Radiation Physics

PV QA 3 - Poster Viewing Q&A 3

TU_4_3152 - Diffusing Alpha-Emitters Radiation Therapy: Template Based TPS for Brachytherapy of Squamous Cell Skin Cancer

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Diffusing Alpha-Emitters Radiation Therapy: Template Based TPS for Brachytherapy of Squamous Cell Skin Cancer
G. Feliciani1, S. R. Bellia2, D. Bianchini1, G. Mazzotti1, V. Ravaglia1, E. Menghi1, M. Del Duca2, I. Kelson3, Y. Keisari4, A. Popovtzer5, M. Monti6, V. Turri7, A. Romeo2, I. Stanganelli8, T. Ibrahim9, and A. Sarnelli1; 1ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI- IRST, MEDICAL PHYSICS DEPARTMENT, Meldola (FC), Italy, 2IRCCS - ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI- IRST, RADIOTHERAPY DEPARTMENT,, Meldola (FC), Italy, 3SCHOOL OF PHYSICS AND ASTRONOMY- TEL AVIV UNIVERSITY, EXACT SCIENCES, Tel Aviv, Italy, 4Tel Aviv University, Tel Aviv, Israel, 5SACKLER FACULTY OF MEDICINE- TEL AVIV UNIVERSITY, CLINICAL MICROBIOLOGY AND IMMUNOLOGY, Meldola (FC), Italy, 6IRCCS - ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI- IRST, BIOSTATISTICS AND CLINICAL EXPERIMENTATION, Meldola (FC), Italy, 7IRCCS - ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI- IRST, MEDICAL DIRECTION, Meldola (FC), Italy, 8IRCCS - ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI- IRST, SKIN CANCER UNIT,, Meldola (FC), Italy, 9IRCCS - ISTITUTO SCIENTIFICO ROMAGNOLO PER LO STUDIO E LA CURA DEI TUMORI- IRST, OSTEONCOLOGY AND RARE TUMORS CENTER CDO-TR, Meldola (FC), Italy

Purpose/Objective(s): The Diffusing Alpha-emitters Radiation Therapy (DaRT) is an novel brachytherapy technique employing 224-Radium enriched seeds releasing short-lived alpha-emitting atoms into the tumor (1). 1st patient in Europe was enrolled and treated at IRST and medical physicists provided a tool to plan the brachytherapy treatment in order improve the precision and safety of needles insertion.

Materials/Methods: Given the novelty of the technique we remind to the references for its general description (1). The patient undergoes a 18-FDG PET\CT for both metabolic uptake control and lesion definition. A sterile patch is applied on the skin lesion just before the image acquisition and an adhesive fiberglass mesh (spaced by 2mm) tape is then placed above. The Radiotherapist contours the lesion and marks possible entrance points for the needles with a radio opaque ink marker. According to the radio opaque marks and metabolic uptake the CTV is now defined and with any commercial brachytherapy TPS it is possible to simulate and adjust the spatial seeds distribution. The method described was previously tested on home-made phantom. Before the treatment the template is placed again on the patient and seeds are inserted accordingly to the plan. Finally correct positioning of the seeds is checked again with a post-treatment CT scan.

Results: The template was correctly placed in position and it was clearly visible in CT. Through the TPS it was possible to visualize entrance points for the needles as suggested by the radiotherapist and eventually improve the coverage of the tumor by adding additional seeds. The post-treatment CT allows to evaluate the correspondence between the planned and actual seeds position.

Conclusion: The procedure implemented in our institution is robust and complete; the method for template definition is a promising tool supporting the Radiotherapoist for precise and safe DaRT delivery. References: [1] Keisari et Al. Growth Int. J. Cancer: 122, 1657–1664 (2008)

Author Disclosure: G. Feliciani: None. S. Bellia: None. G. Mazzotti: None. Y. Keisari: None. M. Monti: None. I. Stanganelli: None.

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