SU-F-BRA-02: Electromagnetic Tracking in Brachytherapy as An Advanced Modality for Treatment Quality Assurance

Abstract

Purpose: To present the use of Electromagnetic Tracking (EMT) for quality assurance in brachytherapy by means of phantom studies and to assess the clinical applicability of EMT during HDR breast brachytherapy. Methods: An EMT system was investigated to examine its suitability for clinical applications in brachytherapy. A field generator served as electromagnetic field emitter. Sensors (magnetic sensitive only), connected to a control unit, were used and their respective position and orientation inside a pre-defined measurement volume (500 mm cube length) determined. Up to three 6DoF sensors were placed on the phantom’s surface to obtain additional reference coordinates used to derive relative measured positions of a smaller 5DoF sensor inserted in the 6F catheters of the implant. The catheters were successively measured by manual displacement of the sensor at ∼40 mm/s. The measured catheter tracks, acquired multiple times at various locations (CT and treatment room), were smoothed, divided into intervals (2.5 mm dwell step size), registered (rigid Iterative Closest Point transformation) and compared against the known phantom geometry. Results: The reference coordinates were used to exclude the influence of external (e.g., respiratory-induced) motion. Precision tests in a clinical setting showed variances below 1 mm (translational) and 1° (rotational), respectively. Our method for catheter reconstruction preserved the length of the tracked catheter (within 1 mm). The measured tracking accuracy was 1±0.3 mm (maximum: 2 mm). The results are less accurate in environments potentially interfering with the magnetic field, e.g., in the vicinity of ferromagnetic table components. Conclusion: Our EMT system is able to perform reproducible and accurate catheter tracking and reconstruction. Currently, measurements of the implant geometry in HDR breast treatments are initiated. Online implant monitoring by means of EM tracking may be a first step towards advanced brachytherapy treatment QA. The study was financially supported by ELEKTA | Nucletron. There are no further disclosures and conflicts.