EM-navigated catheter placement for gynecologic brachytherapy: an accuracy study

Alireza Mehrtash; Antonio Damato; Guillaume Pernelle; Lauren Barber; Nabgha Farhat; Akila Viswanathan; Robert Cormack; Tina Kapur

doi:10.1117/12.2044381

12 March 2014 EM-navigated catheter placement for gynecologic brachytherapy: an accuracy study

Alireza Mehrtash, Antonio Damato, Guillaume Pernelle, Lauren Barber, Nabgha Farhat, Akila Viswanathan, Robert Cormack, Tina Kapur

Author Affiliations +

Proceedings Volume 9036, Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling; 90361F (2014) https://doi.org/10.1117/12.2044381
Event: SPIE Medical Imaging, 2014, San Diego, California, United States

Abstract

Gynecologic malignancies, including cervical, endometrial, ovarian, vaginal and vulvar cancers, cause significant mortality in women worldwide. The standard care for many primary and recurrent gynecologic cancers consists of chemoradiation followed by brachytherapy. In high dose rate (HDR) brachytherapy, intracavitary applicators and /or interstitial needles are placed directly inside the cancerous tissue so as to provide catheters to deliver high doses of radiation. Although technology for the navigation of catheters and needles is well developed for procedures such as prostate biopsy, brain biopsy, and cardiac ablation, it is notably lacking for gynecologic HDR brachytherapy. Using a benchtop study that closely mimics the clinical interstitial gynecologic brachytherapy procedure, we developed a method for evaluating the accuracy of image-guided catheter placement. Future bedside translation of this technology offers the potential benefit of maximizing tumor coverage during catheter placement while avoiding damage to the adjacent organs, for example bladder, rectum and bowel. In the study, two independent experiments were performed on a phantom model to evaluate the targeting accuracy of an electromagnetic (EM) tracking system. The procedure was carried out using a laptop computer (2.1GHz Intel Core i7 computer, 8GB RAM, Windows 7 64-bit), an EM Aurora tracking system with a 1.3mm diameter 6 DOF sensor, and 6F (2 mm) brachytherapy catheters inserted through a Syed-Neblett applicator. The 3D Slicer and PLUS open source software were used to develop the system. The mean of the targeting error was less than 2.9mm, which is comparable to the targeting errors in commercial clinical navigation systems.

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Alireza Mehrtash, Antonio Damato, Guillaume Pernelle, Lauren Barber, Nabgha Farhat, Akila Viswanathan, Robert Cormack, and Tina Kapur "EM-navigated catheter placement for gynecologic brachytherapy: an accuracy study", Proc. SPIE 9036, Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling, 90361F (12 March 2014); https://doi.org/10.1117/12.2044381

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