Analyses of the factors influencing the accuracy of three-dimensional ultrasound in comparison with cone-beam CT in image-guided radiotherapy for prostate cancer with or without pelvic lymph node irradiation.

Three-dimensional ultrasound (3DUS) is an attractive option in image-guided radiotherapy (IGRT) for prostate cancer (PCa) patients. However, the potential factors influencing the accuracy of 3DUS in comparison with cone-beam CT (CBCT) in IGRT for PCa patients haven't been clearly identified.

The differences between US/US and CBCT/CT registrations were analyzed over 586 and 580 sessions for 24 and 25 PCa patients treated with or without pelvic lymph node irradiation, respectively. The clinical factors that may influence registration differences were also evaluated.

The average discrepancies between US/US and CBCT/CT registrations were - 0.28 ± 5.28 mm, - 0.16 ± 3.48 mm, and - 0.47 ± 4.31 mm in the superior-inferior (SI), left-right (LR), and anterior-posterior (AP) directions, respectively. The discrepancies were respectively less than 5 mm longitudinally, laterally, and vertically in 64.4 and 70.1%, 84.9 and 89.2%, and 75.9 and 79.1% of the patients treated with or without pelvic lymph node irradiation, respectively. The registration differences were significantly smaller at least in one direction in patients younger than 70 years, without pelvic lymph node irradiation, guided by transperineal ultrasonography and had a bladder volume smaller than 300 mL.

Age, irradiated regions, 3DUS modality, and bladder volume are important factors that may influence the differences between US/US and CBCT/CT registrations. 3DUS guidance is more feasible for younger PCa patients with a better control of bladder volume during the treatment and those who did not undergo pelvic lymph node irradiation.

Radiation oncology (London, England). 2019 Jan 29*** epublish ***

Sha Zhou, Liling Luo, Jibin Li, Maosheng Lin, Li Chen, Jianhui Shao, Shipei Lu, Yaru Ma, Yingting Zhang, Wenfen Chen, Mengzhong Liu, Shiliang Liu, Liru He

Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng Road East, Guangzhou, 510060, China., Department of Clinical Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China., Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng Road East, Guangzhou, 510060, China. ., Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng Road East, Guangzhou, 510060, China. .

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