ABSTRACT
The role of three-dimensional brachytherapy (3D-BT) in the radical treatment of cervical cancer has been widely recognized. Obtaining the image information through simulated positioning is a key step of 3D-BT.Currently, MRI/CT positioning has been commonly applied in clinical practice, which has respective limitations when applied in radiosurgery. Consequently, it is of necessity to explore an accurate, highly efficient and convenient positioning approach. Besides MRI and CT, ultrasound is a novel positioning method in clinical settings. Through literature review, the application of ultrasound in 3D-BT was summarized, aiming to provide reliable reference for clinicians.
ABSTRACT
En neurocirugía funcional y radioneurocirugía estereotáctica, la fijación de un marco en el cráneo, permite el establecimiento de un sistema tridimensional de coordenadas, para localizar y definir con precisión los objetivos en el cerebro. El montaje se basa en la experiencia y la percepción visual del médico, pero los resultados son subjetivos y la calibración de las coordenadas del marco con respecto al cráneo no siempre es la óptima para el desarrollo del procedimiento quirúrgico. Este estudio evalúa la eficacia y la funcionalidad de un sistema auxiliar diseñado para colocar el marco estereotáctico en el cráneo. La evaluación se realiza por medio de un estudio comparativo de dos grupos de 7 pacientes cada uno sometidos a tratamiento de radioneurocirugía. En el primer grupo no es utilizado el sistema, solo en el segundo, se tomaron 165 imágenes (IRM) en promedio por cada estudio. El empleo del sistema auxiliar disminuye la variación de la inclinación y la rotación del marco con respecto al cráneo hasta un 64%, la apreciación subjetiva del médico es sustituida por una medición objetiva, obteniéndose certidumbre al posicionar el marco sobre el cráneo. Los resultados muestran que el sistema auxiliar diseñado es eficaz y funcional.
In functional neurosurgery and stereotactic radioneurosurgery, the fixation of a frame to the skull allows the establishment of a three-dimensional coordinate system, to locate and precisely defined objectives in the brain. The montage is based on experience and visual perception the doctor, the results obtained and the calibration of the coordinates of the frame with respect to the skull is not always the optimal for developing the surgical procedure. This study evaluates the effectiveness and functionality of an auxiliary system designed to collocate the stereotactic frame to the skull. The evaluation is done by means of a comparative study of two groups of 7 patients each underwent radioneurosurgery treatment. The first group is not using the system, only in the second, were performed on average 165 images (MRI) for each study. The use of auxiliary system reduces the variation of the inclination and rotation of the frame with respect to the skull by 64%, the subjective appreciation the doctor is substituted by an objective measure, thus obtaining certainty to position the frame on the skull. The results show that the auxiliary system designed is effective and functional.