Purpose: To demonstrate the dosimetric effects of observer variability in defining the prostate and critical organs, using Tissue Harmonic (H) ultrasound imaging mode for permanent seed implant brachytherapy.
Methods: Images were acquired using a B -K medical 8848 probe with Brightness (B) and H mode for ten prostate brachytherapy patients. The prostate, rectum and urethra were contoured independently by five observers. The clinically used treatment plans based on B mode imaging fulfilling the dosimetric criteria were applied on these contours. Dosimetric parameters (prostate: D90, V100 and V200; rectum: V100; urethra: V140, V150 and V160) were computed using SPOT PRO™ planning system. Interobserver variability in dosimetric parameters was tested using standard deviations as percentages of means.
Results: Two-factor analysis of variances showed significant (p<0.05) interobserver variability in all dosimetric parameters for both modes. Interobserver agreement in dosimetric parameters improves in H mode due to improved interobserver consistency in contouring these organs on H mode images compared to B mode. There is no significant difference observed (paired student t test, p>0.05) in the mean values of dosimetric parameters in H and B mode for prostate and critical organs.
Conclusions: H mode due to its better image quality helped to improve the interobserver agreement in contouring the prostate and critical organs and hence better interobserver consistency in all dosimetric parameter. Because the difference in the mean value of dosimetric parameters between two imaging modes is not statistically significant, H mode does not appear to offer any clinical advantages in terms of improving the dosimetric outcome.
Keywords: Anatomy; Brachytherapy; Brightness; Dosimetry; H mode; Medical image quality; Medical imaging; Tissues; Ultrasonic effects; Ultrasonography.
© 2012 American Association of Physicists in Medicine.