Thank you for the question.
At the Cancer Diseases Hospital, Zambia (population of about 18million people), we have 1 Linear accelerator, 2 Cobalt-60 machines, 2 brachytherapy afterloader (nucletron), 2 CT scanners and 1 MRI - This is the only cancer referral center in the country.
We perform on average 15 insertions per day at brachytherapy, all our insertions are ultrasound guided (with most patients treated with pre planned “standard” plans and a few cases 3D planned). We have the Ring applicator set, fletcher, modified ring applicator set (the vienna) etc - We have both CT/MR compatible applicators and the ordinary applicators.
The planning system is Oncentra brachy, but unfortunately it does not have the license for image fusion or an applicator library. We have a 3D ultrasound machine.
Background
For brachytherapy, the separation of imaging modalities across different suites prolongs the workflow thereby restricting the number of patients that can realistically be treated to an average of 2-3/day( 3D planning). In high disease burden environments, like Zambia, up 15 patients may be simulated per week and an average of 10 patients/day must undergo brachytherapy procedures to prevent excessively long waiting lists. A possible solution to this problem is the use of ultrasound technology fused with CT for 3D planning. Multiple studies have demonstrated the feasibility of using ultrasound 3D brachytherapy planning in the treatment of cervical cancer.
We are trying to image the cervix fuse it with CT images, contour and export to the treatment planning system for planning.
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Our first huddle is to properly fuse the Ultrasound images with CT and later contour the region of interest. I am not sure our TPS will display fused images. will confirm.
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Dicom send/export on the ultrasound machine is only enabled during real time scanning, whether I can retrieve 3D volume, I doubt but I can check.
Is this something 3Dslicer can help me achieve?