Dynamic brachytherapy of the prostate under active image guidance

Abstract

Image-guided brachytherapy is a promising treatment for early stage prostate cancer. Current research emphasizes methods for intraoperative optimized planning and precise implantation of radioactive seeds. Some new technologies for these purposes are described in this paper. A morphological template will overcome pubic arch interference and achieve better-optimized dose coverage under the real-time dynamic dosimetry technique. Autosegmentation of the prostate anatomy has been implemented for clinical use to reduce operative time. Just-in-time planning and procedure tracking under active image guidance can now be performed in the operating room. Interactive planning and dynamic dosimetry can be achieved based on seed recognition in the live ultrasound images, which permit real-time replanning to eliminate under-dosage. As a result of these advances, prostate brachytherapy of the future will increasingly be practised as a precision procedure rather than an art form.