In cooperation with Prof. Dimos Baltas from the Medical Physics & Engineering department of Klinikum Offenbach we have studied various aspects of anatomy based three-dimensional dose optimization problems in HDR-brachytherapy. This work plays an important role for the project MITTUG IST-1999-10618.

Minimally Invasive Therapy for Tumors 3D Ultra-sound guided

Duration: 30 month, 1st January 2000 - 30th June 2002, Funding: approx. 2.100.000 (EC Contribution), Resources: approx. 750 person month

Information Society Technologies Programme (IST) is a single, integrated research program that builds on the convergence of information processing, communications and media technologies. IST has an indicative budget of 3.600 Million Euro, and is managed by the Information Society DG of the European Commission.

The project will develop minimally invasive therapy for tumors guided by VR images and ultrasound. It will create an integrated brachytherapy system, using online 3D ultrasound images for guidance and navigation systems for seeds or catheters in the context of organ infusion of drugs, chemotherapy etc. Dutch partner in the project is Nucletron bv.

Present treatment conditions have a number of shortcomings. Prior to insertion of catheters, usually a CT scan or X-Ray film (occasionally a 2D-U/S scan is used for prostate) is conducted as basis for planning the number and position of radioactive sources necessary. After insertion of the catheters, an additional scan is required to reconstruct their final positions. Present planning systems are capable of calculating the radiation pattern as the result of this geometry. Such systems are however incapable of solving the inverse problem, i.e. calculating the optimum position of needles once the required or desired amount of radiation on the target volume has been defined. Furthermore, the static CT picture is a poor basis for conducting the radiation itself for two reasons: First, the position of the patient can be different between CT acquisition and treatment, especially when soft tissue is involved. Second, CT scan acquired prior to the needle insertion provides no real-time indication of true position after insertion in the body relative to their planned position. Third, a CT scan is often not available in the radio-oncology department.

The software toolkit WinOpt-HDR together with the 3D ultrasound acquisition and volume rendering software InViVo-ScanNT from the Fraunhofer Institute for Computer Graphics and MedCom Gesellschaft für medizinische Bildverarbeitung mbH are extended and used to create a dual usage brachytherapy system employing catheters (HDR) using 3D-ultrasound images rather than CT scans. The system includes the following main components:

* Patient modelling system based mainly on 3D-ultrasound either than on CT scans. 3D-U/S is much cheaper, widely available and an uncomplicated procedure as compared with CT

* Inverse planing system using the segmented anatomy as stated above derived from 3D-U/S, CT, or from a combination of the two (fusion), calculating the minimum number and the optimal position of catheters to deliver the desired dose on the specified area. An innovative method and an anatomy based 3D-dosage optimisation will solve the inverse problem starting from the desired irradiation pattern and delivering number and location of implants

* Navigation system based on templates or magnetic tracker information which will give doctors for the first time the possibility of seeing the result of their action in real time and will enable them to position implants accurately in the positions defined by the pre-planing. This will increase the effectiveness of the treatment and enable accurate records to be kept

* Anatomy Based Optimisation based on genetic algorithms and fine-tuning the dose delivery to compensate differences between ideal and real implant position

Telemedical features allowing the on-line communication of experts. Unlike previous "teleradiology-motivated" approaches, our approach will enable co-operation during the planing phase as well during the interventional application of treatment

Personal References for the MITTUG project

M. Lahanas, D. Baltas and N. Zamboglou, Anatomy-based three-dimensional dose optimization in brachytherapy using multiobjective genetic algorithms, Med. Phys. 26 1904-1918, 1999

Abstract

M. Lahanas, D. Baltas, N. Milickovic, S. Giannouli and N. Zamboglou, Generation of uniformly distributed dose points for anatomy-based-three-dimensional dose optimization in brachytherapy, Med. Phys. 27 1034-1046, 2000

Abstract

N. Milickovic, S. Giannouli, D. Baltas, M. Lahanas, N. Zamboglou and N. Uzunoglou. Catheter autoreconstruction in CT based brachytherapy treatment planning, Med. Phys. 26 1047-1057, 2000

Abstract

N. Milickovic, S. Giannouli, D. Baltas, M. Lahanas, N. Zamboglou and N. Uzunoglou. Algorithm for autoreconstruction of catheters in computer tomography-based brachytherapy treatment planning, IEEE, Transactions on Biomedical Engineering, 48 No. 3, 372-383, 2001


Abstract

S. Giannouli, D. Baltas, N. Milickovic, M. Lahanas, C. Kolotas, N. Zamboglou and N. Uzunoglu. Autoactivation of Source Dwell Positions for HDR Brachytherapy Treatment Planning, Med. Phys. 27 2517-2520, 2000

Abstract

T. Kemmerer, M. Lahanas, D. Baltas and N. Zamboglou, DVH computation comparisons using conventional methods and optimized FFT algorithms for brachytherapy, Med. Phys. 27 2343-2356, 2000

Abstract

M. Lahanas, T. Kemmerer, N. Milickovic, K. Karouzakis, D. Baltas and N. Zamboglou, Optimized bounding boxes for three-dimensional treatment planning in brachytherapy, Med. Phys. 27 2333-2342, 2000

Abstract

N. Milickovic, D. Baltas, S. Giannouli, M. Lahanas and N. Zamboglou, CT imaging based digitally reconstructed radiographs and their application in brachytherapy, Phys. Med. Biol. 45 1-14, 2000

Abstract

K. Karouzakis, M. Lahanas, N. Milickovic, D. Baltas and N. Zamboglou, Brachytherapy dose–volume histogram computations using optimized stratified sampling methods, Med. Phys. 29 424-432, 2002

Abstract

M. Lahanas, N. Milickovic, D. Baltas and N. Zamboglou, Application of Multiobjective Evolutionary Algorithms for Dose Optimization Problems in Brachytherapy, in Proceedings of the first international conference, EMO 2001, Zurich, Switzerland, edited by E. Zitzler, K. Deb, L. Thiele,  C. A. Coello Coello, D. Corne, Lecture Notes in Computer Science Vol. 1993, Springer, 574-587, 2001

Abstract

N. Milickovic, M. Lahanas, D. Baltas and N. Zamboglou, Comparison of  Evolutionary and Deterministic Multiobjective Algorithms for Dose Optimization in Brachytherapy, in Proceedings of the first international conference, EMO 2001, Zurich, Switzerland, edited by E. Zitzler, K. Deb, L. Thiele, C. A. Coello Coello, D. Corne, Lecture Notes in Computer Science Vol. 1993, Springer 167-180, 2001

M. Lahanas, N. Milickovic, M. Papagiannopoulou, K. Karouzakis, D. Baltas and N. Zamboglou, Application of a Hybrid NSGA-II Multiobjective Algorithm for Anatomy based Dose Optimization in Brachytherapy, EUROGEN 2001 - Evolutionary Methods for Design, Optimisation and Control with Applications to Industrial Problems, Athens, Greece 19-21 September 2001

Abstract

N. Milickovic, M. Lahanas, M. Papagiannopoulou, K. Karouzakis, D. Baltas and N. Zamboglou, Application of Multiobjective Genetic Algorithms in Anatomy based Dose Optimization in Brachytherapy and its Comparison with Deterministic Algorithms, EUROGEN 2001 - Evolutionary Methods for Design, Optimisation and Control with Applications to Industrial  Problems, Athens, Greece 19-21 September 2001

Abstract

D. Baltas, N. Milickovic, S. Giannouli, M. Lahanas, C. Kolotas and N. Zamboglou, New tools of brachytherapy based on three-dimensional imaging Front. Radiat. Ther. Oncol. 34 59-70 2000

Abstract



Additional References by others

E. Firle, C. Wei, S. Wesarg, Registration of 3D U/S and CT Images of the Prostate In: Lemke, Heinz U. (Ed.) et al: Computer Assisted Radiology and Surgery 2002. Proceedings, Berlin, Heidelberg, New York: Springer Verlag, 2002, pp. 527-532

C. Wei, G. Sakas, Q. Peng, A Free Hand Navigation System for Brachytherapy: (in Chinese). In: Jisuanji-fuzhu-sheji-yu-tuxingxue-xuebao = Journal of Computer-Aided Design & Computer Graphics 14 (2002), 9

Jorge Gómez Zardaín, Automatic Registration of PET and CT resp. PET and MRT Volume Data, Darmstadt, 2002 Darmstadt, Techn. Univ., Dipl.-Arbeit, 2002

S. Zimeras, G. Karangelis, E. Firle and T. Lauer, Shape Reconstruction Using Computer-assisted Segmentation Tools. In: Kim, Myoung-Hee (Ed.) u.a.; Deutsches Krebsforschungszentrum (DKFZ): Advanced Medical Image Processing. Proceedings 2002. Germany, 2002

G. Sakas, Trends in Medical Imaging: From 2D to 3D. In: Computers & Graphics 26 (2002), 4, pp. 577-587

G. Anagnostopoulos, D. Baltas, P. Karaiskos, P. Sandilos, P. Papagiannis and L. Sakelliou, Thermoluminescent dosimetry of the selectSeed 125I interstitial brachytherapy seed Med Phys, 29:709- 716, 2002.

D. Baltas, P. Karaiskos, P. Papagiannis, L. Sakelliou, E. Loeffler and N. Zamboglou,  Beta versus gamma dosimetry close to Ir-192 brachytherapy sources Med. Phys. 28, 1875-1882, 2001

P. Karaiskos, P. Papagiannis, L. Sakelliou, G. Anagnostopoulos and D. Baltas, Monte Carlo dosimetry of the selectSeed 125I interstitial brachytherapy seed Med. Phys. 28, 1753-1760, 2001

N. Milickovic, D. Baltas and N. Zamboglou, Automatic Reconstruction of Catheters in CT Based Brachytherapy Treatment Planning Proc. IEEE Nuc. Sci. Symp. And Med. Imag. Conf., IEEE NSS/MIC 2001, San Diego, California, USA, 4-10 November, 2001.

N Milickovic, D Baltas and N. Zamboglou, Algorithms for Calculation of DRRs for Different Accelerator Voltages and Tools for Work with DRRs
Proceedings of the 23rd IEEE EMBS Int. Conference, 23rd Annual International Conference of the IEEE - Engineering in Medicine and Biology Society,
Istanbul, Turkey, 25-28 October, 2001.

Chen, Wei; Firle, Evelyn: Active Patient Immobilization in Brachytherapy In: Center of Advanced European Studies and Research (CAESAR): Third Caesarium on Computer Aided Medicine: Handouts. Bonn, 2001

Chen, Wei; Cai, Wenli; Firle, Evelyn; Wang, Min; Peng, Qunsheng: A Hardware Assisted LDI Building Algorithm with Application to Hybrid Volume Rendering. In: Peng, Qunsheng (Ed.) u.a.: CAD/Graphics 2001. Proceedings of the Seventh International Conference on Computer Aided Design and Computer Graphics. Beijing, China : International Academic Publishers, 2001, S. 225 - 232

E. Firle and W. Chen, Semi-Automatic Registration for MR and CT Datasets. In: Center of Advanced European Studies and Research (CAESAR): Third Caesarium on Computer Aided Medicine : Handouts. Bonn, 2001

E. Firle, Semi-automatische Segmentierung der Prostata mit Hilfe von 3D Ultraschallaufnahmen. In: Handels, H. (Hrsg.) u.a.; Gesellschaft für Informatik (GI): Bildverarbeitung für die Medizin 2001. Proceedings : Algorithmen, Systeme, Anwendungen. Heidelberg : Springer, 2001, S. 262-266

Bruno Sauvonnet, Segmentierung von Plastikkathetern in 3D Ultraschallbildern. Darmstadt, 2001 Darmstadt, Techn. Univ., Dipl.-Arbeit, 2001

G. Karangelis, S. Zimeras, E. Firle, M.Wang, and G. Sakas, Volume Definition Tools for Medical Imaging Applications. In: Niessen, Wiro J. (ed.).: Medical Image Computing and Computer-Assisted Intervention - MICCAI 2001 Proceedings. : 4th International Conference. Berlin, Heidelberg, New York: Springer Verlag, 2001, pp. 1295-1297 (Lecture Notes in Computer Science 2208)

G. Sakas, G. Karangelis, and A. Pommert, Advanced Applications of Volume Visualization Methods in Medicine. In: Stergiopoulos, Stergios (ed,): Advanced Signal Processing Handbook: Theory and Implementation for Radar, Sonar, and Medical Imaging Real-Time Systems.
Boca Raton
: CRC Press LLC, 2001, pp. 7-1 - 7-71

S. Walter,G. Straßmann, N. Zamboglou, C. Kolotas, and G. Sakas, In ViVo-Brachy: A Navigation System for Interstitial Brachytherapy. In: Lemke, Heinz U. (Ed.): Computer Assisted Radiology and Surgery (CARS) 2000. Proceedings. Amsterdam; Lausanne: Elsevier, 2000, S. 701-706
(International Congress Series 1214)

G. Straßmann, C. Kolotas, R. Heyd, S. Walter, D. Baltas, T. Martin, H. Vogt, G. Ioannidis, G. Sakas,and N. Zamboglou, Navigation System for Interstitial Brachytherapy. In: Radiotherapy and Oncology 56 (2000), 1, 49-57

G. Sakas, S. Walter, M. Grimm, M. Richtscheid, Freihandakquisition, Rekonstruktion und Visualisierung von 3D- und 4D-Ultraschall. In: Der Radiologe 40 (2000), 295-303

G. Sakas, Dreidimensionale Bildrekonstruktion aus Ultraschall-Daten. In: Spektrum der Wissenschaft. Digest: Wissenschaftliches Rechnen.
Heidelberg
: Spektrum der Wissenschaft, 1999, 88-93

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