Sci-Sat AM(2): Brachy-06: A Comparison of MR/CT fusion versus CT alone for assessment of implant quality in permanent prostate brachytherapy

Medical Physics
D K SasakiA Chowdhury

Abstract

Low dose-rate permanent implant brachytherapy is widely used in the management of patients with early stage prostate cancer. An assessment of the implant quality is usually carried out 30 days after the implant is delivered, using computed tomography (CT) to identify the prostate and seeds. This is difficult due to poor contrast of the prostate and the superposition of seeds in the CT images. Magnetic resonance (MR) imaging offers superior contrast but inferior visualization of seeds. At our centre, patients are imaged using both CT and T2 weighted MR 30 days after an implant, and the image sets are fused using a commercial software package. The seeds are identified on CT and the prostate volumes are contoured on MR, with fusion performed by matching seeds on CT with seed signal voids on MR. The purpose of this study was to compare standard prostate post-implant dosimetric parameters (D90, V100, etc.) for prostates contoured on CT alone (MR blinded) versus MR/CT fusion. 25 patients were evaluated with all contouring performed by the same physician. We found that the prostate volume was overestimated using CT alone as compared to MR/CT fusion (mean: 37.2cc vs. 35.0cc respectively, p = 0.033). We also found that dosimetric parame...Continue Reading

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