Intravascular ultrasound based dose assessment in endovascular brachytherapy

Gianpiero Catalano, Vittorio Tamburini, Antonio Colombo, Takahiro Nishida, Giovanni Parisi, Chiara Mazzetta, Roberto Orecchia

Research output: Contribution to journalArticlepeer-review

Abstract

Background: the role of endovascular brachytherapy in restenosis prevention is well documented. Dose is usually prescribed at a fixed distance from the source axis by angiographic quantification of vessel diameter. Recently, intravascular ultrasound (IVUS) was introduced in dose prescription, allowing a better evaluation of the vessel anatomy. This study retrospectively explores the difference between prescription following angiographic vessel sizing and delivered dose calculated with IVUS. Methods and results: Seventeen lesions were studied with IVUS, identifying on irradiated segment, three sections on which measuring minimal and maximal distance from the centre of IVUS catheter to the adventitia; using dedicated software, corresponding doses were calculated. The dose ranged widely, with maximal and minimal values of 71. 6 and 4.9Gy; furthermore, heterogeneity in dose among different sections was observed. In the central section, the maximal dose was 206% of the one prescribed with the QCA model at 2 mm from the source axis, while the minimal dose was 96%. In proximal and distal sections, respective values were 182, 45, 243, and 122%. Conclusions: Our analysis confirmed the dose inhomogeneity delivered with an angiographic fixed-dose prescription strategy. A dose variation was found along the irradiated segment due to the differences in vessel thickness. IVUS emerged as an important tool in endovascular brachytherapy, especially for irregular-shaped vessels.

Original languageEnglish
Pages (from-to)199-206
Number of pages8
JournalRadiotherapy and Oncology
Volume68
Issue number2
DOIs
Publication statusPublished - Aug 2003

Keywords

  • Angioplasty
  • Endovascular brachytherapy
  • Intravascular ultrasound
  • Restenosis

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Urology

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