ArticleMedical physics2026
Robust optimization of catheter positions and dwell times for HDR prostate brachytherapy.
Article in Medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundHDR prostate brachytherapy plans are sensitive to catheter placement uncertainty, as discrepancies between planned and delivered catheter positions can degrade target coverage and increase organ at risk dose. Current inverse planning methods optimize dwell times for a fixed implant geometry and do not account for geometric uncertainty during planning. Existing robust optimization approaches for HDR brachytherapy are similarly limited to dwell time optimization, and no framework has jointly optimized catheter configurations and dwell times while explicitly incorporating catheter insertion uncertainty. PURPOSE: To develop an analytical inverse planning method for prostate HDR brachytherapy that improves robustness to catheter placement uncertainty while maintaining nominal target coverage and organ at risk constraints.
methodsOverall, 32 previously treated prostate HDR cases were retrospectively analyzed. Dose was modeled with a TG-43U1 influence matrix. A candidate catheter set was generated by adding four translated trajectories per clinical catheter at
resultsOverall, the combined approach was comparable or an improvement to clinical positions alone. At
conclusionCoupling gMCP based catheter selection with an organ surface dose gradient penalty improved robustness of prostate HDR brachytherapy plans to independent catheter placement uncertainty, with comparable nominal plan quality after normalization.
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