ArticleReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology2026
Evaluation of augmented reality for interstitial brachytherapy optimisation: a prospective phantom-based study protocol and preliminary results.
Article in Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 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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Abstract
Background: Interstitial brachytherapy enables highly conformal tumor irradiation while limiting exposure of surrounding tissues, but its successful execution requires advanced spatial orientation and manual precision. Augmented reality (AR) may support these procedures by providing three-dimensional visualisation of treatment planning data within the procedural environment. This study presents a prospective, phantom-based protocol with preliminary results evaluating the impact of AR guidance on implantation accuracy and procedure duration in interstitial brachytherapy. Materials and methods: A total of 136 implantation procedures are planned using 34 custom-made, tissue-equivalent phantoms. Each phantom undergoes CT imaging and treatment planning with the Oncentra Brachy system. Implantations are performed using a conventional freehand technique and an AR-assisted approach. The AR system, based on Microsoft HoloLens 2 and the HOLO BR platform, enables visualisation of DICOM RT data, including three-dimensional anatomical structures and applicator trajectories. Primary endpoints are implantation accuracy, defined as spatial deviation from the planned needle position, and total procedure time. This manuscript additionally reports preliminary results from a pilot phase comprising 12 AR-assisted and 12 conventional procedures, analysed using non-parametric statistical tests. Results: All pilot procedures were completed successfully. Implantation accuracy was numerically improved with AR guidance compared to the conventional technique, while procedure time was longer in the AR-assisted arm; however, neither difference reached statistical significance. Conclusions: This study provides an experimental framework and initial quantitative data on AR-guided interstitial brachytherapy under controlled conditions. The preliminary results support the feasibility of AR-assisted implantation and justify completion of the full experimental protocol and subsequent clinical validation.
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