Electromagnetic Tracking (EMT) Technology for Improved Treatment Quality Assurance in Interstitial Brachytherapy

Overview

Journal J Appl Clin Med Phys

Specialties Biophysics
General Medicine

Date 2017 Mar 15

PMID 28291934

Citations 11

Authors

Markus Kellermeier

Jens Herbolzheimer

Stephan Kreppner

Michael Lotter

Vratislav Strnad

Christoph Bert

Affiliations

Soon will be listed here.

Abstract

Electromagnetic Tracking (EMT) is a novel technique for error detection and quality assurance (QA) in interstitial high dose rate brachytherapy (HDR-iBT). The purpose of this study is to provide a concept for data acquisition developed as part of a clinical evaluation study on the use of EMT during interstitial treatment of breast cancer patients. The stability, accuracy, and precision of EMT-determined dwell positions were quantified. Dwell position reconstruction based on EMT was investigated on CT table, HDR table and PDR bed to examine the influence on precision and accuracy in a typical clinical workflow. All investigations were performed using a precise PMMA phantom. The track of catheters inserted in that phantom was measured by manually inserting a 5 degree of freedom (DoF) sensor while recording the position of three 6DoF fiducial sensors on the phantom surface to correct motion influences. From the corrected data, dwell positions were reconstructed along the catheter's track. The accuracy of the EMT-determined dwell positions was quantified by the residual distances to reference dwell positions after using a rigid registration. Precision and accuracy were investigated for different phantom-table and sensor-field generator (FG) distances. The measured precision of the EMT-determined dwell positions was ≤ 0.28 mm (95th percentile). Stability tests showed a drift of 0.03 mm in the first 20 min of use. Sudden shaking of the FG or (large) metallic objects close to the FG degrade the precision. The accuracy with respect to the reference dwell positions was on all clinical tables < 1 mm at 200 mm FG distance and 120 mm phantom-table distance. Phantom measurements showed that EMT-determined localization of dwell positions in HDR-iBT is stable, precise, and sufficiently accurate for clinical assessment. The presented method may be viable for clinical applications in HDR-iBT, like implant definition, error detection or quantification of uncertainties. Further clinical investigations are needed.

Citing Articles

Electromagnetic tracking for integrated quality assurance in breast interstitial brachytherapy: The impact of registration method.

Sauer B, Durrbeck C, Bert C J Contemp Brachytherapy. 2024; 16(4):297-305.

PMID: 39628819 PMC: 11609855. DOI: 10.5114/jcb.2024.143610.

Is model-based dose calculation based on cone-beam computed tomography suitable for adaptive treatment planning in brachytherapy?.

Karius A, Shariff M, Schaller S, Lotter M, Strnad V, Lackner N Strahlenther Onkol. 2024; 201(1):57-70.

PMID: 39601857 PMC: 11739252. DOI: 10.1007/s00066-024-02318-3.

A novel multi-modality imaging phantom for validating interstitial needle guidance for high dose rate gynecological brachytherapy.

Eckroate B, Ayala-Peacock D, Venkataraman R, Campelo S, Chino J, Stephens S J Appl Clin Med Phys. 2023; 24(10):e14075.

PMID: 37335537 PMC: 10562025. DOI: 10.1002/acm2.14075.

On electromagnetic head digitization in MEG and EEG.

Jaiswal A, Nenonen J, Parkkonen L Sci Rep. 2023; 13(1):3801.

PMID: 36882438 PMC: 9992397. DOI: 10.1038/s41598-023-30223-9.

Advantages of TRUS-based delineation for high-dose-rate prostate brachytherapy planning.

Lavoie-Gagnon H, Martin A, Poulin E, Archambault L, Pilote L, Foster W J Contemp Brachytherapy. 2022; 14(1):1-6.

PMID: 35233228 PMC: 8867234. DOI: 10.5114/jcb.2022.113544.

References

Kovacs G . Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy. J Contemp Brachytherapy. 2015; 6(4):404-16. PMC: 4300360. DOI: 10.5114/jcb.2014.47813. View

Seppenwoolde Y, Shirato H, Kitamura K, Shimizu S, Van Herk M, Lebesque J . Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy. Int J Radiat Oncol Biol Phys. 2002; 53(4):822-34. DOI: 10.1016/s0360-3016(02)02803-1. View

Strnad V, Hildebrandt G, Potter R, Hammer J, Hindemith M, Resch A . Accelerated partial breast irradiation: 5-year results of the German-Austrian multicenter phase II trial using interstitial multicatheter brachytherapy alone after breast-conserving surgery. Int J Radiat Oncol Biol Phys. 2010; 80(1):17-24. DOI: 10.1016/j.ijrobp.2010.01.020. View

Wiles A, Likholyot A, Frantz D, Peters T . A statistical model for point-based target registration error with anisotropic fiducial localizer error. IEEE Trans Med Imaging. 2008; 27(3):378-90. DOI: 10.1109/TMI.2007.908124. View

Bert C, Metheany K, Doppke K, Taghian A, Powell S, Chen G . Clinical experience with a 3D surface patient setup system for alignment of partial-breast irradiation patients. Int J Radiat Oncol Biol Phys. 2006; 64(4):1265-74. DOI: 10.1016/j.ijrobp.2005.11.008. View

Kolkman-Deurloo I, de Kruijf W, Levendag P . On-line implant reconstruction in HDR brachytherapy. Radiother Oncol. 2005; 78(1):53-9. DOI: 10.1016/j.radonc.2005.12.003. View

Audette M, Ferrie F, Peters T . An algorithmic overview of surface registration techniques for medical imaging. Med Image Anal. 2001; 4(3):201-17. DOI: 10.1016/s1361-8415(00)00014-1. View

Bharat S, Kung C, Dehghan E, Ravi A, Venugopal N, Bonillas A . Electromagnetic tracking for catheter reconstruction in ultrasound-guided high-dose-rate brachytherapy of the prostate. Brachytherapy. 2014; 13(6):640-50. DOI: 10.1016/j.brachy.2014.05.012. View

Barry M, Ho A, Morrow M . The evolving role of partial breast irradiation in early-stage breast cancer. Ann Surg Oncol. 2013; 20(8):2534-40. DOI: 10.1245/s10434-013-2923-8. View

10.

Potter R, Haie-Meder C, Van Limbergen E, Barillot I, De Brabandere M, Dimopoulos J . Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics,.... Radiother Oncol. 2006; 78(1):67-77. DOI: 10.1016/j.radonc.2005.11.014. View

11.

Damato A, Viswanathan A, Don S, Hansen J, Cormack R . A system to use electromagnetic tracking for the quality assurance of brachytherapy catheter digitization. Med Phys. 2014; 41(10):101702. PMC: 7993398. DOI: 10.1118/1.4894710. View

12.

Cherpak A, Ding W, Hallil A, Cygler J . Evaluation of a novel 4D in vivo dosimetry system. Med Phys. 2009; 36(5):1672-9. DOI: 10.1118/1.3100264. View

13.

Franz A, Haidegger T, Birkfellner W, Cleary K, Peters T, Maier-Hein L . Electromagnetic tracking in medicine--a review of technology, validation, and applications. IEEE Trans Med Imaging. 2014; 33(8):1702-25. DOI: 10.1109/TMI.2014.2321777. View

14.

Lei P, Moeslein F, Wood B, Shekhar R . Real-time tracking of liver motion and deformation using a flexible needle. Int J Comput Assist Radiol Surg. 2010; 6(3):435-46. PMC: 3404485. DOI: 10.1007/s11548-010-0523-7. View

15.

Kirisits C, Rivard M, Baltas D, Ballester F, De Brabandere M, van der Laarse R . Review of clinical brachytherapy uncertainties: analysis guidelines of GEC-ESTRO and the AAPM. Radiother Oncol. 2013; 110(1):199-212. PMC: 3969715. DOI: 10.1016/j.radonc.2013.11.002. View

16.

Ezzell G, Galvin J, Low D, Palta J, Rosen I, Sharpe M . Guidance document on delivery, treatment planning, and clinical implementation of IMRT: report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee. Med Phys. 2003; 30(8):2089-115. DOI: 10.1118/1.1591194. View

17.

Strnad V, Ott O, Hildebrandt G, Kauer-Dorner D, Knauerhase H, Major T . 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast:.... Lancet. 2015; 387(10015):229-38. DOI: 10.1016/S0140-6736(15)00471-7. View

18.

De Bari B, Daidone A, Alongi F . Is high dose rate brachytherapy reliable and effective treatment for prostate cancer patients? A review of the literature. Crit Rev Oncol Hematol. 2015; 94(3):360-70. DOI: 10.1016/j.critrevonc.2015.02.003. View

19.

Roue A, Ferreira I, van Dam J, Svensson H, Venselaar J . The EQUAL-ESTRO audit on geometric reconstruction techniques in brachytherapy. Radiother Oncol. 2006; 78(1):78-83. DOI: 10.1016/j.radonc.2005.12.004. View

20.

Kickuth R, Reichling C, Bley T, Hahn D, Ritter C . C-Arm Cone-Beam CT Combined with a New Electromagnetic Navigation System for Guidance of Percutaneous Needle Biopsies: Initial Clinical Experience. Rofo. 2015; 187(7):569-76. DOI: 10.1055/s-0034-1399313. View