TY - JOUR
T1 - Robotic MR-guided high dose rate brachytherapy needle implantation in the prostate (ROBiNSon)—a proof-of-concept study
AU - Rasing, Marnix J.A.
AU - van Schelven, Leonard J.
AU - van Lier, Astrid L.H.M.W.
AU - Boskovic, Ernest
AU - van Son, Marieke
AU - Schokker, Rogier I.
AU - van Vliet-Van den Ende, Katelijne M.
AU - Kelder, Daniëlle D.
AU - Verkerk, Jacqueline
AU - van de Pol, Sandrine M.G.
AU - Lagendijk, Jan J.W.
AU - Peters, Max
AU - van der Voort van Zyp, Jochem R.N.
AU - Moerland, Marinus A.
N1 - Publisher Copyright:
© 2024 The Author(s). Published on behalf of Institute of Physics and Engineering in Medicine by IOP Publishing Ltd.
PY - 2024/9/7
Y1 - 2024/9/7
N2 - Objective. A robotic needle implant device for MR-guided high-dose-rate (HDR) prostate brachytherapy was developed. This study aimed to assess the feasibility and spatial accuracy of HDR brachytherapy using the robotic device, for a single intraprostatic target point. Approach. Five patients were treated from November 2019-June 2022 with the robot. The robot fits a 1.5 T MR scanner and the needle can be shifted and angulated. An intraprocedural MR scan was fused with the diagnostic MR and one preplanned needle position was selected for robotic insertion. The needle entry point and angles were set for a needle tip target point within the intraprostatic target volume. The needle was tapped stepwise towards the target point pneumatically. Final needle position was verified with MR, followed by plan optimization and dose delivery. Any remaining planned needles were inserted manually. Needle tip to geometrical target error (NTG-error) was defined as the deviation of the actual tip position relative to the predefined geometric target point, using MR-coordinates. Needle tip to treatment target error (NTT-error) was defined as the deviation of the actual tip position relative to the treatment target point, using fused MR-images pre- and post-needle implantation taking into account prostate deformation. Difference between NTT-error and NTG-error and fiducial marker shifts indicated prostate movement. For determining prostate deformation, the Jaccard index and prostate volumes were assessed. Main results. The robotic device was able to tap the needle to the planned depth for all patients. Mean robotic procedure duration was 142 min. NTG-error was 3.2 (range 1.1-6.7) mm and NTT-error 4.5 (range 2.6-9.6) mm. Marker displacements were smaller than 3 mm. No treatment-related acute toxicity was reported. Feasibility of needle placement within the prostate was considered adequate. Significance. MR-guided robotic needle insertion is feasible with a mean geometric accuracy of 3.2 mm and <3 mm prostate movement.
AB - Objective. A robotic needle implant device for MR-guided high-dose-rate (HDR) prostate brachytherapy was developed. This study aimed to assess the feasibility and spatial accuracy of HDR brachytherapy using the robotic device, for a single intraprostatic target point. Approach. Five patients were treated from November 2019-June 2022 with the robot. The robot fits a 1.5 T MR scanner and the needle can be shifted and angulated. An intraprocedural MR scan was fused with the diagnostic MR and one preplanned needle position was selected for robotic insertion. The needle entry point and angles were set for a needle tip target point within the intraprostatic target volume. The needle was tapped stepwise towards the target point pneumatically. Final needle position was verified with MR, followed by plan optimization and dose delivery. Any remaining planned needles were inserted manually. Needle tip to geometrical target error (NTG-error) was defined as the deviation of the actual tip position relative to the predefined geometric target point, using MR-coordinates. Needle tip to treatment target error (NTT-error) was defined as the deviation of the actual tip position relative to the treatment target point, using fused MR-images pre- and post-needle implantation taking into account prostate deformation. Difference between NTT-error and NTG-error and fiducial marker shifts indicated prostate movement. For determining prostate deformation, the Jaccard index and prostate volumes were assessed. Main results. The robotic device was able to tap the needle to the planned depth for all patients. Mean robotic procedure duration was 142 min. NTG-error was 3.2 (range 1.1-6.7) mm and NTT-error 4.5 (range 2.6-9.6) mm. Marker displacements were smaller than 3 mm. No treatment-related acute toxicity was reported. Feasibility of needle placement within the prostate was considered adequate. Significance. MR-guided robotic needle insertion is feasible with a mean geometric accuracy of 3.2 mm and <3 mm prostate movement.
KW - brachytherapy
KW - HDR
KW - MR-guided
KW - prostate cancer
KW - robotic
UR - http://www.scopus.com/inward/record.url?scp=85201989118&partnerID=8YFLogxK
U2 - 10.1088/1361-6560/ad69f8
DO - 10.1088/1361-6560/ad69f8
M3 - Article
C2 - 39084657
AN - SCOPUS:85201989118
SN - 0031-9155
VL - 69
JO - Physics in medicine and biology
JF - Physics in medicine and biology
IS - 17
M1 - 175011
ER -