Publication: Evaluation of patient dose during multi-catheter insertion in CT-guided interstitial liver brachytherapy
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Date
2024-07
Authors
Sivaprakasam, Puviya
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Abstract
Introduction: Brachytherapy is a type of cancer treatment that involves placing an encapsulated radioactive source either near or directly into the tumour. Liver brachytherapy has been practiced in institutions where multiple catheters are inserted into the liver under CT-guidance. Numerous studies have acknowledged the dose received during brachytherapy, however, the dose received during CT-guided multi-catheter insertion lacks in discussion, hence, the optimisation of the procedure is presented by investigating various aspects of the procedure. Objectives: This study aims to evaluate the patient dose received from multi-catheter insertion during interstitial liver brachytherapy, to determine the association between number of catheters with the CT dose values (𝐶𝑇𝐷𝐼𝑣𝑜𝑙 and total DLP) and to evaluate the organ dose for the patients undergoing multi-catheter insertion in CT-guided interstitial liver brachytherapy using IndoseCT software as well. Methods: This study involved a retrospective survey on 18 patients who undergone CT-guided multi-catheter insertion for liver brachytherapy for evaluation of the patient dose received from the procedure. Patients’ demographic information (age and gender), CT data (number of catheters, number of CT phases, exposure settings – kVp, mAs, pitch and scan length (in cm)), patient dose data (𝐶𝑇𝐷𝐼𝑣𝑜𝑙(in mGy) and total DLP (in mGy.cm)), volume of lesion (in cm3) and diameter of lesion (in cm) were retrieved from CT workstation and recorded for further analysis. Besides that, the axial CT images of patients were obtained and retrieved from the Picture Archiving and Communication System (PACS) for further analysis. The collected CT images were uploaded in the IndoseCT software (Version 20b) to estimate the organ dose (developed by Anam et al., 2021). Result: Number of catheters showed weak correlation with CT dose indices (CTDIvol and total DLP) and number of CT phases while number of catheters had strong correlation with volume and diameter of lesion. Furthermore, the organ that received the highest dose for patient undergone RTP Abdomen HCT 3 mm protocol was heart with 755.79 mGy, while kidneys received the highest dose (964.79 mGy) for patients underwent RTP Abdo/Pelvis HCT 3 mm protocol. Conclusion: The examination of association between variables used in the procedures is extremely important to further optimise the procedure as well as provide insight on accurate decision making for future advancements.
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Keywords
computed tomography , catheter