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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: Serena.Hilman@uhbw.nhs.uk

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

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