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Program Information

US Guided Systems for Brachytherapy

L Beaulieu

X Yang

A Fenster

L Beaulieu1*, X Yang2*, A Fenster3*, (1) Centre hospitalier universitaire de Quebec, Quebec, QC, (2) Emory University, Atlanta, GA, (3) Robarts Research Institute, London, ON


4:30 PM : Advances in US guided brachytherapy - L Beaulieu, Presenting Author
4:55 PM : MRI-Ultrasound-CT Registration and Segmentation in Ultrasound-guided Prostate Brachytherapy - X Yang, Presenting Author
5:20 PM : 3DUS-guidance in brachytherapy - A Fenster, Presenting Author

MO-F-708-0 (Monday, July 31, 2017) 4:30 PM - 6:00 PM Room: 708

Brachytherapy relies on accurate guidance of needles, catheters and applicators to planned locations so that the prescribed radiation dose is delivered accurately and precisely. Thus, image guidance of needle to the planned target, and verification of needle positions prior to treatment is critical. Various devices are being used to guide the brachytherapy insertions, and ultrasound and CT are typically used for most brachytherapy applications, with real-time MRI being used by a very limited number of groups.

Ultrasound (US) has become a key imaging modality in prostate brachytherapy. In permanent seed implant, it allowed for a streamlined, one day outpatient procedure where dosimetric planning, needle insertion guidance and seed delivery is all performed under real-time US. Recently, temporary prostate high dose rate brachytherapy has also started to perform entirely using real-time US in many centers across the globe. In fact, the level of integration between US and dedicated treatment planning system now enables real-time dynamical planning for both seed and HDR prostate brachytherapy. These could be considered success stories for US imaging not only in brachytherapy but radiation therapy at large.

This session is composed of three presentations all tackling state-of-the-art use and application of ultrasound imaging. An overview of the methods of 3D ultrasound image acquisition, reconstruction and viewing, as well as descriptions of the three robotic methods will be covered in the first presentation. Results of experiments will demonstrate the accuracy and variability of the three brachytherapy techniques. The second lecture will provide an overview of tumor-targeted ultrasound-guided HDR brachytherapy for prostate cancer, a workflow of multimodality image fusion and segmentation in HDR brachytherapy, as well as some results of prostate image registration and segmentation. The last one will look at the state-of-the-art use of US imaging in brachytherapy, beyond prostate. In particular, we will review usage for breast and GYN brachytherapy, and time permits look at literature for lung, kidney and liver. We will discuss the advantages and limitations for each site separately.

Learning Objectives:
1. Understand how 3D ultrasound images are generated and the issues related to clinical application of the three 3D ultrasound-guided robotic systems.
2. Understand the significance of accurate multimodality image fusion/registration and segmentation in ultrasound-guided HDR brachytherapy and how multimodality image fusion/registration and segmentation is performed.
3. Understand how ultrasound imaging could help improve brachytherapy treatments for various tumors sites, as well as the advantages and limitations of ultrasound imaging for a variety of tumor sites.

Funding Support, Disclosures, and Conflict of Interest: Aaron Fenster: Acknowledges research support from CIHR and OICR. Xiaofeng Yang: Nothing to disclose. Luc Beaulieu: Acknowledges research support from NSERC and NSERC-Elekta Industrial Research Chair. No other disclosure or CoI to report


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