Estimating the actual dose delivered by intravascular coronary brachytherapy using geometrically correct 3D modeling

Andreas Wahle; John J. Lopez; Edward C. Pennington; Sanford L. Meeks; Kathleen C. Braddy; James M. Fox; Theresa M. H. Brennan; John M. Buatti; James D. Rossen; Milan Sonka

doi:10.1117/12.480218

30 May 2003 Estimating the actual dose delivered by intravascular coronary brachytherapy using geometrically correct 3D modeling

Andreas Wahle, John J. Lopez, Edward C. Pennington, Sanford L. Meeks, Kathleen C. Braddy, James M. Fox, Theresa M. H. Brennan, John M. Buatti, James D. Rossen, Milan Sonka

Author Affiliations +

Proceedings Volume 5029, Medical Imaging 2003: Visualization, Image-Guided Procedures, and Display; (2003) https://doi.org/10.1117/12.480218
Event: Medical Imaging 2003, 2003, San Diego, California, United States

Abstract

Intravascular brachytherapy has shown to reduce re-occurrence of in-stent restenosis in coronary arteries. For beta radiation, application time is determined from source activity and the angiographically estimated vessel diameter. Conventionally used dosing models assume a straight vessel with the catheter centered and a constant-diameter circular cross section. Aim of this study was to compare the actual dose delivered during in-vivo intravascular brachytherapy with the target range determined from the patient's prescribed dose. Furthermore, differences in dose distribution between a simplified tubular model (STM) and a geometrically correct 3-D model (GCM) obtained from fusion between biplane angiography and intravascular ultrasound were quantified. The tissue enclosed by the segmented lumen/plaque and media/adventitia borders was simulated using a structured finite-element mesh. The beta-radiation sources were modeled as 3-D objects in their angiographically determined locations. The accumulated dose was estimated using a fixed distance function based on the patient-specific radiation parameters. For visualization, the data was converted to VRML with the accumulated doses represented by color encoding. The statistical comparison between STM and GCM models in 8 patients showed that the STM significantly underestimates the dose delivered and its variability. The analysis revealed substantial deviations from the target dose range in curved vessels.

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Andreas Wahle, John J. Lopez, Edward C. Pennington, Sanford L. Meeks, Kathleen C. Braddy, James M. Fox, Theresa M. H. Brennan, John M. Buatti, James D. Rossen, and Milan Sonka "Estimating the actual dose delivered by intravascular coronary brachytherapy using geometrically correct 3D modeling", Proc. SPIE 5029, Medical Imaging 2003: Visualization, Image-Guided Procedures, and Display, (30 May 2003); https://doi.org/10.1117/12.480218

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