{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:20:33Z","timestamp":1787156433361,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010dose\u2010rate (HDR) brachytherapy (BT) has been acknowledged as a widely utilized treatment for patients with intermediate\u2010 and high\u2010risk prostate cancer, despite its side effects such as edema, incontinence, and impotence. Nevertheless, the treatment is consistently limited by the potential danger of excessive irradiation to organs\u2010at\u2010risk (OARs) like the urethra, bladder, and rectum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aims to introduce curvilinear catheter implantation in the prostate gland for HDR treatment. The objective is to improve the radiation dose distribution by offering access channels conformal to the prostate anatomy. This approach seeks to minimize toxicity to nearby OARs while utilizing a reduced number of needles, potentially leading to improved clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Curvilinear catheters were first pre\u2010planned for an anonymized patient using Oncentra treatment planning system (TPS) and hybrid inverse planning optimization (HIPO) algorithm. The trajectories of the catheters were then analyzed using MATLAB to extract their radius of curvature. Tendon\u2010driven active needles were then used to implant curvilinear catheters inside an anthropomorphic phantom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Proposed curvilinear catheter implantation resulted in significant improvement in terms of dosimetric constraints to the OARs and coverage to the prostate. Tendon\u2010driven active needles were shown to be capable of realizing the required pre\u2010planned curvatures inside prostate. It was shown that the active needle can realize a desired radius of curvature and a desired trajectory with an average accuracy of 9.1\u00a0\u00b1\u00a08.6\u00a0 and 1.27\u00a0\u00b1\u00a00.50\u00a0mm in air and inside a tissue\u2010mimicking phantom, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This work demonstrates the feasibility of using tendon\u2010driven active curvilinear catheter implantation in prostate to improve the outcomes of HDR\u2010BT via improved radiation dose distribution to the prostate and reduced toxicity to the OARs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17113","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T10:14:01Z","timestamp":1714644841000},"page":"6332-6347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Curvilinear catheter implantation in HDR prostate brachytherapy: feasibility study"],"prefix":"10.1002","volume":"51","author":[{"given":"Blayton","family":"Padasdao","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering University of Hawaii at Manoa  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rex","family":"Imanaka","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering University of Hawaii at Manoa  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun K.","family":"Podder","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology SUNY Upstate Medical University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bardia","family":"Konh","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering University of Hawaii at Manoa  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American Cancer Society (ACS) Cancer Statistics Center.2023. 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