• A first-in-human randomized cl...

*Result*: A first-in-human randomized clinical trial of graphics processing units based multi-criteria optimization (gMCO) versus IPSA in high-dose-rate prostate brachytherapy.

Title:
A first-in-human randomized clinical trial of graphics processing units based multi-criteria optimization (gMCO) versus IPSA in high-dose-rate prostate brachytherapy.
Authors:
Lacroix F; Service de Physique Médicale et Radioprotection, CHU de Québec, Québec, Quebec, Canada. Electronic address: frederic.lacroix@chudequebec.ca., Poulin E; Service de Physique Médicale et Radioprotection, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada; Département de Physique, Génie Physique et D'optique, et Centre de Recherche sur le Cancer, Université Laval, Québec, Quebec, Canada., Bélanger C; Service de Physique Médicale et Radioprotection, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada; Département de Physique, Génie Physique et D'optique, et Centre de Recherche sur le Cancer, Université Laval, Québec, Quebec, Canada., Aubin S; Service de Physique Médicale et Radioprotection, CHU de Québec, Québec, Quebec, Canada., Carignan D; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada., Vigneault E; Service de Radio-Oncologie, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada., Martin AG; Service de Radio-Oncologie, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada., Bachand F; Service de Radio-Oncologie, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada., Beaulieu L; Service de Physique Médicale et Radioprotection, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada; Département de Physique, Génie Physique et D'optique, et Centre de Recherche sur le Cancer, Université Laval, Québec, Quebec, Canada., Foster W; Service de Radio-Oncologie, CHU de Québec, Québec, Quebec, Canada; Axe Oncologie, CRCHU de Québec - Université Laval, CHU de Québec, Québec, Quebec, Canada.
Source:
Brachytherapy [Brachytherapy] 2026 Mar-Apr; Vol. 25 (2), pp. 354-360. Date of Electronic Publication: 2025 Dec 15.
Publication Type:
Journal Article; Randomized Controlled Trial; Comparative Study
Language:
English
Journal Info:
Publisher: Elsevier, 2002- Country of Publication: United States NLM ID: 101137600 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1449 (Electronic) Linking ISSN: 15384721 NLM ISO Abbreviation: Brachytherapy Subsets: MEDLINE
Imprint Name(s):
Original Publication: New York, NY : Elsevier, 2002-
MeSH Terms:
Prostatic Neoplasms*/radiotherapy , Prostatic Neoplasms*/diagnostic imaging , Brachytherapy*/methods , Radiotherapy Planning, Computer-Assisted*/methods , Computer Graphics*, Humans ; Male ; Radiotherapy Dosage ; Algorithms ; Aged
Contributed Indexing:
Keywords: Inverse planning; Multi-criteria optimization (gMCO); Prostate HDR
Entry Date(s):
Date Created: 20251216 Date Completed: 20260223 Latest Revision: 20260223
Update Code:
20260224
DOI:
10.1016/j.brachy.2025.11.009
PMID:
41402166
Database:
MEDLINE

*Further Information*

*Purpose: The purpose of this work, a first-in-human randomized clinical trial, was to compare gMCO, a GPU-based multi criteria optimization (MCO) algorithm, to reference plans in terms of planning time and plan quality for prostate HDR brachytherapy.
Methods and Materials: The brachytherapy procedure was as follows: (1) Patient installation, (2) Catheter implantation under transrectal ultrasound (US) guidance, (3) 3D US scan, (4) Contouring/catheter reconstruction on Oncentra Prostate (Elekta, Veenendaal, Netherlands), (5) Planning, (6) Treatment. Planning (step 5) was performed, after randomization, using either IPSA (Oncentra Prostate, Veenendaal, Netherlands) or gMCO. The planning times on IPSA or gMCO were recorded. Patients previously had a planning MR in order to identify whether a gross tumor volume (GTV, PIRADS 3 and above) was visible and, if present, the GTV was boosted to a minimum of 19 Gy of the prescription dose. Fifty-five patients were accrued and distributed randomly between both treatment arms. Dosimetric indices (Prostate V100, V150, V200, GTV D90, Urethra D10, Rectum and Bladder V75 and D1cc) of gMCO and Inverse-Planning Simulated Annealing algorithm (IPSA) plans were compared to determine if plan quality and planning times were statistically different.
Results: Results show that the optimization time is reduced by half when using gMCO as compared to IPSA, going from 10-5.2 minutes. Although no statistically significant difference is present between gMCO and IPSA plans when comparing pairs of individual dosimetric indices, gMCO plans exhibit a higher pass rate (higher by a factor ranging from 1.3 to 1.6), as compared to IPSA, when considering a basket of dosimetric indices simultaneously.
Conclusion: The use of gMCO halves the planning time for prostate HDR brachytherapy as compared to IPSA, without decreasing plan quality. The overall gain in efficiency related to the planning process has led to the use of gMCO for all of our HDR prostate cases.
(Copyright © 2025 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)*