Permanent Prostate Brachytherapy Postimplant Magnetic Resonance Imaging Dosimetry Using Positive Contrast Magnetic Resonance Imaging Markers

Overview

Journal Brachytherapy

Specialty Radiology

Date 2017 May 15

PMID 28501429

Citations 1

Authors

Geoffrey V Martin

Thomas J Pugh

Usama Mahmood

Rajat J Kudchadker

Jihong Wang

Teresa L Bruno

Tharakeswara Bathala

Pierre Blanchard

Steven J Frank

Affiliations

Soon will be listed here.

Abstract

Purpose: Permanent prostate brachytherapy dosimetry using computed tomography-magnetic resonance imaging (CT-MRI) fusion combines the anatomic detail of MRI with seed localization on CT but requires multimodality imaging acquisition and fusion. The purpose of this study was to compare the utility of MRI only postimplant dosimetry to standard CT-MRI fusion-based dosimetry.

Methods And Materials: Twenty-three patients undergoing permanent prostate brachytherapy with use of positive contrast MRI markers were included in this study. Dose calculation to the whole prostate, apex, mid-gland, and base was performed via standard CT-MRI fusion and MRI only dosimetry with prostate delineated on the same T2 MRI sequence. The 3-dimensional (3D) distances between seed positions of these two methods were also evaluated. Wilcoxon-matched-pair signed-rank test compared the D90 and V100 of the prostate and its sectors between methods.

Results: The day 0 D90 and V100 for the prostate were 98% versus 94% and 88% versus 86% for CT-MRI fusion and MRI only dosimetry. There were no differences in the D90 or V100 of the whole prostate, mid-gland, or base between dosimetric methods (p > 0.19), but prostate apex D90 was high by 13% with MRI dosimetry (p = 0.034). The average distance between seeds on CT-MRI fusion and MRI alone was 5.5 mm. After additional automated rigid registration of 3D seed positions, the average distance between seeds was 0.3 mm, and the previously observed differences in apex dose between methods was eliminated (p > 0.11).

Conclusions: Permanent prostate brachytherapy dosimetry based only on MRI using positive contrast MRI markers is feasible, accurate, and reduces the uncertainties arising from CT-MRI fusion abating the need for postimplant multimodality imaging.

Citing Articles

Interobserver variability of 3.0-tesla and 1.5-tesla magnetic resonance imaging/computed tomography fusion image-based post-implant dosimetry of prostate brachytherapy.

Watanabe K, Katayama N, Katsui K, Matsushita T, Takamoto A, Ihara H J Radiat Res. 2019; 60(4):483-489.

PMID: 31083713 PMC: 6640899. DOI: 10.1093/jrr/rrz012.

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