of all dwell positions were determined using catheter- and marker-based registrations. Wilcoxon signed-rank tests were performed to compare the results from the different time points. Results: The MRDs measured on the two repeat CTs were significantly different from CT1. The mean prostate volume change derived from the difference in MRD was +4.3% (range -9.3% to +15.6%) for CT1-CT2 (p < .05) and +4.4% (range -7.5% to +16.3%) for CT1-CT3 (p < .05). These values represented a mean increase of 1.2 cm3 in the first 24 hours and 1.5 cm3 in the subsequent 24 hours. There was no clear sign of prostate expansion from the change in inter-marker distance (CT1-CT2: 0.2 ± 1.8 mm; CT1-CT3: 0.6 ± 2.2 mm). Catheter configuration remained stable; shifts in catheter positions were largest in the C-C direction: 0 ± 1.8 mm for CT1-CT2 and 0 ± 1.4 mm for CT2-CT3. Conclusions: The volume changes derived from catheter displacements were small and therefore considered clinically insignificant. Implant configuration remains stable during 2 days of treatment, confirming the safety of this technique.

AB - Background: In pulsed-dose rate prostate brachytherapy the dose is delivered during 48 hours after implantation, making the treatment sensitive to oedematic effects possibly affecting dose delivery. The aim was to study changes in prostate volume during treatment by analysing catheter configurations on three subsequent scans. Methods: Prostate expansion was determined for 19 patients from the change in spatial distribution of the implanted catheters, using three CT-scans: a planning CT (CT1) and two CTs after 24 and 48 hours (CT2, CT3). An additional 4 patients only received one repeat CT (after 24 hours). The mean radial distance (MRD) of all dwell positions to the geometric centre of all dwell positions used was calculated to evaluate volume changes. From three implanted markers changes in inter-marker distances were assessed. The relative shifts of all dwell positions were determined using catheter- and marker-based registrations. Wilcoxon signed-rank tests were performed to compare the results from the different time points. Results: The MRDs measured on the two repeat CTs were significantly different from CT1. The mean prostate volume change derived from the difference in MRD was +4.3% (range -9.3% to +15.6%) for CT1-CT2 (p < .05) and +4.4% (range -7.5% to +16.3%) for CT1-CT3 (p < .05). These values represented a mean increase of 1.2 cm3 in the first 24 hours and 1.5 cm3 in the subsequent 24 hours. There was no clear sign of prostate expansion from the change in inter-marker distance (CT1-CT2: 0.2 ± 1.8 mm; CT1-CT3: 0.6 ± 2.2 mm). Catheter configuration remained stable; shifts in catheter positions were largest in the C-C direction: 0 ± 1.8 mm for CT1-CT2 and 0 ± 1.4 mm for CT2-CT3. Conclusions: The volume changes derived from catheter displacements were small and therefore considered clinically insignificant. Implant configuration remains stable during 2 days of treatment, confirming the safety of this technique.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84924132081&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/25497373

U2 - 10.1186/s13014-014-0272-9

DO - 10.1186/s13014-014-0272-9

M3 - Article

VL - 9

JO - Radiation Oncology

JF - Radiation Oncology

SN - 1748-717X

IS - 1

M1 - 210

ER -