Dual-source strength seed loading for eye plaque brachytherapy using eye physics eye plaques: A feasibility study.
Abstract
<h4>Purpose</h4>This study quantifies the dosimetric impact of incorporating two iodine-125
(125I) seed source strengths in Eye Physics eye plaques for treatment of uveal melanoma.<h4>Material
and methods</h4>Plaque Simulator was used to retrospectively plan 15 clinical cases
of three types: (1) Shallow tumors (< 5.5 mm) with large base dimensions (range, 16-19
mm); (2) Tumors near the optic nerve planned with notched plaques; and (3) Very shallow
(< 3.0 mm) tumors with moderate base dimensions (range, 13.5-15.5 mm) planned with
larger plaques than requested by the ocular oncologist. Circular plaques were planned
with outer ring sources twice the source strength of inner sources, and notched plaques
with the six seeds closest to the notch at twice the source strength.<h4>Results</h4>In
cases of type (1), the dual-source strength plan decreased prescription depth, and
doses to critical structures were lower: inner sclera -25% ±2%, optic disc -7% ±3%,
and fovea -6% ±3%. In four out of five cases of type (2), the dual-source strength
plan decreased prescription depth, and dose to inner sclera was lower (-22% ±5%),
while dose to optic disc (17% ±7%) and fovea (20% ±12%) increased. In cases of type
(3), a smaller dual-source strength plaque was used, and scleral dose was lower (-45%
±3%), whereas dose to optic disc (1% ±14%) and fovea (5% ±5%) increased.<h4>Conclusions</h4>Dual-source
strength loading as described in this study can be used to cover tumor margins and
decrease dose to sclera, and therefore the adjacent retina, but can either decrease
or increase radiation dose to optic disc and fovea depending on location and size
of the tumor. This technique may allow the use of a smaller plaque, if requested by
the ocular oncologist. Clinical determination to use this technique should be performed
on an individual basis, and additional QA steps are required. Integrating the use
of volumetric imaging may be warranted.
Type
Journal articleSubject
Eye Physics eye plaquesPlaque Simulator treatment planning system
eye plaque treatment planning
plaque brachytherapy
uveal melanoma
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https://hdl.handle.net/10161/26672Published Version (Please cite this version)
10.5114/jcb.2022.123979Publication Info
Meltsner, Sheridan G; Kirsch, David G; Materin, Miguel A; Kim, Yongbok; Sheng, Yang;
& Craciunescu, Oana (2022). Dual-source strength seed loading for eye plaque brachytherapy using eye physics eye
plaques: A feasibility study. Journal of contemporary brachytherapy, 14(6). pp. 590-600. 10.5114/jcb.2022.123979. Retrieved from https://hdl.handle.net/10161/26672.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Oana Craciunescu
Professor of Radiation Oncology
Yongbok Kim
Professor of Radiation Oncology
David Guy Kirsch
Barbara Levine University Distinguished Professor
My clinical interests are the multi-modality care of patients with bone and soft tissue
sarcomas and developing new sarcoma therapies. My laboratory interests include utilizing
mouse models of cancer to study cancer and radiation biology in order to develop new
cancer therapies in the pre-clinical setting.
Miguel Angel Materin
Professor of Ophthalmology
Ocular oncologist Miguel Materin, MD joined Duke Eye Center as Professor of Ophthalmology
and Director of Ophthalmic Oncology in September 2016. He joins Duke from Yale University
School of Medicine where he was an Associate Professor of Ophthalmology & Visual Science.
Prior to his appointment at Yale, he was at Wills Eye Hospital at Thomas Jefferson
University in Philadelphia, where he served as Director of Diagnostic Studies for
the Ocular Oncology Service. Dr. Materin&rsquo
Sheridan Griffin Meltsner
Assistant Professor of Radiation Oncology
Yang Sheng
Assistant Professor of Radiation Oncology
My research interest focuses on machine learning and AI application in radiation oncology
treatment planning, including prostate cancer, head-and-neck cancer and pancreatic
cancer etc.
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