Ultrasonic mirror image from ruthenium plaque facilitates calculation of uveal melanoma treatment dose

Charlotte Alfast Espensen*, Peter Koch Jensen, Lotte Stubkjær Fog, Ane Lindegaard Appelt, Kristian Klemp, Hans Callø Fledelius, Lena Specht, Jens Folke Kiilgaard

*Corresponding author af dette arbejde
3 Citationer (Scopus)

Abstract

Background/aims To present a new method to determine dose depth and the distance from the concave side of the plaque to the tumour base in patients with uveal melanoma treated with ruthenium-106 based on ultrasonic mirror image. Methods We used the mirror image associated with ultrasound during plaque brachytherapy to determine intraobserver reproducibility and interobserver agreement between two surgeons. 230 eyes with primary uveal melanoma were included in a retrospective analysis to determine the distance from the plaque to the tumour base using ultrasound. A phantom study was used to illustrate the effects on radiation dose to apex of the tumour when the dose depth was incorrectly determined. Doses to apex of the tumour were determined using Plaque Simulator. Results The intraobserver variation in dose depth measurement with plaque was significantly lower than for measures without plaque (p<0.001). Agreement between the surgeons was better with a plaque in place. Distances from the plaque to the tumour base were distributed with mean=0.99 (median: 1, range: 0.1-2.9 mm). From the phantom study, it was clear that the tumour did not receive the prescribed 100 Gy if the dose depth was incorrectly determined. Conclusions The dose depth in patients with uveal melanoma must be measured accurately for correct calculation of the radiation dose to the apex of the tumour. Repeated in vivo and in vitro ultrasound measurements of dose depth showed higher variance than measurements using the mirror image produced from a ruthenium plaque. Using the mirror image thus help to improve the dose calculation.

OriginalsprogEngelsk
TidsskriftBritish Journal of Ophthalmology
Vol/bind101
Udgave nummer9
Sider (fra-til)1206-1210
Antal sider5
ISSN0007-1161
DOI
StatusUdgivet - sep. 2017

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