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42. Dynamic Brachytherapy of the Prostate Under Active Image Guidance

Gang Cheng5, Haisong Liu5, Lydia Liao6 and Yan Yu5

(5)  Department of Radiation Oncology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
(6)  Department of Radiology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
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. Auto-segmentation 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.

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