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Brachytherapy is a type of radiation therapy where the radiation source is located close to or inside the target area. It is an effective treatment and has less side effects compared to external radiation therapy, but requires surgery to introduce a set of needles into the patient. Up to now Brachytherapy is mainly used for prostate, breast and cervical cancer, but it is a promising technique for the treatment of oligometastases. Due to the variety of tumor positions, the source placement in oligometastases is unique for each patient. Therefore, the concept of a simulation-based planning tool is developed and evaluated in this project. The simulator enables to model the complexity of the planning process like changes of the delivered dose distributions due to target deformation and risks during needle insertion (e.g. perforation of vessels).
The following developments are included in the project:
- A real-time modeling of the interaction between the needle and the tissue, including the simulation of their deformation.
- A planning module to optimize source parameters (dwell time and dwell position) and calculate the expected dose distributions taking the deformation into account.
- A tracking system, which allows the user to insert the needle and experience haptic feedback during the insertion. It tracks translation, rotation and bending of the needle.
- A controller and visualization module, which allows the user to load DICOM data, insert planning parameters, configure needle paths, and view the deformation of the tissue, as well as dose distributions and dose volume histograms.
(1) Jerg, K. I., Austermühl, R. P., Roth, K., Große Sundrup, J., Kanschat, G., Hesser, J. W., & Wittmayer, L. (2020). Diffuse domain method for needle insertion simulations. International journal for numerical methods in biomedical engineering, 36(9), e3377.
(2) Guthier, C. V., Damato, A. L., Viswanathan, A. N., Hesser, J. W., & Cormack, R. A. (2017). A fast multitarget inverse treatment planning strategy optimizing dosimetric measures for high‐dose‐rate (HDR) brachytherapy. Medical physics, 44(9), 4452-4462.
(3) Guthier, C., Aschenbrenner, K. P., Buergy, D., Ehmann, M., Wenz, F., & Hesser, J. W. (2015). A new optimization method using a compressed sensing inspired solver for real-time LDR-brachytherapy treatment planning. Physics in Medicine & Biology, 60(6), 2179.