Impact of catheter positioning on planned target volume (PTV) coverage and organs at risk (OARs) in high-dose-rate (HDR) endotracheal brachytherapy: a comparative 2D vs 3D study.
5 affiliations
- 1Department of Radiation Oncology, Hospital Central de la Defensa Gómez Ulla, CSVE.
- 2Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Network Biomedical Research Center for Liver and Digestive Diseases (CIBEREHD), University of Alcalá, 28801 Alcala de Henares, Spain.
- 3Department of Radiation Protection and Medical Physics, Hospital Central de la Defensa Gómez Ulla, CSVE.
- 4Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain.
- 5Department of Pathology, Hospital Central de la Defensa Gómez Ulla, CSVE.
Abstract
Background and purpose
High-dose-rate endobronchial brachytherapy (HDR-BTE) is an effective technique for the treatment of malignant tracheobronchial tumors. Although two-dimensional (2D) planning provides limited dosimetric information and does not accurately assess the relationship between the catheter and the tumor or the dose delivered to organs at risk (OARs), it continues to be used because it ensures adequate PTV coverage, is associated with low toxicity, and minimizes the risk of catheter displacement by avoiding patient transfer to the CT simulation room.Patient and methods
An 83-year-old patient with 2D HDR-BTE for tracheal recurrence of previously resected lung adenocarcinoma was analyzed and compared with four simulated 3D plans based on catheter position relative to the tumor volume, while keeping the active length and prescribed dose constant.Results
The favorable oblique scenario achieved the best PTV coverage (D90: 9.05 Gy; V100: 100%), although with highest V150 (96.47%) and homogeneity index (IH: 5.14). The unfavorable oblique and posterior positions significantly reduced coverage (V100: 51.4% and 61.29%, respectively). The esophagus was the most sensitive organ, showing the highest doses in the posterior orientation of the catheter. The contralateral lung and heart received low doses; while the aorta showed higher doses in the favorable oblique scenario due to the location of the PTV.Conclusions
Catheter orientation in HDR-BTE has a significant impact on PTV coverage and the dose delivered to critical organs. Despite the trend toward 3D planning, there is no direct clinical evidence comparing the two techniques.
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BibTeX
@article{castellon2026impact,
title = {{Impact of catheter positioning on planned target volume (PTV) coverage and organs at risk (OARs) in high-dose-rate (HDR) endotracheal brachytherapy: a comparative 2D vs 3D study.}},
author = {J Navarro Castellón and I Flores Cacho and Mc López Carrizosa and C Ibáñez Villoslada and M Domínguez Morcillo and E Carrasco Esteban and P Sáez Bueno and Z Zalabarría Zarrabeitia and A Pontes Sanz and N Curiel Pérez and Fj San Miguel Avedillo and M Cámara Gallego and M A Ortega and Ma Sáez García},
journal = {International journal of medical sciences},
year = {2026},
month = sep,
doi = {10.7150/ijms.136860},
url = {https://europepmc.org/article/MED/42909360},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of catheter positioning on planned target volume (PTV) coverage and organs at risk (OARs) in high-dose-rate (HDR) endotracheal brachytherapy: a comparative 2D vs 3D study.
AU - J Navarro Castellón
AU - I Flores Cacho
AU - Mc López Carrizosa
AU - C Ibáñez Villoslada
AU - M Domínguez Morcillo
AU - E Carrasco Esteban
AU - P Sáez Bueno
AU - Z Zalabarría Zarrabeitia
AU - A Pontes Sanz
AU - N Curiel Pérez
AU - Fj San Miguel Avedillo
AU - M Cámara Gallego
AU - M A Ortega
AU - Ma Sáez García
PY - 2026
DA - 2026/09/24
JO - International journal of medical sciences
DO - 10.7150/ijms.136860
UR - https://europepmc.org/article/MED/42909360
AB - Background and purpose High-dose-rate endobronchial brachytherapy (HDR-BTE) is an effective technique for the treatment of malignant tracheobronchial tumors. Although two-dimensional (2D) planning provides limited dosimetric information and does not accurately assess the relationship between the catheter and the tumor or the dose delivered to organs at risk (OARs), it continues to be used because it ensures adequate PTV coverage, is associated with low toxicity, and minimizes the risk of catheter displacement by avoiding patient transfer to the CT simulation room.Patient and methods An 83-year-old patient with 2D HDR-BTE for tracheal recurrence of previously resected lung adenocarcinoma was analyzed and compared with four simulated 3D plans based on catheter position relative to the tumor volume, while keeping the active length and prescribed dose constant.Results The favorable oblique scenario achieved the best PTV coverage (D90: 9.05 Gy; V100: 100%), although with highest V150 (96.47%) and homogeneity index (IH: 5.14). The unfavorable oblique and posterior positions significantly reduced coverage (V100: 51.4% and 61.29%, respectively). The esophagus was the most sensitive organ, showing the highest doses in the posterior orientation of the catheter. The contralateral lung and heart received low doses; while the aorta showed higher doses in the favorable oblique scenario due to the location of the PTV.Conclusions Catheter orientation in HDR-BTE has a significant impact on PTV coverage and the dose delivered to critical organs. Despite the trend toward 3D planning, there is no direct clinical evidence comparing the two techniques.
SN - 1449-1907
ER -