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Evaluation of dosimetric consistency between pre- and postoperative CT-guided 3D-printed noncoplanar template-assisted ¹²⁵I seed implantation in recurrent and metastatic thoracic tumors: a retrospective study

evidence-based-medicine
oncology
pathology
radiology-and-medical-imaging
surgery-and-surgical-specialties

Abstract

Objective: Recurrent and metastatic thoracic tumors are difficult to treat due to their proximity to critical organs and the influence of respiratory motion. This study aimed to evaluate the consistency of dosimetric parameters between preoperative planning and postoperative verification in CT-guided, 3D-printed noncoplanar template (3DPNCT)-assisted ¹²⁵I seed implantation (RISI).

Methods: A retrospective analysis was conducted on 32 patients with recurrent or metastatic thoracic tumors. Preoperative and postoperative dosimetric parameters—including D90, V100, V150, conformity index (CI), external index (EI), and homogeneity index (HI)—were compared. Data normality was assessed using the Shapiro–Wilk test, and consistency was evaluated using paired t-tests and Bland–Altman analysis.

Results: Postoperative D90 was significantly lower than preoperative D90 (142.47 ± 28.90 Gy vs. 135.06 ± 31.66 Gy, P = 0.022). No significant differences were observed in V100, V200, CI, or EI (P > 0.05). HI increased significantly after implantation (P = 0.049). Bland–Altman analysis indicated overall good agreement, although D90 and V150 showed larger deviations.

Conclusions: 3DPNCT-assisted ¹²⁵I seed implantation demonstrated favorable dosimetric consistency in the treatment of thoracic tumors. Although respiratory motion and seed displacement contributed to variability in D90 and V150, this approach remains a promising option for complex thoracic cases. Future studies should incorporate optimized respiratory management strategies and validate these findings in larger prospective cohorts to confirm long-term efficacy and safety.

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