Patient-Derived Training Simulator for Image-Guided Adaptive Brachytherapy of Locally Advanced Cervical Cancers: Development and Initial Use.
Kento TomizawaTakahiro OikeKen AndoDaisuke IrieMakoto SakaiHirofumi ShimadaTatsuya OhnoPublished in: Journal of clinical medicine (2022)
Image-guided adaptive brachytherapy (IGABT) using intracavitary and interstitial (IC/IS) techniques plays a pivotal role in definitive radiotherapy for locally advanced cervical cancers. However, the training opportunities for interstitial needle application are limited, preventing this technique from becoming widespread. This study aimed to develop a training simulator for IC/IS brachytherapy. The simulator consists of a soft silicone tumor phantom and acrylic tube mimicking the vagina; it has high visibility because of translucent materials and is compatible with computed tomography (CT) and magnetic resonance imaging (MRI). A patient harboring a typical bulky and irregular-shaped cervical tumor was selected from 495 in-house IGABT-treated candidates, and a tumor phantom (68 × 49 × 45 mm) modeled on this patient was produced from three-dimensional real-scale measurements of the MRI-based high-risk clinical target volume at first brachytherapy. In trial use by two physicians with different levels of IGABT skills, a Fletcher-Suit Asian Pacific applicator, and a Venezia applicator with interstitial needles were nicely applied to the simulator, facilitating successful creation of CT-based treatment plans consistent with clinical practice. Thus, the training simulator can be useful for the training of IC/IS brachytherapy, and warrants further research employing a greater number of phantoms and practitioners to verify its educational value.
Keyphrases
- virtual reality
- locally advanced
- high dose
- magnetic resonance imaging
- contrast enhanced
- computed tomography
- radiation therapy
- rectal cancer
- neoadjuvant chemotherapy
- image quality
- squamous cell carcinoma
- dual energy
- phase ii study
- primary care
- low dose
- positron emission tomography
- magnetic resonance
- case report
- study protocol
- clinical trial
- ultrasound guided
- health insurance
- combination therapy
- diffusion weighted imaging
- young adults