Ej. Holupka et al., ULTRASOUND IMAGE FUSION FOR EXTERNAL-BEAM RADIOTHERAPY FOR PROSTATE-CANCER, International journal of radiation oncology, biology, physics, 35(5), 1996, pp. 975-984
Citations number
28
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To determine whether real-time ultrasound imaging and targeti
ng system for the treatment of prostate cancer was feasible, The initi
al phase of this project included a study to develop and determine (a)
software for the fusion of ultrasound images to standard x-rays obtai
ned during simulation, and (b) the potential reduction in field size w
ith real-time imaging. Methods and Materials: During 13 patient simula
tions a transrectal ultrasound image was obtained, Orthogonal x-ray fi
lms were acquired with the rectal probe in place, Both the x-ray and u
ltrasound images were digitized and a fusion image was created of the
prostate position in relation to the probe, bladder, and rectum, The t
wo-dimensional area of the rectum, bladder, and prostate was determine
d in the lateral projection, Potential conformal blocks were designed
for the lateral portals in a four-field treatment technique. Results:
The transrectal ultrasound probe enabled real-time prostate imaging, T
he lateral field size can be reduced to 6.08 x 5.68 cm(2) +/- 0.62 x 0
.48 cm(2) from the standard 8 x 8 cm(2) field, The posterior rectal wa
ll was physically displaced out of the lateral field, The area of the
rectum included in the lateral field is 1.75 cm(2) +/- 0.85 cm(2). Con
clusion: The prostate position can be determined with certainty on a r
egular basis with transrectal ultrasonography, The amount of normal ti
ssue in the high dose volume can be reduced, This approach may reduce
acute and chronic morbidity and allow further dose escalation.