Genaue modellbasierte Identifikation von gyn\"akologischen Katheterpfaden f\"ur die MRT-bildgest\"utzte Brachytherapie

Abstract

German text, english abstract: Mortality in gynecologic cancers, including cervical, ovarian, vaginal and vulvar cancers, is more than 6% internationally [1]. In many countries external radiotherapy is supplemented by brachytherapy with high locally administered doses as standard. The superior ability of magnetic resonance imaging (MRI) to differentiate soft tissue has led to an increasing use of this imaging technique in the intraoperative planning and implementation of brachytherapy. A technical challenge associated with the use of MRI imaging for brachytherapy - in contrast to computed tomography (CT) imaging - is the dark-diffuse appearance and thus difficult identification of the catheter paths in the resulting images. This problem is addressed by the precise method described herein of tracing the catheters from the catheter tip. The average identification time for a single catheter path was three seconds on a standard PC. Segmentation time, accuracy and precision are promising indicators of the value of this method for the clinical application of image-guided gynecological brachytherapy. After surgery (OP), the healthy surrounding tissue of the tumor is usually irradiated. This reduces the risk of leaving behind residual cells that would likely cause a recurrence of the cancer or the formation of metastases - secondary tumors elsewhere in the body. In the case of a tumor on the cervix or prostate, the operation is minimally invasive, ie. the removal of the cancer and the irradiation are performed cost-effectively and risk-avoiding by keyhole surgery instead of open surgery.