1,489 results match your criteria Brachytherapy[Journal]


A semiautomatic segmentation method for interstitial needles in intraoperative 3D transvaginal ultrasound images for high-dose-rate gynecologic brachytherapy of vaginal tumors.

Brachytherapy 2020 Jul 3. Epub 2020 Jul 3.

School of Biomedical Engineering, The University of Western Ontario, London, Ontario, Canada; Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.

Purpose: The purpose of this study was to evaluate the use of a semiautomatic algorithm to simultaneously segment multiple high-dose-rate (HDR) gynecologic interstitial brachytherapy (ISBT) needles in three-dimensional (3D) transvaginal ultrasound (TVUS) images, with the aim of providing a clinically useful tool for intraoperative implant assessment.

Methods And Materials: A needle segmentation algorithm previously developed for HDR prostate brachytherapy was adapted and extended to 3D TVUS images from gynecologic ISBT patients with vaginal tumors. Two patients were used for refining/validating the modified algorithm and five patients (8-12 needles/patient) were reserved as an unseen test data set. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.05.006DOI Listing

Techniques for and uncertainties of MRI-based reconstruction of titanium tandem and ring brachytherapy applicators.

Brachytherapy 2020 Jul 2. Epub 2020 Jul 2.

Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA. Electronic address:

Purpose: Eliminating patient computed tomography (CT) scans for tandem and ring (T&R) brachytherapy can reduce overall procedure time and eliminates imaging dose. However, reconstructing titanium applicators in magnetic resonance imaging (MRI) is challenging. We evaluated the uncertainty of different applicator reconstruction workflows in MR-guided brachytherapy, and assessed the clinical impact of reconstruction uncertainties. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.05.005DOI Listing

Overall survival comparison between androgen deprivation therapy (ADT) plus external beam radiation therapy (EBRT) vs ADT plus EBRT with brachytherapy boost in clinically node-positive prostate cancer.

Brachytherapy 2020 Jul 2. Epub 2020 Jul 2.

Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.

Purpose: Optimal therapy for clinically node-positive, nonmetastatic (cN1) prostate cancer (PC) patients remains controversial, ranging from aggressive local therapy to palliative systematic therapy alone. Despite guideline support, it is unclear if a brachytherapy (BT) boost should be considered for cN1 patients as these patients were excluded from randomized trials establishing its benefit. Herein, we compare definitive radiation therapy (RT) with or without a BT boost in cN1 PC. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.05.007DOI Listing

Brachytherapy education and certification-A Canadian approach.

Brachytherapy 2020 Jun 24. Epub 2020 Jun 24.

BC Cancer Kelowna, University of British Columbia, Kelowna, BC, Canada.

The Royal College of Physicians and Surgeons of Canada has established a diploma certification program in brachytherapy, with the goal of standardizing brachytherapy training and standards. The diploma may be obtained either by way of a training route or a Practice Eligibility Route. Training is undergone through a Royal College-accredited brachytherapy program, analogous to a residency program with clearly defined curriculum, objectives, and expectations. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.05.004DOI Listing

Toxicity and cosmetic outcomes after treatment with a novel form of breast IORT.

Brachytherapy 2020 Jun 19. Epub 2020 Jun 19.

Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.

Purpose: Intraoperative radiation therapy (IORT), a form of accelerated partial breast irradiation (APBI), is an appealing alternative to postoperative whole breast irradiation for early-stage breast cancer. The purpose of this study was to examine the toxicity and cosmetic outcomes of patients treated with a novel form of breast IORT (precision breast IORT; PB-IORT), that delivers a targeted, higher dose of radiation than conventional IORT.

Methods And Materials: The first 204 patients treated with PB-IORT in a Phase II clinical trial (NCT02400658) with 12 months of followup were included. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.05.002DOI Listing

Development of an indigenous low-cost multichannel cylinder applicator for vaginal tumors.

Brachytherapy 2020 Jun 12. Epub 2020 Jun 12.

Department of Radiation Therapy, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.

Purpose: The purpose of this study was to report our experience regarding the development of a low-cost multichannel vaginal cylinder applicator for superficial and recurrent vaginal tumors.

Methods And Materials: The applicator mold was created by applying heated wax sheets in layers around a plastic tube. Interstitial stainless-steel needles were placed at equal distance around the mold surface to create multiple channels for treatment. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.05.001DOI Listing
June 2020
1.987 Impact Factor

A knowledge-based organ dose prediction tool for brachytherapy treatment planning of patients with cervical cancer.

Brachytherapy 2020 Jun 5. Epub 2020 Jun 5.

Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, CA. Electronic address:

Purpose: The purpose of this study is to explore knowledge-based organ-at-risk dose estimation for intracavitary brachytherapy planning for cervical cancer. Using established external-beam knowledge-based dose-volume histogram (DVH) estimation methods, we sought to predict bladder, rectum, and sigmoid D for tandem and ovoid treatments.

Methods And Materials: A total of 136 patients with loco-regionally advanced cervical cancer treated with 456 (356:100 training:validation ratio) CT-based tandem and ovoid brachytherapy fractions were analyzed. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.04.008DOI Listing

Outcomes of freehand interstitial brachytherapy in advanced gynecologic malignancies.

Brachytherapy 2020 May 25. Epub 2020 May 25.

Department of Radiation Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.

Purpose: The purpose of the study is to present the first results of freehand interstitial brachytherapy (ISBT) used to treat patients with carcinoma of the cervix and the vagina.

Methods And Materials: Patients diagnosed with carcinoma of the cervix or carcinoma of the vagina who were not suitable for intracavitary brachytherapy were treated with freehand ISBT. The implant was performed transperineally using C arm or transrectal ultrasound guidance. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.04.010DOI Listing

COVID 19 crisis: Maintaining brachytherapy access and strategies for risk mitigation.

Brachytherapy 2020 Apr 29. Epub 2020 Apr 29.

President, American Brachytherapy Society, Department of Radiation Oncology, Monument Health Cancer Care Institute, Rapid City, SD. Electronic address:

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http://dx.doi.org/10.1016/j.brachy.2020.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188651PMC

Esophageal brachytherapy: Institut Gustave Roussy's experience.

Brachytherapy 2020 May 19. Epub 2020 May 19.

Radiotherapy Department, Gustave Roussy, Villejuif, France.

Purpose: Esophageal cancer is characterized by its propension to local evolution, which conditions prognosis and quality of life. Brachytherapy may be a therapeutic option for all stages of esophageal cancer.

Methods And Materials: This retrospective unicentric study included all consecutive patients treated for an esophageal high-dose-rate brachytherapy in our institution from 1992 to 2018. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.04.002DOI Listing

Proposed brachytherapy recommendations (practical implementation, indications, and dose fractionation) during COVID-19 pandemic.

Brachytherapy 2020 May 1. Epub 2020 May 1.

Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA. Electronic address:

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http://dx.doi.org/10.1016/j.brachy.2020.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252026PMC

PNaV: A tool for generating a high-dose-rate brachytherapy treatment plan by navigating the Pareto surface guided by the visualization of multidimensional trade-offs.

Brachytherapy 2020 May 15. Epub 2020 May 15.

Department of Radiation Oncology, Mayo Clinic, Rochester, MN.

Purpose: A Pareto Navigation and Visualization (PNaV) tool is presented for interactively constructing a high-dose-rate (HDR) brachytherapy treatment plan by navigating and visualizing the multidimensional Pareto surface. PNaV aims to improve treatment planning time and quality and is generalizable to any number of dose-volume histogram (DVH) and convex dose metrics.

Methods And Materials: Pareto surface visualization and navigation were demonstrated for prostate, breast, and cervix HDR brachytherapy sites. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.013DOI Listing

Brachytherapy during the COVID-19- Lessons from Iran.

Brachytherapy 2020 May 14. Epub 2020 May 14.

Cancer Research Center, Iran Cancer Institute , Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1016/j.brachy.2020.05.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221400PMC

The American Brachytherapy society consensus statement for skin brachytherapy.

Brachytherapy 2020 May 11. Epub 2020 May 11.

Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.

Purpose: Keratinocyte carcinoma (KC, previously nonmelanoma skin cancer) represents the most common cancer worldwide. While surgical treatment is commonly utilized, various radiation therapy techniques are available including external beam and brachytherapy. As such, the American Brachytherapy Society has created an updated consensus statement regarding the use of brachytherapy in the treatment of KCs. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.04.004DOI Listing

Letter to the editor regarding "Rectal spacing, prostate coverage, and periprocedural outcomes after hydrogel spacer injection during low-dose-rate brachytherapy implantation".

Brachytherapy 2020 May 11. Epub 2020 May 11.

Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran.

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http://dx.doi.org/10.1016/j.brachy.2020.04.003DOI Listing

Peer-based credentialing for brachytherapy: Application in permanent seed implant.

Brachytherapy 2020 May 10. Epub 2020 May 10.

Department of Oncology, University of Calgary, Calgary, AB; Department of Physics and Astronomy, University of Calgary, Calgary, AB.

Purpose: The purpose of the study was to establish a quantitative method for implant quality evaluation in permanent seed implant brachytherapy for credentialing. Delivery-based credentialing will promote consistency in brachytherapy seed delivery and improve patient outcomes.

Methods: A workflow for delivery-based credentialing was outlined and applied to permanent breast seed implant brachytherapy. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.007DOI Listing

Quality comparison between three-dimensional T2-weighted SPACE and two-dimensional T2-weighted turbo spin echo magnetic resonance images for the brachytherapy planning evaluation of prostate and periprostatic anatomy.

Brachytherapy 2020 May 10. Epub 2020 May 10.

Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.

Purpose: The purpose of this study was to compare an isotropic three-dimensional (3D) T2-weighted sequence sampling perfection with application-optimized contrasts by using flip angle evolution (SPACE) with an axial two-dimensional T2-weighted turbo spin echo (TSE) sequence with regard to overall image quality and the delineation of normal prostate and periprostatic anatomy for low-dose-rate prostate cancer brachytherapy planning evaluation.

Methods And Materials: Patients (n = 69) with prostate cancer who had pelvic magnetic resonance imaging (MRI) for low-dose-rate brachytherapy treatment planning were included. Three radiologists independently assessed the visibility of nine anatomic structures on each sequence by using a 5-point scale and overall image quality by using a 4-point scale. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.04.001DOI Listing

Advanced design, simulation, and dosimetry of a novel rectal applicator for contact brachytherapy with a conventional HDR Ir source.

Brachytherapy 2020 May 5. Epub 2020 May 5.

Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address:

Purpose: Dose escalation yields higher complete response to rectal tumors, which may enable the omission of surgery. Dose escalation using 50 kVp contact x-ray brachytherapy (CXB) allow the treatment of a selective volume, resulting in low toxicity and organs-at-risk preservation. However, the use of CXB devices is limited because of its high cost and lack of treatment planning tools. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.009DOI Listing

Hypnosedation for endocavitary uterovaginal applications: A pilot study.

Brachytherapy 2020 Apr 29. Epub 2020 Apr 29.

Radiation Oncology Department, Brachytherapy Unit, Gustave Roussy, Villejuif, France.

Purpose: Implantations for uterovaginal brachytherapy are usually performed under general or spinal anesthesia, which are not without risk. As it is a rather short procedure and since postoperative pain is minimal, hypnosedation was proposed to selected patients requiring endocavitary applications as part of their routine treatment.

Methods And Materials: Consecutive patients requiring intracavitary uterovaginal brachytherapy from January to October 2019 were included if they accepted the procedure. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.008DOI Listing

COVID-19 impact on timing of brachytherapy treatment and strategies for risk mitigation.

Brachytherapy 2020 Apr 21. Epub 2020 Apr 21.

Department of Radiation Oncology, University of Washington, Seattle, WA. Electronic address:

Purpose: The purpose of this study was to highlight the importance of timely brachytherapy treatment for patients with gynecologic, breast, and prostate malignancies, and provide a framework for brachytherapy clinical practice and management in response to the COVID-19 pandemic.

Methods And Materials: We review amassing evidence to help guide the management and timing of brachytherapy for gynecologic, breast, and prostate cancers. Where concrete data could not be found, peer-reviewed expert opinion is provided. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.04.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172676PMC

A comparison of long-term clinical outcomes of accelerated partial breast irradiation using interstitial brachytherapy as per GEC-ESTRO, ASTRO, updated ASTRO, and ABS guidelines.

Brachytherapy 2020 May - Jun;19(3):337-347

Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India.

Purpose: The purpose of this study is to evaluate long-term clinical outcomes of women treated with accelerated partial breast irradiation (APBI) using multicatheter interstitial brachytherapy (MIB-APBI) with risk groups defined by Groupe Européen de Curie-thérapie and the European Society for Radiotherapy & Oncology (GEC-ESTRO), American Society for Radiation Oncology (ASTRO), updated ASTRO, and American Brachytherapy Society (ABS) guidelines and to elucidate the most appropriate guideline that could differentiate outcomes among its risk groups.

Methods And Materials: Two hundred forty women underwent MIB-APBI during July 2000 to March 2013. Comparisons of long-term clinical outcomes (local control [LC], disease-free survival [DFS], cause-specific survival [CSS], and overall survival [OAS]) stratified by the risk groups proposed by the aforementioned patient selection guidelines were carried out on a prospectively maintained database. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.011DOI Listing
January 2020
1.987 Impact Factor

Partial-breast irradiation versus whole-breast radiotherapy for early breast cancer: A systematic review and update meta-analysis.

Brachytherapy 2020 Apr 24. Epub 2020 Apr 24.

Faculdade de Medicina de Ribeirão Preto, Ribeirão Prceto, São Paulo, Brazil.

Purpose: The purpose of this study was to compare the treatment outcomes of partial-breast irradiation (PBI) versus whole-breast radiotherapy (WBRT) in early breast cancer.

Methods And Materials: Eligible randomized clinical trials were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through December 2019. A meta-analysis for local recurrence (LR), overall mortality (OM), and non-breast cancer mortality (NBCM) was conducted. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.003DOI Listing

Acute patient-reported bowel quality of life and rectal bleeding with the combination of prostate external beam radiation, low-dose-rate brachytherapy boost, and SpaceOAR.

Brachytherapy 2020 Apr 21. Epub 2020 Apr 21.

Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address:

Purpose: This study evaluates acute patient-reported bowel quality of life (QOL) and rectal bleeding in prostate cancer patients treated with combination external beam radiation (EBRT), low-dose-rate brachytherapy (LDR-BT), and SpaceOAR.

Materials And Methods: A retrospective review of prostate cancer patients treated with EBRT (45 Gy), cesium-131 LDR-BT (85 Gy), and SpaceOAR was conducted. Patient-reported acute (≤3 months after LDR-BT) bowel QOL and rectal bleeding was analyzed from Expanded Prostate Cancer Index Composite (EPIC) questionnaires. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.006DOI Listing

One thousand cases of cobalt-based high dose rate brachytherapy treated at a tertiary care center: A retrospective study.

Brachytherapy 2020 Apr 21. Epub 2020 Apr 21.

Department of Radiation Oncology, Ramaiah Medical College and Hospital, Bengaluru, India.

Purpose: This is a study of our experience with Co-60 high dose rate brachytherapy (HDR BT) from a tertiary care center.

Materials And Methods: One thousand patients were treated with Cobalt-based HDR BT for more than 6 years. The practice of BT was analyzed for clinical outcome, physical, radiobiological, and technical aspects. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.005DOI Listing

Clinical feasibility of MR-assisted CT-based cervical brachytherapy using MR-to-CT deformable image registration.

Brachytherapy 2020 Apr 20. Epub 2020 Apr 20.

Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA. Electronic address:

Purpose: The purpose of this study is to evaluate the feasibility of using deformable image registration algorithms to improve high-dose-rate high-risk clinical target volume (HR-CTV) delineation between preapplicator implantation MRI (pre-MRI) and postapplicator implantation CT (post-CT) in the treatment of locally advanced cervical cancer (LACC).

Method And Materials: Twenty-six patients were identified for the study. Regions of interest were segmented on MRI and CT. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.001DOI Listing

Feasibility of using multiple-dwell positions in Ir Leipzig-style brachytherapy surface applicators to expand target coverage and clinical application.

Brachytherapy 2020 Apr 20. Epub 2020 Apr 20.

Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT.

Purpose: Leipzig-style applicators for surface brachytherapy are traditionally used with a single-source dwell position. This study explores the feasibility of using multiple-source dwell positions ("multidwell") to improve the dose coverage and applicability of Leipzig-style applicators.

Methods And Materials: A virtual model of the Leipzig-style applicator was commissioned for a model-based dose calculation algorithm (MBDCA) and compared against American Association of Physicists in Medicine working group 186 benchmarking data sets and ionization chamber point measurements. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.002DOI Listing

Conventional vs machine learning-based treatment planning in prostate brachytherapy: Results of a Phase I randomized controlled trial.

Brachytherapy 2020 Apr 18. Epub 2020 Apr 18.

Department of Medical Physics, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada. Electronic address:

Purpose: The purpose of this study was to evaluate the noninferiority of Day 30 dosimetry between a machine learning-based treatment planning system for prostate low-dose-rate (LDR) brachytherapy and the conventional, manual planning technique. As a secondary objective, the impact of planning technique on clinical workflow efficiency was also evaluated.

Materials And Methods: 41 consecutive patients who underwent I-125 LDR monotherapy for low- and intermediate-risk prostate cancer were accrued into this single-institution study between 2017 and 2018. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.03.004DOI Listing
April 2020
1.987 Impact Factor

Clinical utility and value contribution of an MRI-positive line marker for image-guided brachytherapy in gynecologic malignancies.

Brachytherapy 2020 May - Jun;19(3):305-315. Epub 2020 Apr 4.

Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:

Purpose: The purpose of this study was to investigate the utility of a novel MRI-positive line marker, composed of C4:S (cobalt chloride-based contrast agent) encapsulated in high-density polyethylene tubing, in permitting dosimetry and treatment planning directly on MRI.

Methods And Materials: We evaluated the clinical feasibility of the C4:S line markers in nine sequential brachytherapy procedures for gynecologic malignancies, including six tandem-and-ovoid and three interstitial cases. We then quantified the internal resource utilization of an intraoperative MRI-guided procedural episode via time-driven activity-based costing, identifying opportunities for cost-containment with use of the C4:S line markers. Read More

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http://dx.doi.org/10.1016/j.brachy.2019.12.005DOI Listing
April 2020
1.987 Impact Factor

Dose-effect response in image-guided adaptive brachytherapy for cervical cancer: A systematic review and meta-regression analysis.

Brachytherapy 2020 Apr 4. Epub 2020 Apr 4.

Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun City, PR China.

Purpose: This study aimed to integrate and update the dose-effect relationship between volumetric dose and local control for cervical cancer brachytherapy.

Methods And Materials: We identified studies that reported high-risk clinical target volume (HR-CTV) D and local control probability by searching PubMed, Web of Science, and the Cochrane Library databases through Oct 27, 2019. The regression analyses were performed using a probit model between HR-CTV D, D, intermediate-risk clinical target volume (IR-CTV) D, and dose to Point A vs. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.012DOI Listing

Dosimetry, efficacy, and safety of three-dimensional printing noncoplanar template-assisted and CT-guided I seed implantation for recurrent retroperitoneal lymphatic metastasis after external beam radiotherapy.

Brachytherapy 2020 May - Jun;19(3):380-388. Epub 2020 Apr 2.

Department of Radiation Oncology, Peking University Third Hospital, Beijing, China. Electronic address:

Objectives: To evaluate the dosimetry, efficacy, and safety of radioactive I seed implantation (RISI) assisted by three-dimensional printing noncoplanar template (3D-PNCT) and CT for recurrent retroperitoneal lymphatic metastasis (RRLM) after previous external beam radiotherapy.

Methods And Materials: From June 2016 to August 2018, 32 patients with RRLM successfully underwent 3D-PNCT-assisted and CT-guided RISI. The dosimetry, pain relief rate, performance improvement rate, overall response rate, disease control rate, local control time (LCT), overall survival (OS), and safety profiles were evaluated. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.009DOI Listing
April 2020
1.987 Impact Factor

Development and comprehensive commissioning of an automated brachytherapy plan checker.

Brachytherapy 2020 May - Jun;19(3):355-361. Epub 2020 Apr 2.

Department of Radiation Oncology, University of Michigan, Ann Arbor, MI. Electronic address:

Purpose: To present on the commissioning of an automated brachytherapy plan checker (BPC) for the evaluation of high-dose-rate brachytherapy treatment plans in support of standardized workflows and patient safety.

Methods And Materials: A BPC was developed using an applications programming interface in a commercial treatment planning system based on different inputs (e.g. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.003DOI Listing

Analysis of patent innovation in the field of brachytherapy.

Brachytherapy 2020 Apr 2. Epub 2020 Apr 2.

Department of Radiation Oncology, Rush University Medical Center, Chicago, IL.

Purpose: To characterize inventions and assess trends in brachytherapy innovation based on brachytherapy-related patents awarded across the past 2 decades and provide insights that will help inform future research and entrepreneurship in the field.

Methods: The United States Patent and Trademark Office database was searched for patents awarded between 1999 and 2018 with a classification code corresponding to the broadest brachytherapy search category. Patent characteristics were stratified and compared by geographic location, affiliation, and theme of invention. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.010DOI Listing

Novel and programmatic improvements to the workflow associated with the AccuBoost breast brachytherapy procedure.

Brachytherapy 2020 May - Jun;19(3):372-379. Epub 2020 Apr 2.

Department of Radiation Oncology, The Warren Alpert Medical School of Brown University, Providence, RI. Electronic address:

Purpose: While the noninvasive breast brachytherapy (NIBB) treatment procedure, known as AccuBoost, for breast cancer patients is well established, the treatment quality can be improved by the efficiency of the workflow delivery. A formalized approach evaluated the current workflow through failure modes and effects analysis and generated insight for developing new procedural workflow techniques to improve the clinical treatment process.

Methods And Materials: AccuBoost treatments were observed for several months while gathering details on the multidisciplinary workflow. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.007DOI Listing

Evaluation of the urethral α/β ratio and tissue repair half-time for iodine-125 prostate brachytherapy with or without supplemental external beam radiotherapy.

Brachytherapy 2020 May - Jun;19(3):290-297. Epub 2020 Apr 2.

Department of Radiology, Sapporo Medical University, Sapporo, Hokkaido, Japan. Electronic address:

Purpose: To assess the correlation between postimplant dosimetric quantifiers and the genitourinary (GU) toxicity of low-dose rate brachytherapy for prostate cancer.

Methods And Materials: The minimum urethral dose (UD10, 30, and 90) and the percent volume of the urethra receiving the prescription dose (V100, V150) were calculated from the postimplant dose-volume histograms of 182 patients. We then calculated various urethral biologically equivalent doses (uBEDs) using different values of the α/β ratio and tissue repair half-time (t1/2) and examined the correlations with GU toxicity. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.007DOI Listing

Cesium-131 prostate brachytherapy: A single institutional long-term experience.

Brachytherapy 2020 May - Jun;19(3):298-304. Epub 2020 Apr 2.

Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address:

Aims: To report on the PSA outcomes in men undergoing prostate seed implant (PSI) with Cesium-131 at a single institution.

Materials And Methods: All patients who underwent prostate brachytherapy with Cesium-131 (Cs) at our institution and had the potential for at least 24 months of follow up were included in this study. Results are reported for the by NCCN risk group (low, low/high-intermediate, and high), as well as by treatment received (monotherapy, combination external beam radiation + PSI, or trimodal therapy with androgen deprivation). Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.006DOI Listing

The addition of interstitial needles to intracavitary applicators in the treatment of locally advanced cervical cancer: Why is this important and how to implement in low- and middle-income countries?

Brachytherapy 2020 May - Jun;19(3):316-322. Epub 2020 Mar 28.

Medical Physics, BC Cancer, Kelowna, British Columbia, Canada.

Purpose: Cervical cancer is the leading cause of cancer mortality of women in low-/middle-income countries. Interstitial needles improve outcomes but require resources beyond those available in endemic regions. We conducted a retrospective review of the use of interstitial needles in locally advanced cervical cancer and simulated both 3D planning without needles and 2D planning to explore the benefit of interstitial needles. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.004DOI Listing

Time-driven activity-based costing of a novel form of CT-guided high-dose-rate brachytherapy intraoperative radiation therapy compared with conventional breast intraoperative radiation therapy for early stage breast cancer.

Brachytherapy 2020 May - Jun;19(3):348-354. Epub 2020 Mar 28.

Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA. Electronic address:

Introduction: Intraoperative radiation therapy is an emerging option for adjuvant therapy for early stage breast cancer, although it is not currently considered standard of care in the United States. We applied time-driven activity-based costing to compare two alternative methods of breast intraoperative radiation therapy, including treatment similar to the techniques employed in the TARGIT-A clinical trial and a novel version with CT-guidance and high-dose-rate (HRD) brachytherapy.

Methods And Materials: Process maps were created to describe the steps required to deliver intraoperative radiation therapy for early stage breast cancer at each institution. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198347PMC

Using infrared depth-sensing technology to improve the brachytherapy operating room experience.

Brachytherapy 2020 May - Jun;19(3):323-327. Epub 2020 Mar 25.

Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Sunnybrook Health Sciences Centre, Toronto, Ontario. Electronic address:

Purpose: The purpose of this study was to discuss the merits of using depth-sensing infrared camera technology in the brachytherapy operating room during interstitial brachytherapy for gynecologic malignancies.

Materials And Methods: The infrared depth-sensing camera from a Microsoft Kinect that had been adapted for surgical use was introduced into a high-volume interstitial brachytherapy operating room. Brachytherapists then used the touchless, gestural interface to review preoperative MRI in real time to guide needle insertion. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.001DOI Listing
March 2020
1.987 Impact Factor

Long-term biochemical control and cause-specific survival in men with Gleason grade Group 4 and 5 prostate cancer treated with brachytherapy and external beam irradiation.

Brachytherapy 2020 May - Jun;19(3):275-281. Epub 2020 Mar 23.

Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY.

Purpose: Men with Gleason grade Group (GG) 4 and 5 prostate cancer have high failure rates when treated by conventional therapy. We investigated the effect of higher radiation doses on freedom from biochemical failure (FBF) and prostate cancer mortality (cause-specific survival [CSS]) in men treated with a combination of permanent implant and external beam irradiation (EBRT).

Methods And Materials: Three hundred twenty men with GG4 (n = 186) and 5 (n = 134) prostate cancer were treated with I-125 or Pd-103 implant followed by 45 Gy of EBRT. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.008DOI Listing

A phase IB clinical trial of 15 Gy HDR brachytherapy followed by hypofractionated/SBRT in the management of intermediate-risk prostate cancer.

Brachytherapy 2020 May - Jun;19(3):282-289. Epub 2020 Mar 23.

Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.

Purpose: High dose-rate (HDR) brachytherapy is commonly administered as a boost to external beam radiation therapy (EBRT). Our purpose was to compare toxicity with increasingly hypofractionated EBRT in combination with a single 15 Gy HDR boost for men with intermediate-risk prostate cancer.

Methods And Materials: Forty-two men were enrolled on this phase IB clinical trial to one of three EBRT dose cohorts: 10 fractions, seven fractions, or five fractions. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172676PMC

End-to-end delivery quality assurance of computed tomography-based high-dose-rate brachytherapy using a gel dosimeter.

Brachytherapy 2020 May - Jun;19(3):362-371. Epub 2020 Mar 21.

Department of Radiation Oncology, Hospital East, National Cancer Center, Chiba, Japan.

Purpose: The purpose of this study was to develop a novel quality assurance (QA) program to check the entire treatment chain of image-guided brachytherapy with dose distribution evaluation in a single setup and irradiation using a gel dosimeter.

Methods And Materials: A polymer gel was used, and the readout was performed by magnetic resonance scanning. A CT-based treatment plan was generated using the Oncentra planning system (Elekta, Sweden), and irradiation was performed three times using an afterloading device with an Ir-192 source. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.02.002DOI Listing

Anesthetic and analgesic methods for gynecologic brachytherapy: A meta-analysis and systematic review.

Brachytherapy 2020 May - Jun;19(3):328-336. Epub 2020 Feb 29.

Department of Anesthesiology, Moffitt Cancer Center and Research Institute, Tampa, FL. Electronic address:

Gynecologic brachytherapy procedures require targeted procedural and anesthetic needs including optimization of intra- and post-procedure analgesia, low rate of complications, and appropriate and timely transitions of care. It is uncertain whether neuraxial or general anesthesia is superior for these and other anesthetic outcomes. After a targeted search of the recent literature for anesthesia and analgesia studies for gynecologic brachytherapy, twenty studies were identified and appraised for potential review. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.006DOI Listing
February 2020

Rectal spacing, prostate coverage, and periprocedural outcomes after hydrogel spacer injection during low-dose-rate brachytherapy implantation.

Brachytherapy 2020 Mar - Apr;19(2):228-233. Epub 2020 Feb 19.

Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA; Hunter Holmes McGuire Veterans Affairs Medical Center, Radiation Oncology Service, Richmond, VA. Electronic address:

Purpose: To analyze the dosimetric impact and periprocedural outcomes with a bioabsorbable hydrogel rectal spacer injected during low-dose-rate (LDR) prostate brachytherapy implants.

Methods And Materials: A consecutive series of 80 patients implanted with stranded I-125 LDR brachytherapy seeds were evaluated, of which 40 underwent a transperineal injection of polyethylene glycol (5 cc) in between the prostate and rectum. Same day CT-based dosimetry was compared between patients with and without hydrogel spacer to evaluate for differences in rectal and prostate dosimetry. Read More

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http://dx.doi.org/10.1016/j.brachy.2019.11.002DOI Listing
February 2020

Maximizing gynecologic brachytherapy experience during radiation oncology residency training.

Brachytherapy 2020 Feb 15. Epub 2020 Feb 15.

Department of Radiation Oncology, Magee Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA.

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http://dx.doi.org/10.1016/j.brachy.2020.01.005DOI Listing
February 2020

FMEA-guided transition from microSelectron to Flexitron for HDR brachytherapy.

Brachytherapy 2020 Mar - Apr;19(2):241-248. Epub 2020 Feb 16.

Radiation Oncology, Huntsman Cancer Institution, University of Utah, Salt Lake City, UT.

Purpose: To utilize failure mode and effects analysis (FMEA) to effectively direct the transition from the Elekta microSelectron to the Flexitron high dose-rate afterloader system.

Materials And Methods: Our FMEA was performed in two stages. In the first stage, the lead brachytherapy physicists used FMEA to guide the brainstorming sessions and to identify vulnerabilities during this transition. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.004DOI Listing
February 2020

Dose planning variations related to delineation variations in MRI-guided brachytherapy for locally advanced cervical cancer.

Brachytherapy 2020 Mar - Apr;19(2):146-153. Epub 2020 Feb 14.

Department of Medical Physics, Oslo University Hospital, Oslo, Norway.

Purpose: To examine the variability in prescribed dose due to contouring variations in intracavitary image-guided adaptive brachytherapy for cervical cancer. To identify correlations between dosimetric outcomes and delineation uncertainty metrics.

Methods And Materials: A data set from an EMBRACE sub-study on contouring uncertainties was used, consisting of magnetic resonance images of six patients with cervical cancer delineated by 10 experienced observers (target volumes and organs at risk). Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.002DOI Listing
February 2020
1.987 Impact Factor

Influence of tumor shape and location in eye plaque brachytherapy dosimetry.

Brachytherapy 2020 Mar - Apr;19(2):249-254. Epub 2020 Feb 13.

Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL.

Purpose: A common treatment planning technique for eye plaque brachytherapy is to model the tumor as an ellipse. For posterior tumors near the optic disc and fovea, this approach may lead to overlap between tumor and the organ at risk (OAR). We hypothesized that a superior plan can be generated by modeling the actual tumor shape. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.001DOI Listing
February 2020

Upfront radiotherapy with brachytherapy for medically inoperable and unresectable patients with high-risk endometrial cancer.

Brachytherapy 2020 Mar - Apr;19(2):139-145. Epub 2020 Feb 12.

Department of Radiation Oncology, Harold C. Simmons Comprehensive Cancer Center, Dallas, TX. Electronic address:

Objectives: Comprehensive surgery with adjuvant therapy is standard of care for high-risk endometrial cancers, whereas upfront radiotherapy with brachytherapy is indicated for inoperable/unresectable patients, irrespective of risk. We evaluated outcomes for inoperable/unresectable patients with high-risk endometrial cancer (HREC: stage III and/or grade 3) and low-risk endometrial cancer (LREC: stage I/II and grade 1/2) treated with upfront radiotherapy.

Methods: Twenty-nine patients with inoperable/unresectable endometrial cancer were treated with upfront radiotherapy at an academic medical center from 2012 to 2019. Read More

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http://dx.doi.org/10.1016/j.brachy.2020.01.003DOI Listing
February 2020

Improving gynecologic brachytherapy patient experience by optimizing MRI, anesthesia, and scheduling to decrease the length of time tandem and ovoid applicators are in place.

Brachytherapy 2020 Mar - Apr;19(2):162-167. Epub 2020 Jan 22.

Department of Radiation Oncology, Stanford Cancer Institute, Stanford, CA. Electronic address:

Purpose: Brachytherapy requires multiple different steps and plays a critical role in treatment for gynecological cancer. In an effort to improve gynecologic patient experience, we investigated how different aspects of the procedure influence how long the patient has the brachytherapy applicator in place.

Methods And Materials: We prospectively recorded 145 consecutive tandem and ovoid treatments for 33 patients and determined how anesthesia vs. Read More

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http://dx.doi.org/10.1016/j.brachy.2019.11.011DOI Listing
January 2020

Can intermediate-energy sources lead to elevated bone doses for prostate and head & neck high-dose-rate brachytherapy?

Brachytherapy 2020 Mar - Apr;19(2):255-263. Epub 2020 Jan 18.

Medical Physics Unit, McGill University, Montréal, QC, Canada; Department of Oncology, McGill University, Montréal, QC, Canada; Research Institute of the McGill University Health Centre, Montréal, QC, Canada.

Purpose: Several radionuclides with high (Co, Se) and intermediate (Yb, Gd) energies have been investigated as alternatives to Ir for high-dose-rate brachytherapy. The purpose of this study was to evaluate the impact of tissue heterogeneities for these five high- to intermediate-energy sources in prostate and head & neck brachytherapy.

Methods And Materials: Treatment plans were generated for a cohort of prostate (n = 10) and oral tongue (n = 10) patients. Read More

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http://dx.doi.org/10.1016/j.brachy.2019.12.004DOI Listing
January 2020