AccScience Publishing / ARNM / Volume 2 / Issue 3 / DOI: 10.36922/arnm.3781
PERSPECTIVE ARTICLE

Interventional radiotherapy: CT-sim guided modern minimally invasive technique

Qiman Han1† Yi Chen1† Bin Qiu1 Zhe Ji1 Ping Jiang1* Junjie Wang1*
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1 Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
Submitted: 28 May 2024 | Accepted: 15 August 2024 | Published: 11 September 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The concept of interventional radiology was introduced in 1976 as a new diagnostic and therapeutic method, relying on image guidance, such as X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging. Its indications mainly include obstructive diseases, and to a lesser extent, malignant tumors. Radiotherapy (RT) plays a pivotal role in the comprehensive treatment of cancer. The advent of the CT simulator has significantly enhanced the precision of RT and improvement outcomes and accelerated the development of a series of diagnostic and RT modalities, including puncture biopsy, fiducial marker implantation, high-dose rate after-loading after-loading brachytherapy, and radioactive seed implantation. The innovative concept of image-guidance interventional RT, inspired by interventional radiology, extends the benefits to not only cancer diagnosis but also RT. The image-guidance interventional RT advances the field of RT by expanding its indications and connotation.

Keywords
Intervention
Radiology
Radiotherapy
Carcinoma
Brachytherapy
Funding
None.
Conflict of interest
Junjie Wang and Ping Jiang are the Editor-in-Chief and the Editorial Board Member of the journal, respectively, but were not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
References
  1. Hwang EJ, Park CM, Yoon SH, Lim HJ, Goo JM. Risk factors for haemoptysis after percutaneous transthoracic needle biopsies in 4,172 cases: Focusing on the effects of enlarged main pulmonary artery diameter. Eur Radiol. 2018;28:1410-1419. doi: 10.1007/s00330-017-5101-8

 

  1. Kawashima H, Ohno E, Ishikawa T, et al. Endoscopic management of perihilar cholangiocarcinoma. Dig Endosc. 2022;34:1147-1156. doi: 10.1111/den.14317

 

  1. Elmunzer BJ, Maranki JL, Gómez V, et al. ACG clinical guideline: Diagnosis and management of biliary strictures. Am J Gastroenterol. 2023;118:405-426. doi: 10.14309/ajg.0000000000002190

 

  1. Chung C, Kim Y, Park D. Transthoracic needle biopsy: How to maximize diagnostic accuracy and minimize complications. Tuberc Respir Dis (Seoul). 2020;83:S17-S24. doi: 10.4046/trd.2020.0156

 

  1. De Filippo M, Saba L, Silva M, et al. CT-guided biopsy of pulmonary nodules: Is pulmonary hemorrhage a complication or an advantage? Diagn Interv Radiol. 2014;20:421-425. doi: 10.5152/dir.2014.14019

 

  1. Ji Z, Jiang Y, Guo F, et al. Dosimetry verification of radioactive seed implantation for malignant tumors assisted by 3D printing individual templates and CT guidance. Appl Radiat Isot. 2017;124:68-74. doi: 10.1016/j.apradiso.2016.12.009

 

  1. Wang H, Ren T, Chen P, et al. Application of 3-dimensionally printed coplanar template improves diagnostic yield of CT-guided percutaneous core needle biopsy for pulmonary nodules. Technol Cancer Res Treat. 2022;21. doi: 10.1177/15330338221089940

 

  1. Haoran E, Chen J, Sun W, et al. Three-dimensionally printed navigational template: A promising guiding approach for lung biopsy. Transl Lung Cancer Res. 2022;11:393-403. doi: 10.21037/tlcr-22-172

 

  1. Desai R, Rich KM. Therapeutic role of gamma knife stereotactic radiosurgery in neuro-oncology. Mo Med. 2020;117:33-38.

 

  1. Spina A, Garbin E, Albano L, Bisoglio A, Boari N, Mortini P. Gamma Knife radiosurgery for central neurocytoma: A quantitative systematic review and metanalysis. Neurosurg Rev. 2024;47:64. doi: 10.1007/s10143-024-02301-7

 

  1. Nemoto H, Saito M, Suzuki T, et al. Evaluation of computed tomography metal artifact and CyberKnife fiducial recognition for novel size fiducial markers. J Appl Clin Med Phys. 2023;24:e14142. doi: 10.1002/acm2.14142

 

  1. Suzuki T, Saito M, Onishi H, et al. Comparison of CT artifacts and image recognition of various fiducial markers including two types of thinner fiducial markers for CyberKnife treatment. Rep Pract Oncol Radiother. 2020;25:117-124. doi: 10.1016/j.rpor.2019.12.005

 

  1. Marsico M, Gabbani T, Lunardi S, Galli A, Biagini MR, Annese V. Percutaneous ultrasound-guided fiducial marker placement for liver cancer robotic stereotactic radio-surgery treatment: A comparative analysis of three types of markers and needles. Arab J Gastroenterol. 2017;18:83-86. doi: 10.1016/j.ajg.2017.05.007

 

  1. Scher N, Bollet M, Bouilhol G, et al. Safety and efficacy of fiducial marker implantation for robotic stereotactic body radiation therapy with fiducial tracking. Radiat Oncol. 2019;14:167. doi: 10.1186/s13014-019-1373-2

 

  1. Akasaka H, Mizonobe K, Oki Y, et al. Fiducial marker position affects target volume in stereotactic lung irradiation. J Appl Clin Med Phys. 2022;23:e13596. doi: 10.1002/acm2.13596

 

  1. Kim JH, Hong SS, Kim JH, et al. Safety and efficacy of ultrasound-guided fiducial marker implantation for CyberKnife radiation therapy. Korean J Radiol. 2012;13:307-313. doi: 10.3348/kjr.2012.13.3.307

 

  1. Ali ZS, Solomon E, Mann P, Wong S, Chan KKW, Taggar AS. High dose rate brachytherapy in the management of anal cancer: A review. Radiother Oncol. 2022;171:43-52. doi: 10.1016/j.radonc.2022.03.019

 

  1. Strouthos I, Karagiannis E, Zamboglou N, Ferentinos K. High-dose-rate brachytherapy for prostate cancer: Rationale, current applications, and clinical outcome. Cancer Rep (Hoboken). 2022;5:e1450. doi: 10.1002/cnr2.1450

 

  1. Miglierini P, Malhaire JP, Goasduff G, Miranda O, Pradier O. Cervix cancer brachytherapy: High dose rate. Cancer Radiother. 2014;18:452-457. doi: 10.1016/j.canrad.2014.06.008

 

  1. Viswanathan AN, Beriwal S, De Los Santos JF, et al. American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part II: High-dose-rate brachytherapy. Brachytherapy. 2012;11:47-52. doi: 10.1016/j.brachy.2011.07.002

 

  1. Renard S, Salleron J, Py JF, et al. High-dose-rate brachytherapy for facial skin cancer: Outcome and toxicity assessment for 71 cases. Brachytherapy. 2021;20:624-630. doi: 10.1016/j.brachy.2021.01.009

 

  1. Itami J, Murakami N, Watanabe M, et al. Combined interstitial and intracavitary high-dose rate brachytherapy of cervical cancer. Front Oncol. 2021;11:809825. doi: 10.3389/fonc.2021.809825

 

  1. Zeng H, Dai J, Cao D, et al. Safety and efficacy associated with single-fraction high-dose-rate brachytherapy in localized prostate cancer: A systematic review and meta-analysis. Strahlenther Onkol. 2023;199:525-535.

 

  1. Krzysztofiak T, Suchorzepka M, Tukiendorf A, Wojcieszek P, Kamińska-Winciorek G. Basal cell carcinoma after high dose rate brachytherapy: Medium-term dermoscopic evaluation of cancer’s response. Dermatol Ther (Heidelb). 2023;13:2063-2078. doi: 10.1007/s13555-023-00981-5

 

  1. Yamazaki H, Masui K, Suzuki G, et al. Reirradiation for recurrent head and neck carcinoma using high-dose-rate brachytherapy: A multi-institutional study. Brachytherapy. 2022;21:341-346. doi: 10.1016/j.brachy.2021.12.011

 

  1. Dankulchai P, Petsuksiri J, Chansilpa Y, Hoskin PJ. Image-guided high-dose-rate brachytherapy in inoperable endometrial cancer. Br J Radiol. 2014;87:20140018. doi: 10.1259/bjr.20140018

 

  1. Henry A, Pieters BR, André Siebert F, Hoskin P. GEC-ESTRO ACROP prostate brachytherapy guidelines. Radiother Oncol. 2022;167:244-251. doi: 10.1016/j.radonc.2021.12.047

 

  1. Sanmamed N, Lee J, Berlin A, et al. Tumor-targeted dose escalation for localized prostate cancer using MR-guided HDR brachytherapy (HDR) or integrated VMAT (IB-VMAT) boost: Dosimetry, toxicity and health related quality of life. Radiother Oncol. 2020;149:240-245. doi: 10.1016/j.radonc.2020.05.029

 

  1. Corkum M, Loblaw A, Hasan Y, et al. Prostate high dose-rate brachytherapy as monotherapy for prostate cancer: Late toxicity and patient reported outcomes from a randomized phase II clinical trial. Radiother Oncol. 2021;156:160-165. doi: 10.1016/j.radonc.2020.12.021

 

  1. Alayed Y, Loblaw A, McGuffin M, et al. Single-fraction HDR brachytherapy as monotherapy in low and intermediate risk prostate cancer: Outcomes from two clinical trials with and without an MRI-guided boost. Radiother Oncol. 2021;154:29-35. doi: 10.1016/j.radonc.2020.09.007

 

  1. Chin J, Rumble RB, Kollmeier M, et al. Brachytherapy for patients with prostate cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update. J Clin Oncol. 2017;35:1737-1743. doi: 10.1200/jco.2016.72.0466

 

  1. Mohler JL, Antonarakis ES. NCCN guidelines updates: Management of prostate cancer. J Natl Compr Canc Netw. 2019;17:583-586. doi: 10.6004/jnccn.2019.5011

 

  1. Wang J, Chai S, Wang R, et al. Expert consensus on computed tomography-assisted three-dimensional-printed coplanar template guidance for interstitial permanent radioactive 125I seed implantation therapy. J Cancer Res Ther. 2019;15:1430-1434. doi: 10.4103/jcrt.JCRT_434_19

 

  1. Luo YJ, Liu ZL, Ye PC, et al. Safety and efficacy of intraoperative iodine-125 seed implantation brachytherapy for rectal cancer patients: A retrospective clinical research. J Gastroenterol Hepatol. 2016;31:1076-1084. doi: 10.1111/jgh.13261

 

  1. Wang J, Yuan H, Ma Q, et al. Interstitial 125I seeds implantation to treat spinal metastatic and primary paraspinal malignancies. Med Oncol. 2010;27:319-326. doi: 10.1007/s12032-009-9212-1

 

  1. Jiang YL, Ji Z, Tian SQ, et al. CT-guidance interstitial Iodine-125 seed brachytherapy as a salvage therapy for recurrent head and neck carcinoma. Zhonghua yi xue za zhi. 2018;98:3686-3691. doi: 10.3760/cma.j.issn.0376-2491.2018.45.011

 

  1. Wang H, Wang J, Jiang Y, et al. The investigation of 125I seed implantation as a salvage modality for unresectable pancreatic carcinoma. J Exp Clin Cancer Res. 2013;32:106. doi: 10.1186/1756-9966-32-106

 

  1. Wang JJ, Yuan HS, Li JN, Jiang YL, Tian SQ, Yang RJ. CT-guided radioactive seed implantation for recurrent rectal carcinoma after multiple therapy. Med Oncol. 2010;27:421-429. doi: 10.1007/s12032-009-9227-7

 

  1. Huang M, Lin Q, Wang H, et al. Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT: A retrospective matched cohort study. Eur Radiol. 2016;26:3428-3436. doi: 10.1007/s00330-015-4198-x

 

  1. Yang M, Fang Z, Yan Z, et al. Transarterial chemoembolisation (TACE) combined with endovascular implantation of an iodine-125 seed strand for the treatment of hepatocellular carcinoma with portal vein tumour thrombosis versus TACE alone: A two-arm, randomised clinical trial. J Cancer Res Clin Oncol. 2014;140:211-219. doi: 10.1007/s00432-013-1568-0

 

  1. Sun H, Zhang M, Liu R, Liu Y, Hou Y, Wu C. Endovascular implantation of 125I seed combined with transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma. Future Oncol. 2018;14:1165-1176. doi: 10.2217/fon-2017-0354

 

  1. Mo Z, Zhang T, Zhang Y, et al. Feasibility and clinical value of CT-guided 125I brachytherapy for metastatic soft tissue sarcoma after first-line chemotherapy failure. Eur Radiol. 2018;28:1194-1203. doi: 10.1007/s00330-017-5036-0

 

  1. Qu A, Jiang P, Sun H, et al. Efficacy and dosimetry analysis of image-guided radioactive ¹²⁵I seed implantation as salvage treatment for pelvic recurrent cervical cancer after external beam radiotherapy. J Gynecol Oncol. 2019;30:e9. doi: 10.3802/jgo.2019.30.e9

 

  1. Tong L, Liu P, Huo B, Guo Z, Ni H. CT-guided 125I interstitial brachytherapy for pelvic recurrent cervical carcinoma after radiotherapy. Onco Targets Ther. 2017;10:4081-4088. doi: 10.2147/ott.S139571

 

  1. Chen Y, Jiang Y, Ji Z, et al. Dosimetry, efficacy, and safety of three-dimensional printing noncoplanar template-assisted and CT-guided 125I seed implantation for recurrent retroperitoneal lymphatic metastasis after external beam radiotherapy. Brachytherapy. 2020;19:380-388. doi: 10.1016/j.brachy.2020.02.009

 

  1. Davis BJ, Horwitz EM, Lee WR, et al. American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy. Brachytherapy. 2012;11:6-19. doi: 10.1016/j.brachy.2011.07.005

 

  1. Yamada Y, Rogers L, Demanes DJ, et al. American Brachytherapy Society consensus guidelines for high-dose-rate prostate brachytherapy. Brachytherapy. 2012;11:20-32. doi: 10.1016/j.brachy.2011.09.008

 

  1. Li Q, Tian Y, Yang D, Liang Y, Cheng X, Gai B. Permanent Iodine-125 seed implantation for the treatment of nonresectable retroperitoneal malignant tumors. Technol Cancer Res Treat. 2019;18. doi: 10.1177/1533033819825845

 

  1. Liu Y, Shen Z, Qu A, Jiang P, Jiang Y, Wang J. A comparative study of dosimetric parameters of 3D-printed non-coplanar template-assisted CT-guided iodine-125 seed implantation brachytherapy in patients with inguinal lymph node metastatic carcinomas. J Contemp Brachytherapy. 2022;14:452-461. doi: 10.5114/jcb.2022.121564

 

  1. Yao L, Cao Q, Wang J, et al. CT-guided 125I seed interstitial brachytherapy as a salvage treatment for recurrent spinal metastases after external beam radiotherapy. Biomed Res Int. 2016;2016:8265907. doi: 10.1155/2016/8265907

 

  1. Jiang W, Jiang P, Wei S, et al. The accuracy and safety of CT-guided iodine-125 seed implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma. World J Surg Oncol. 2020;18:307. doi: 10.1186/s12957-020-02087-0

 

  1. Yan H, Mo Z, Xiang Z, et al. CT-guided 125I brachytherapy for locally recurrent nasopharyngeal carcinoma. J Cancer. 2017;8:2104-2113. doi: 10.7150/jca.19078

 

  1. Ji Z, Jiang Y, Sun H, et al. 3D-printed template and optical needle navigation in CT-guided Iodine-125 permanent seed implantation. J Contemp Brachytherapy. 2021;13:410-418. doi: 10.5114/jcb.2021.108595

 

  1. Ji Z, Sun H, Jiang Y, et al. Comparative study for CT-guided 125I seed implantation assisted by 3D printing coplanar and non-coplanar template in peripheral lung cancer. J Contemp Brachytherapy. 2019;11:169-173. doi: 10.5114/jcb.2019.84503

 

  1. Ji Z, Jiang Y, Guo F, et al. Safety and efficacy of CT-guided radioactive iodine-125 seed implantation assisted by a 3D printing template for the treatment of thoracic malignancies. J Cancer Res Clin Oncol. 2020;146:229-236. doi: 10.1007/s00432-019-03050-7

 

  1. Zhang F, Wang J, Guo J, et al. Chinese expert consensus workshop report: Guideline for permanent iodine-125 seed implantation of primary and metastatic lung tumors. Thorac Cancer. 2019;10:388-394. doi: 10.1111/1759-7714.12912

 

  1. Gai B, Zhang F. Chinese expert consensus on radioactive 125I seeds interstitial implantation brachytherapy for pancreatic cancer. J Cancer Res Ther. 2018;14:1455-1462. doi: 10.4103/jcrt.JCRT_96_18

 

  1. Li W, Guan J, Yang L, Zheng X, Yu Y, Jiang J. Iodine-125 brachytherapy improved overall survival of patients with inoperable stage III/IV non-small cell lung cancer versus the conventional radiotherapy. Med Oncol. 2015;32:395. doi: 10.1007/s12032-014-0395-8

 

  1. Zhang S, Zheng Y, Yu P, et al. The combined treatment of CT-guided percutaneous 125I seed implantation and chemotherapy for non-small-cell lung cancer. J Cancer Res Clin Oncol. 2011;137:1813-1822. doi: 10.1007/s00432-011-1048-3

 

  1. Chen Y, Jiang Y, Ji Z, et al. Efficacy and safety of CT-guided 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma after surgery and external beam radiotherapy: A 12-year study at a single institution. Brachytherapy. 2020;19:81-89. doi: 10.1016/j.brachy.2019.09.006
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing