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Topological methods for the comparison of structures using LDR-brachytherapy of the prostate as an example

H Schiefer1, F von Toggenburg2, W W Seelentag1, L Plasswilm1, G Ries1, H-P Schmid2, T Leippold2, B Krusche3, J Roth4 and D Engeler2

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The dose coverage of low dose rate (LDR)-brachytherapy for localized prostate cancer is monitored 4–6 weeks after intervention by contouring the prostate on computed tomography and/or magnetic resonance imaging sets. Dose parameters for the prostate (V100, D90 and D80) provide information on the treatment quality. Those depend strongly on the delineation of the prostate contours. We therefore systematically investigated the contouring process for 21 patients with five examiners. The prostate structures were compared with one another using topological procedures based on Boolean algebra. The coincidence number CV measures the agreement between a set of structures. The mutual coincidence C(i, j) measures the agreement between two structures i and j, and the mean coincidence C(i) compares a selected structure i with the remaining structures in a set. All coincidence parameters have a value of 1 for complete coincidence of contouring and 0 for complete absence. The five patients with the lowest CV values were discussed, and rules for contouring the prostate have been formulated. The contouring and assessment were repeated after 3 months for the same five patients. All coincidence parameters have been improved after instruction. This shows objectively that training resulted in more consistent contouring across examiners.


PACS

87.53.Jw Therapeutic applications, including brachytherapy

87.59.bd Computed radiography

87.61.-c Magnetic resonance imaging

87.19.X- Diseases

87.55.-x Treatment strategy

Subjects

Biological physics

Medical physics

Dates

Issue 16 (21 August 2009)

Received 7 April 2009, in final form 25 June 2009

Published 30 July 2009



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