Dual-source strength seed loading for eye plaque brachytherapy using eye physics eye plaques: A feasibility study.
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2022-12
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Abstract
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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.Material and methods
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.Results
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.Conclusions
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
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Meltsner, Sheridan G, David G Kirsch, Miguel A Materin, Yongbok Kim, Yang Sheng and Oana Craciunescu (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.
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Scholars@Duke
Sheridan Griffin Meltsner
Miguel Angel Materin
Miguel A. Materin, MD serves as Division Chief of Ocular Oncology, Professor of Ophthalmology, Professor of Radiation Oncology at Duke Eye Center.
His full-time clinical practice involves diagnosis and treatment of patients with ocular tumors. He specializes in ocular melanoma, retinoblastoma, choroidal hemangioma, retinal hemangioblastoma, ocular metastases, astrocytic retinal tumors and tumors related to other conditions or syndromes, such as von Hippel Lindau disease, Tuberous Sclerosis among others.
Dr. Materin joined Duke in September 2016 from Yale University School of Medicine where he was an Associate Professor of Ophthalmology & Visual Science, and Director of Ophthalmic Oncology at Smilow Cancer Hospital at Yale New Haven.
Prior to his appointment at Yale, he was the Director of Diagnostic Studies and Research Fellows for the Ocular Oncology Service at Wills Eye Hospital at Thomas Jefferson University in Philadelphia, where he completed his fellowship in ocular oncology in 1999.
He is an internationally recognized ocular oncologist who has more than 100 publications in peer-reviewed literature, including journals and book chapters. Dr. Materin has been invited as a visiting professor in the U.S., Canada, Israel, Spain, Brazil, Puerto Rico, Argentina, and has given more than 300 lectures.
Dr. Materin received the Achievement Award and Senior Achievement Award from the American Academy of Ophthalmology. He is a Member of Merit of Clinica Barraquer (Barcelona, Spain) and Colombian Society of Ophthalmology. He is an active member of the International Society of Ocular Oncology, American Academy of Ophthalmology, Pan American Association of Ophthalmology.
Dr. Materin served on the education committee of the American Association of Ocular Oncology and Pathology and is past-President of the Pan American Society of Ocular Oncology. He is a Panel Member of the National Comprehensive Cancer Network for Uveal Melanoma.
Yongbok Kim
Yang Sheng
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.
Oana Craciunescu
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