IJMPCERO  Vol.4 No.2 , May 2015
Pseudo Central-Catheter Method for Asymmetrical Vaginal Prescription with Multi-Channel Cylindrical Applicators in Image-Guided High Dose-Rate Brachytherapy
Multi-channel cylindrical applicators for high dose-rate (HDR) brachytherapy are utilized mainly for special gynecology cases often involving image-guidance high dose-rate (IG-HDR or IGBT) brachytherapy. In these cases, doses are prescribed to partial vaginal wall/depth where the disease is indicated by an MRI study scanned on the same day. These novel IG-HDR procedures are logistical challenges comparing to typical HDR out-patient treatments due to the complexity of planning for asymmetrical prescriptions as well as the extension of the whole procedure. Indeed the main advantages of HDR over LDR brachytherapy would be significantly weaken unless the IG-HDR procedures become more efficient in time, thus timely treatment planning becomes crucial. Based on our clinical experience, we propose the pseudo central-catheter method to reduce errors, to minimize uncertainty and to ensure efficiency. In this method, the central hollow path of the multi-channel cylindrical applicator is digitized into a pseudo catheter similar to other active catheters, and the asymmetrical prescription points could be generated corresponding to the pseudo dwelling points in the pseudo central-catheter. The pseudo dwelling points are later deleted after generating the prescription point arrays. This method is robust with minimal chance of errors or uncertainties, and demonstrates high efficiency with much less chance of uncertainty, which is significant for IG-HDR brachytherapy procedures utilizing multi-channel applicators.
Cite this paper: Wang, K. , Ferenci, M. , Padgett, K. , Zhang, M. , Monterroso, M. and Chao, M. (2015) Pseudo Central-Catheter Method for Asymmetrical Vaginal Prescription with Multi-Channel Cylindrical Applicators in Image-Guided High Dose-Rate Brachytherapy. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 4, 124-131. doi: 10.4236/ijmpcero.2015.42016.

[1]   Houdek, P.V., Schwade, J.G., Abitbol, A.A., Pisciotta, V., Wu, X.D., Serago, C.F., Markoe, A.M., Levin, A.A., Averette, H.E., Aevin, B.U., et al. (1991) Optimization of High Dose-Rate Cervix Brachytherapy; Part I: Dose Distribution. International Journal of Radiation Oncology*Biology* Physics, 21, 1621-1625.

[2]   Demanes, D.J., Rege, S., Rodriquez, R.R., Schutz, K.L., Altieri, G.A. and Wong, T. (1999) The Use and Advantages of a Multichannel Vaginal Cylinder in High-Dose-Rate Brachytherapy. International Journal of Radiation Oncology*Biology* Physics, 44, 211-219.

[3]   Tanderup, K. and Lindegaard, J.C. (2004) Multi-Channelintracavitary Vaginal Brachytherapy Using Three-Dimensional Optimization of Source Geometry. Radiotherapy & Oncology, 70, 81-85.

[4]   Iftimia, I., Cirino, E.T., Mower, H.W. and McKee, A.B. (2013) Treatment Planning Methodology for the Miami Multichannel Applicator Following the American Brachytherapy Society Recently Published Guidelines: The Lahey Clinic Experience. Journal of Applied Clinical Medical Physics, 14, 4098.