Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T12:16:21.023Z Has data issue: false hasContentIssue false

Transperineal ultrasound for aiding target volume delineation and monitoring during prostate cancer radiotherapy in men with bilateral hip prostheses

Published online by Cambridge University Press:  14 September 2020

Serena Jayne Hilman*
Affiliation:
Bristol Cancer Institute, Bristol, UK
Thomas Bird
Affiliation:
Bristol Cancer Institute, Bristol, UK
Piotr Gieryluk
Affiliation:
Bristol Cancer Institute, Bristol, UK
Amy Richardson
Affiliation:
Bristol Cancer Institute, Bristol, UK
Petra Jacobs
Affiliation:
Bristol Cancer Institute, Bristol, UK
*
Author for correspondence: Serena Jayne Hilman, Bristol Cancer Institute, Horfield Road, BristolBS2 8ED, UK. Tel: 0117 342 6296. E-mail: [email protected]

Abstract

Aims:

To investigate the use of co-registration of the computerised tomography (CT) planning scan with transperineal ultrasound (TPUS) as an aid to the delineation of the clinical target volume (CTV), and the use of TPUS as a tool for inter- and intra-fractional monitoring in men with bilateral hip prostheses (b-P) undergoing prostate radiotherapy.

Materials and methods:

We marked the CTV of three patients with and without the co-registered TPUS images. A metal artefact reduction algorithm was utilised. Two patients were treated with intensity-modulated radiotherapy (IMRT) and one with volumetric-modulated arc therapy (VMAT). The inter- and intra-fractional monitoring details were reviewed retrospectively.

Results:

Clinician marking with TPUS/CT fusion improved the confidence of prostate CTV delineation leading to a consistent change in volumes across two observers. Inter- and intra-fractional monitoring was possible using TPUS as image guidance, as it is for those patients with non-prosthetic hips.

Findings:

Using TPUS in the radiotherapy workflow has enabled us to more confidently plan, treat and monitor patients with b-HP. Due to transperineal image acquisition, the ultrasound images are not affected by the presence of hip prostheses, which are outside the field of view.

Type
Short Communication
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

15th Annual Report – National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. https://www.hqip.org.uk/resource/national-joint-registry-15th-annual-report-2018/#.XvRyiihKiUl. Accessed on 25th June 2020.Google Scholar
Li, H, Noel, C, Chen, H et al. Clinical evaluation of a commercial orthopedic metal artifact reduction tool for CT simulations in radiation therapy. Med Phys 2012; 39 (12): 75077517. doi: 10.1118/1.4762814.CrossRefGoogle ScholarPubMed
Hagen, M, Kretschmer, M, Wurschmidt, F et al. Clinical relevance of metal artefact reduction in computed tomography (iMAR) in the pelvic and head and neck region: multi-institutional contouring study of gross tumour volumes and organs at risk on clinical cases. J Med Imaging Radiat Oncol 2019; 63 (6): 842851. doi: 10.1111/1754-9485.12924.CrossRefGoogle ScholarPubMed
Zaorsky, N G, Showalter, T N, Ezzell, G A et al. ACR appropriateness criteria: external beam radiation therapy treatment planning for clinically localized prostate cancer, part I of II. Adv Radiat Oncol 2017; 2 (1): 6284. doi: 10.1016/j.adro.2016.10.002.CrossRefGoogle ScholarPubMed
Hilman, S, Smith, R, Masson, S et al. Implementation of a daily transperineal ultrasound system as image-guided radiotherapy for prostate cancer. Clin Oncol 2017; 29: e49. doi: 10.1016/j.clon.2016.07.002.CrossRefGoogle ScholarPubMed
Richardson, A K, Jacobs, P. Intrafraction monitoring of prostate motion during radiotherapy using the Clarity® Autoscan Transperineal Ultrasound (TPUS) system. Radiography 2017; 23: 310313. doi: 10.1016/j.radi.2017.07.003.CrossRefGoogle ScholarPubMed
Boda-Heggemann, J, Haneder, S, Ehmann, M et al. Stereotactic ultrasound for target volume definition in a patient with prostate cancer and bilateral total hip replacement. Pract Radiat Oncol 2015; 5 (3): 197202. doi: 10.1016/j.prro.2014.08.008.CrossRefGoogle Scholar
Dube, F, Mahadevan, A, Sheldon, T. Fusion of CT and 3D Ultrasound (3DUS) for prostate delineation of patients with metallic hip prostheses (MHP). Int J Radiat Oncol Biol Phys 2009; 75 (3, Supplement): S327S328. doi: 10.1016/j.ijrobp.2009.07.751.CrossRefGoogle Scholar
Rosewall, T, Kong, V, Vesprini, D et al. Prostate delineation using CT and MRI for radiotherapy patients with bilateral hip prostheses. Radiother Oncol 2009; 90 (3): 325330. doi: 10.1016/j.radonc.2008.11.015.CrossRefGoogle ScholarPubMed
Charnley, N, Morgan, A, Thomas, E et al. The use of CT-MR image registration to define target volumes in pelvic radiotherapy in the presence of bilateral hip replacements. Br J Radiol 2005; 78 (931): 634636. doi: 10.1259/bjr/28412864.CrossRefGoogle ScholarPubMed
Camps, S M, Fontanarosa, D, de With, P H N, Verhaegen, F, Vanneste, B G L. The use of ultrasound imaging in the external beam radiotherapy workflow of prostate cancer patients. BioMed Res Int 2018: 7569590. doi: 10.1155/2018/7569590.Google ScholarPubMed
Bittner, N, Butler, W M, Kurko, B S, Merrick, G S. Effect of metal hip prosthesis on the accuracy of electromagnetic localization tracking. Pract Radiat Oncol 2015 5 (1): 4348. doi: 10.1016/j.prro.2014.03.010.CrossRefGoogle ScholarPubMed