gms | German Medical Science

48th Meeting of the Particle Therapy Co-Operative Group

Particle Therapy Co-Operative Group (PTCOG)

28.09. - 03.10.2009, Heidelberg

Endorectal Coil MRI Utilization for Prostate Proton Irradiation

Meeting Abstract

  • A. Thornton - Midwest Proton Radiotherapy Institute, Bloomington, USA
  • M. Fitzek - Midwest Proton Radiotherapy Institute, Bloomington, USA
  • A. Chang - Midwest Proton Radiotherapy Institute, Bloomington, USA
  • J. Simmons - Midwest Proton Radiotherapy Institute, Bloomington, USA
  • A. Aisen - Department of Radiology, Indiana University Medical Center, Indianapolis, USA

PTCOG 48. Meeting of the Particle Therapy Co-Operative Group. Heidelberg, 28.09.-03.10.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09ptcog202

doi: 10.3205/09ptcog202, urn:nbn:de:0183-09ptcog2027

Veröffentlicht: 24. September 2009

© 2009 Thornton et al.
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Background: Over 300 patients with prostatic adenocarcinoma have received proton particle irradiation at the Midwest Proton Radiotherapy Institute since February, 2004. The technique of treatment has been consistent throughout this period, owing in large part to one author being the sole provider for the initial three years (AT).

Material and methods: Patients have been treated uniformly with rectal balloon, daily bilateral range-modulated proton beams, rigid full torso/pelvic cast immobilization, and seed/coil fiducial placement. Furthermore, daily pre-treatment simulation films have been employed in all patients, utilizing the rectal balloon, bony anatomy, and seed/coil fiducial placement. We have reported on the accuracy of this technique previously.

Results: Building on the experience of D'Amico and associates utilizing MRI-based endorectal coil imaging, we have integrated this imaging into the treatment planning process of selected patients. Over 10 patients have been found to have extracapsular extension, not otherwise suspected, with the use of this technique. Choices of surgical resection, brachytherapy treatment, and external irradiation were often dictated by this MRI finding. Furthermore, PTV definition was refined using the fused-MRI images, increasing coverage around the suspected extracapsular extension. The fusion technique is currently being utilized for patients with advanced prostate cancer, high-grade or high-risk pathology, or for patients suspected to have extracapsular/seminal vesicle extension (ie, perineural extension).

Conclusions: The technique of imaging will be described in detail, as will the effects of volume-definition for selected patients. Prostate patient work-up, CTV/GTV definition, and set-up and treatment will be explained.