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Dekura Y, Nishioka K, Hashimoto T, Miyamoto N, Suzuki R, Yoshimura T, Matsumoto R, Osawa T, Abe T, Ito YM, Shinohara N, Shirato H, Shimizu S. The urethral position may shift due to urethral catheter placement in the treatment planning for prostate radiation therapy. Radiat Oncol 2019; 14:226. [PMID: 31831045 PMCID: PMC6909476 DOI: 10.1186/s13014-019-1424-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/20/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To determine the best method to contour the planning organ at risk volume (PRV) for the urethra, this study aimed to investigate the displacement of a Foley catheter in the urethra with a soft and thin guide-wire. METHODS For each patient, the study used two sets of computed tomography (CT) images for radiation treatment planning (RT-CT): (1) set with a Foley urethral catheter (4.0 mm diameter) plus a guide-wire (0.46 mm diameter) in the first RT-CT and (2) set with a guide-wire alone in the second CT recorded 2 min after the first RT-CT. Using three fiducial markers in the prostate for image fusion, the displacement between the catheter and the guide-wire in the prostatic urethra was calculated. In 155 consecutive patients treated between 2011 and 2017, 5531 slices of RT-CT were evaluated. RESULTS Assuming that ≥3.0 mm of difference between the catheter and the guide-wire position was a significant displacement, the urethra with the catheter was displaced significantly from the urethra with the guide-wire alone in > 20% of the RT-CT slices in 23.2% (36/155) of the patients. The number of patients who showed ≥3.0 mm anterior displacement with the catheter in ≥20% RT-CT slices was significantly larger at the superior segment (38/155) than at the middle (14/155) and inferior segments (18/155) of the prostatic urethra (p < 0.0167). CONCLUSIONS The urethral position with a Foley catheter is different from the urethral position with a thin and soft guide-wire in a significant proportion of the patients. This should be taken into account for the PRV of the urethra to ensure precise radiotherapy such as in urethra-sparing radiotherapy.
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Affiliation(s)
- Yasuhiro Dekura
- Department of Radiation Oncology, Graduate School of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Kentaro Nishioka
- Department of Radiation Medical Science and Engineering, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Takayuki Hashimoto
- Department of Radiation Medicine, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.,Global Station for Biomedical Science and Engineering, Global Institute for Cooperative Research and Education, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Naoki Miyamoto
- Global Station for Biomedical Science and Engineering, Global Institute for Cooperative Research and Education, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.,Department of Medical Physics, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Ryusuke Suzuki
- Department of Medical Physics, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Takaaki Yoshimura
- Department of Health Sciences and Technology, Faculty of Health Sciences, Hokkaido University, North-12, West-5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Ryuji Matsumoto
- Department of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Takahiro Osawa
- Department of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Takashige Abe
- Department of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yoichi M Ito
- Department of Statistical Data Science, The Institute of Statistical Mathematics, 10-3, Midori-cho, Tachikawa, Tokyo, 190-0014, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hiroki Shirato
- Department of Radiation Medicine, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.,Global Station for Biomedical Science and Engineering, Global Institute for Cooperative Research and Education, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Shinichi Shimizu
- Department of Radiation Medical Science and Engineering, Faculty of Medicine, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.,Global Station for Biomedical Science and Engineering, Global Institute for Cooperative Research and Education, Hokkaido University, North-15, West-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
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