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EM-navigated Catheter Placement for Gynecologic Brachytherapy: An Accuracy Study

Institution:
Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
Publication Date:
Mar-2014
Volume Number:
9036
Pages:
90361F
Citation:
Proceedings of SPIE Medical Imaging, Image-Guided Procedures, Robotic Interventions, and Modeling 2014 Mar; 9036,90361F.
PubMed ID:
25076828
PMCID:
PMC4112824
Keywords:
gynecologic brachytherapy, electromagnetic tracking, catheter placement, image-guided therapy, radiation therapy
Appears in Collections:
NCIGT, NA-MIC, SLICER
Sponsors:
P41 EB015898/EB/NIBIB NIH HHS/United States
R01 CA111288/CA/NCI NIH HHS/United States
U54 EB005149/EB/NIBIB NIH HHS/United States
R03 EB013792/EB/NIBIB NIH HHS/United States
Generated Citation:
Mehrtash A., Damato A., Pernelle G., Barber L., Farhat N., Viswanathan A.N., Cormack R.A., Kapur T. EM-navigated Catheter Placement for Gynecologic Brachytherapy: An Accuracy Study. Proceedings of SPIE Medical Imaging, Image-Guided Procedures, Robotic Interventions, and Modeling 2014 Mar; 9036,90361F. PMID: 25076828. PMCID: PMC4112824.
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Gynecologic malignancies, including cervical, endometrial, ovarian, vaginal and vulvar cancers, cause significant mortality in women worldwide. The standard care for many primary and recurrent gynecologic cancers consists of chemoradiation followed by brachytherapy. In high dose rate (HDR) brachytherapy, intracavitary applicators and/or interstitial needles are placed directly inside the cancerous tissue so as to provide catheters to deliver high doses of radiation. Although technology for the navigation of catheters and needles is well developed for procedures such as prostate biopsy, brain biopsy, and cardiac ablation, it is notably lacking for gynecologic HDR brachytherapy. Using a benchtop study that closely mimics the clinical interstitial gynecologic brachytherapy procedure, we developed a method for evaluating the accuracy of image-guided catheter placement. Future bedside translation of this technology offers the potential benefit of maximizing tumor coverage during catheter placement while avoiding damage to the adjacent organs, for example bladder, rectum and bowel. In the study, two independent experiments were performed on a phantom model to evaluate the targeting accuracy of an electromagnetic (EM) tracking system. The procedure was carried out using a laptop computer (2.1GHz Intel Core i7 computer, 8GB RAM, Windows 7 64-bit), an EM Aurora tracking system with a 1.3mm diameter 6 DOF sensor, and 6F (2 mm) brachytherapy catheters inserted through a Syed-Neblett applicator. The 3D Slicer and PLUS open source software were used to develop the system. The mean of the targeting error was less than 2.9mm, which is comparable to the targeting errors in commercial clinical navigation systems.

Additional Material
1 File (141.634kB)
Mehrtash-SPIE2014-fig2.jpg (141.634kB)