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Mario Chrétien

Publications and source records attributed to Mario Chrétien.

2 recordsLinked to original sources

Evaluation of an automatic needle-loading system.

The purpose of this paper is to evaluate the dosimetric capabilities and the radiation protection (RP) performance of a new automatic needle-loading system for permanent prostate implants, the Isoloader (Mentor Corp.). The unit has been used in more than 100 clinical cases at our institution. The Isoloader is a computerized workstation that allows automated seed testing by a solid-state CdZnTe radiation detector and loading in surgical needles. The seeds are received in a shielded and ready-to-use cartridge. Radiation protection measurements were done on a cartridge filled with 67 (125)I seeds and during dosimetric seed verification and needle loading. The reproducibility of the detector was tested and its accuracy was determined by comparison to specified activities of six calibration seeds and to their measurements in a calibrated well-chamber (WC). Finally, the times required to complete dosimetric verification and needle loading were evaluated. The cartridge was found to be adequately shielded, since no significant amount of radiation was detected around it. Radiation during seed assay was found to be worst at the cartridge's bottom, where it has a value of 15.2 microSv/h (1.4 microSv/h at 10 cm). For the needle-loading task, measurements were performed with a typical needle (three seeds) at the shielded needle holder surface yielding 307.2 microSv/h (8.3 microSv/h at 20 cm). Seed dosimetric verification takes an average of 15 s/seed, while it takes a mean time of 50 s/needle to complete the loading task. Measurements of the six seed activities were within 0.65% of the ordered activities and 1.9% higher on average than those from the WC (min = 0.7%; max = 3.5%). The reproducibility of the measurements of the CdZnTe detector was excellent, with an average of 0.01% of deviation from a reference measurement (N = 120; = 1.9%). We therefore conclude that the Isoloader is a safe, fast, and effective needle-loading system.

Brachytherapy↗

Early clinical experience with anatomy-based inverse planning dose optimization for high-dose-rate boost of the prostate.

PURPOSE: To present an exhaustive dosimetric comparison between three geometric optimization methods and our inverse-planning simulated annealing (IPSA) algorithm, with two different prescriptions for high-dose-rate (HDR) boost of the prostate. The objective of this analysis was to quantify the dosimetric advantages of the IPSA algorithm compared with more standard geometric optimizations. METHODS AND MATERIALS: Between September 1999 and June 2001, 34 patients were treated to a dose of 40-44 Gy by external pelvic fields, followed by an HDR boost of 18 Gy in 3 fractions. The first 4 patients were treated with HDR using geometric optimization, and anatomy-based inverse-planning dose optimization was used for the remaining 30 patients. We retrospectively used the data from these 30 patients to create HDR dose distributions according to five different dose optimization protocols, including our IPSA algorithm. The various geometric optimization procedures differed in the way the dwell positions were activated and plan normalization was performed. Dose-volume histograms from all these plans were analyzed and multiple implant quality indexes extracted. RESULTS: The IPSA algorithm provided better clinical tumor volume prescription dose coverage than did the geometric optimizations. The average prostate volume receiving 100% of the prescribed dose (V100) was 96.3% and 94.5% for IPSA with two different prescriptions compared with 92.1%, 92.6%, and 88.8% for the three geometric optimization schemes. The average urethra V150 value was 0.0% and 0.7% for IPSA with two different prescriptions, and the three geometric optimization protocols generated average values of 22.9%, 33.9%, and 38.8%. The bladder and rectal dose-volume histograms were similar, although the latest version of the IPSA algorithm slightly decreases the dose to these organs at risk because of organ-specific dose constraints included in the objective function. CONCLUSION: We found that planning an HDR prostate boost could be performed in a fast, secure, and effective manner with the IPSA algorithm. We demonstrated that our inverse-planning algorithm produces superior HDR plans than more conventional geometric optimizations for adenocarcinoma of the prostate. The organs at risk protection included in the objective function is a major feature of the algorithm and should allow us to escalate the HDR dose to the prostate without increasing undesirable side effects.

Adenocarcinoma↗