The Clinical Efficiency and Learning Curve of Ultrasound (us)-Based Planning in High Dose Rate (hdr) Prostate Brachytherapy

To investigate the impacts on procedure time and clinical efficiency of moving from a CT to a US based prostate HDR procedure. The data comes from a high-volume center performing over 200 prostate HDR cases per year. The cases consist of a 15 Gy prostate boost given before or after a 44 Gy pelvis irradiation delivered with VMAT. HDR prostate brachytherapy had been performed since 1999 at our center and was performed using a CT on rails located inside the operating room (OR) for the data presented here. In early 2016, our institution moved to an US-based approach for prostate HDR brachytherapy. This is a significant change susceptible to impact the clinical productivity. Thus, the objective of this work is to quantify how the change in imaging modality affects the catheter implantation, contouring, reconstruction and dosimetric planning times.