Manual on Image-Guided Brachytherapy of Inner Organs: Technique, Indications and Evidence

Preface
Contents
About the Editors
1: Introduction: Why and When Radiotherapy with iBT? When SBRT?
	References
2: Historical Development and Current Indications of Image-Guided Brachytherapy
	Historical Background
	Imaging Techniques
	Image-Guided Brachytherapy Treatment Using Modern Imaging Techniques
	Example of Image-Guided Brachytherapy in Liver Tumors
	Other Examples of Image-Guided Brachytherapy
	References
3: Radiotherapeutic Fundamentals of Image-Guided HDR Brachytherapy
	Introduction
	Radiation Effects on Tumor Lesions
	Radiation Effects of on Normal Tissues
	Radiotherapy Techniques for Radio-Ablation with Single Doses
	Comparison of Image-Guided HDR Brachytherapy with Fractionated Radiotherapy
	References
4: A Physicist’s View
	Introduction
	Preplanning
	Reconstruction of Catheters
	Dose Optimization
	Plan Approval and Verification
	Treatment Delivery
	Emergency Procedures
	Future Perspectives
	References
5: Image-Guided Brachytherapy: Interventional Setting, Technique, and Peri-interventional Patient Management
	General Considerations
	Interventional Setting
	Materials
	Implantation Method: Positioning of the Patient
	Implantation Method: CT
	Implantation Method: MRI
	Radiation Treatment Planning: Imaging
	Conclusion of Treatment: Withdrawal of the Brachytherapy Catheter and the Sheath
	Intervention-Related Complications and Their Treatment
	Clinical Environment Required for Interstitial Brachytherapy
	References
6: Image-Guided Brachytherapy: Follow-Up. Imaging and Clinical Management
	Clinical Management
		Patient Management in the Outpatient Clinic for Microtherapy and Interventional Radiology
		Admission to the Ward and Peri-interventional Standard Procedure
		Anesthesia and Peri-interventional Patient-Monitoring
		Standard Operative Procedures and Follow-Up
	Follow-Up and Imaging
		General Aspects of Treatment Response of Locoregional Therapies
		Special Aspects of Response Assessment in iBT
	References
7: Image-Guided Brachytherapy in Oligometastasis: Criteria for Patient Selection from an Oncological Perspective
	Introduction
	Concept of Oligometastasis
	Definition of Oligometastatic Disease
	Possible Effects of Radical Treatment in Oligometastatic Disease
	Imaging Before Local Treatment in Oligometastatic Disease
	Evidence for Metastasis-Directed Therapy in Oligometastatic Tumors
	The Integrated View
	References
8: Brachytherapy of Primary Liver Lesions
	Interstitial Brachytherapy and Transarterial Chemoembolization in Patients with Hepatocellular Carcinomas: Comparison in a Randomized Study
	Interstitial Brachytherapy as a Bridging Therapy Before Liver Transplantation
	Prognostic Factors
	Safety
	References
9: Ablation of Liver Metastases by Brachytherapy
	Local Radioablation by Catheter-Based Radiotherapy (Brachytherapy)
	Local Tumor Control
		Colorectal Cancer Liver Metastases
		Breast Cancer Liver Metastases
		Neuroendocrine Tumors Liver Metastases
		Renal Cancer Liver Metastases
	Liver Metastases of Other Cancer Entities
	Overall Survival/Survival Rate
		Colorectal Cancer Liver Metastases
		Breast Cancer Liver Metastases
		Neuroendocrine Tumors Liver Metastases
		Renal Cancer Liver Metastases
	Liver Metastases of Other Cancer Entities
	Special Considerations
		Damage to Adjacent Organs
		Abscess
		Bile Duct Damage
	References
10: Liver Brachytherapy: Experience from Asia
	Magnitude of the Problem: Epidemiology of Liver Malignancies
	Local Ablative Therapy (LAT) of Primary Liver Malignancies in Asia
	Local Ablative Therapy (LAT) in Liver Metastases
	Status of Liver Brachytherapy in Asia
	Clinical Experience with Liver iBT in Asia
	Future of Liver Brachytherapy
	References
11: Tolerability of Interstitial Brachytherapy of the Liver: RILD, Imaging, and Laboratory Monitoring
	References
12: Lung Brachytherapy: Experience from Germany
	Introduction
	General Indications and Contraindications
	Assessment and Preparation
	Interventional Technique
		Interventional Team
		Patient Positioning
		Anesthesiological Management
		Additional Medications
		Catheter Positioning
		Irradiation Treatment Planning
		Irradiation
		Material Retraction
		Post-procedural and Inpatient Management
		Dose Prescription and Reporting
	Follow-Up Care of Patients, Quality Control
	Oncological Outcomes
	Safety, Complications, and Management
	Topical Challenges and Future Opportunities
	References
13: CT-Guided Interstitial HDR Brachytherapy for Malignant Lung Lesions: Experience from University of California Los Angeles
	Introduction
		Lung Brachytherapy
		Interventional Percutaneous Ablative Therapies
		Stereotactic Body Radiotherapy
	Procedure
		Interstitial Catheter Implantation
		Brachytherapy Planning and Treatment Delivery
	Clinical Cases
		Case 1
		Case 2
		Case 3
	Clinical Outcomes
	Future Directions
	Conclusion
	References
14: Brachytherapy of Renal and Adrenal Tumors
	Patient Management
		Renal Tumors
			Imaging
			Renal Function Tests
			Pretreatment Biopsy
			Patient Preparation
			Follow-Up and Treatment Response
		Adrenal Tumors
			Imaging
			Pretreatment Biopsy
			Patient Preparation
			Hormone Substitution
			Follow-Up
	Interventional Technique
		Access Routes
		Helpful Techniques
		Catheter Removal
	Dose Considerations
		Renal Cell Carcinoma
		Adrenal and Renal Metastases
		Dose Constraints
	Efficacy and Safety
		Local Tumor Control and Survival
		Peri-interventional Complications
		Side Effects of Radiation
	References
15: Image-Guided HDR Brachytherapy of Abdominal Lymph Nodes, Pancreatic, and Peritoneal Neoplasms
	Introduction
	Method
		Technical Aspects for Single-Dose iBT
	Results
	Discussion
	Conclusion
	References
16: Interventional Image-Guided HDR Brachytherapy as a Salvage Treatment: Exclusive or in Combination with Other Local Therapies
	Introduction
	Liver
		Interventional Radiotherapy (Brachytherapy)
		Local Therapies (Interventional Radiology, IR)
		Combination Treatment
	Lung
		Interventional Radiotherapy (Brachytherapy)
		Locoregional Therapies (Interventional Radiology)
		Combination Treatment
	Head and Neck
		Interventional Radiotherapy (Brachytherapy)
		Local Therapies (Interventional Radiology)
		Combination Treatment
	References
17: Adverse Events in iBT and Their Clinical Management
	Procedural and Radiotherapy Complications
	Interstitial Brachytherapy in the Context of Biliodigestive Anastomosis
	Peri-interventional Prophylaxis of Thrombosis with Low-Molecular-Weight Heparins: Risk of Bleeding and Thrombosis
	The Risk of Needle-Tract Metastases
	Organs at Risk: Bile Ducts, Stomach, Duodenum, Kidney, Pancreas
	The Lung as a Treatment Target and OAR
	Kidney, Pancreas, and Adrenal Glands as Treatment Targets and/or OARs
	References
18: Radiological Interventions in the Age of Immunotherapy, Molecular Diagnostics, and Liquid Biopsy
	References
Summary
	References
Index