PURPOSE

An electromagnetic tracking device (EMT) has been integrated in an HDR 3D ultrasound guidance system for prostate HDR. The aim of this study was to compare the efficiency of HDR workflows with and without EM tracking.

METHODS AND MATERIALS

A total of 58 patients with a 15 Gy HDR prostate boost were randomized in two arms and two operation room (OR) procedures using: (1) the EMT investigational device, and (2) the Oncentra prostate system (OCP). OR times were compared for both techniques.

RESULTS

The overall procedure median time was about 20% shorter for EMT (63 min) compared to OCP (79 min). The US acquisition and contouring was longer for OCP compared to EMT (23 min vs. 16 min). The catheter reconstruction's median times were 23 min and 13 min for OCP and EMT respectively. For the automatic reconstruction with EMT, 62% of cases required no or few manual corrections. Using the EM technology in an OR environment was challenging. In some cases, interferences or the stiffness of the stylet introduced errors in the reconstruction of catheters. The last step was the dosimetry with median times of 11 min (OCP) and 15.5 min (EMT). Finally, it was observed that there was no learning curve associated with the introduction of this new technology.

CONCLUSIONS

The EMT device offers an efficient solution for automatic catheter reconstruction for HDR prostate while reducing the possibility of mis-reconstructed catheters caused by issues of visualization in the US images. Because of that, the overall OR times was shorter when using the EMT system.

中文翻译：

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用于 HDR 近距离放射治疗的美国引导 EM 跟踪系统：首个针对整个前列腺治疗的男性随机研究

目的

电磁跟踪设备 (EMT) 已集成到用于前列腺 HDR 的 HDR 3D 超声引导系统中。本研究的目的是比较有和没有 EM 跟踪的 HDR 工作流程的效率。

方法和材料

总共 58 名接受 15 Gy HDR 前列腺增强的患者被随机分为两组和两次手术室 (OR) 程序，使用：( 1 ) EMT 研究设备和 ( 2 ) Oncentra 前列腺系统 (OCP)。比较了两种技术的 OR 时间。

结果

EMT（63 分钟）的总体手术中位时间比 OCP（79 分钟）短约 20%。与 EMT 相比，OCP 的 US 采集和轮廓绘制时间更长（23 分钟 vs. 16 分钟）。OCP 和 EMT 导管重建的中位时间分别为 23 分钟和 13 分钟。对于 EMT 自动重建，62% 的病例不需要或很少需要手动校正。在手术室环境中使用 EM 技术具有挑战性。在某些情况下，干扰或管心针的硬度会在导管重建中引入误差。最后一步是剂量测定，中位时间为 11 分钟 (OCP) 和 15.5 分钟 (EMT)。最后，我们发现引入这项新技术不存在任何学习曲线。

结论

EMT 设备为 HDR 前列腺自动导管重建提供了有效的解决方案，同时减少了由于 US 图像可视化问题导致导管重建错误的可能性。因此，使用 EMT 系统时整体手术时间更短。