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We evaluated the potential impact of introducing 3D treatment planning and quantified the theoretical clinical benefits in terms of tumour control probability (TCP) and normal tissue complication probability (NTCP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Treatment plans for thirty\u2010two patients were optimized using 3D image\u2010guided treatment planning and compared to the original 2D clinical plans. Optimization of plans was done in an image\u2010based treatment planning system by optimizing the plaque position and treatment time such that the entire tumour received the prescribed dose of 100\u00a0Gy. TCP and NTCP for 2D clinical plans and optimized 3D image\u2010guided plans were estimated from published outcome prediction models and compared within patients using Wilcoxon signed\u2010rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median minimum tumour dose (D<jats:sub>99%<\/jats:sub>) for 2D clinical plans was 93\u00a0Gy (range: 23\u2013158\u00a0Gy), corresponding to 5\u2010year TCP of 75% (IQR 61\u201386%), while median tumour D<jats:sub>99%<\/jats:sub> for optimized 3D image\u2010guided plans was 115\u00a0Gy (range 103\u2013141\u00a0Gy), corresponding to TCP of 82% (IQR 80\u201384%). This was a statistically significant increase in estimated TCP (median increase in TCP 8% (IQR: \u22125\u201323, p = 0.006). While the dose to normal tissue increased somewhat, there was no significant change in NTCP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>3D treatment planning theoretically allows for improved tumour dose delivery for Ru\u2010106 brachytherapy of choroidal melanomas, resulting in a significant increase in expected tumour control compared to traditional approaches using 2D calculations. The deliverability of optimized plans, and potential increased risk of late complications, will have to be confirmed in future clinical studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14663","type":"journal-article","created":{"date-parts":[[2020,12,19]],"date-time":"2020-12-19T12:16:52Z","timestamp":1608380212000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["3D image\u2010guided treatment planning for Ruthenium\u2010106 brachytherapy of choroidal melanomas"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2914-461X","authenticated-orcid":false,"given":"Charlotte A.","family":"Espensen","sequence":"first","affiliation":[{"name":"Department of Oncology Section of Radiotherapy Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"},{"name":"Department of Ophthalmology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1054-1460","authenticated-orcid":false,"given":"Jens F.","family":"Kiilgaard","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9849-0057","authenticated-orcid":false,"given":"Kristian","family":"Klemp","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-7937","authenticated-orcid":false,"given":"Anita","family":"Gothelf","sequence":"additional","affiliation":[{"name":"Department of Oncology Section of Radiotherapy Copenhagen University Hospital Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2792-9218","authenticated-orcid":false,"given":"Ane L.","family":"Appelt","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research at St James\u2019s, University of Leeds Leeds Cancer Centre University of Leeds St James\u2019s University Hospital Leeds UK"},{"name":"Leeds Cancer Centre St James\u2019s University Hospital Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0040-9880","authenticated-orcid":false,"given":"Lotte S.","family":"Fog","sequence":"additional","affiliation":[{"name":"The Alfred Hospital Alfred Health Radiation Oncology Melbourne Victoria Australia"},{"name":"The Peter MacCallum Cancer Centre Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(90)90077-W"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1573971"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10334-016-0529-4"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2015.04.010"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.02.059"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2016-309626"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11081124"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2020.1762925"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.595258"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radmeas.2011.07.032"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.01.010"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2010.10.002"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(01)01768-0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(03)00211-6"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/rpd\/nci266"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4754031"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000328254"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4828786"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2018.01.001"},{"key":"e_1_2_6_21_1","first-page":"591","volume-title":"Uveal melanoma. 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