Minimum Required Interval Between Hydrogel Spacer Injection and Treatment Planning for Stereotactic Body Radiation Therapy for Prostate Cancer

Purpose: The present study evaluated the short-term characteristics (<3 days) of a hydrogel spacer from the time of injection during stereotactic body radiation therapy (SBRT) for prostate cancer. Methods and Materials: Fifteen patients treated with SBRT via the CyberKnife system (36.25 Gy/5 fractions) were enrolled in this retrospective study. Two magnetic resonance (MR) images were obtained with a hydrogel spacer: one on a computed tomography (CT) simulation day (MR pretreatment [MRpre]) and the other on the last treatment day (MR posttreatment [MRpost]). Two medical physicists contoured the hydrogel spacer on each MR image. The changes of the shapes and the volume for the hydrogel spacer between 2 MR images were evaluated. Results: The median period between hydrogel spacer injection and CT simulation was 1 day (range, 1-9 days). The median period between CT simulation and the last treatment was 17 days (range, 14-25 days). Regarding the volume change of the hydrogel spacer, the 2 observers observed significant differences between the volumes of the hydrogel spacer on the MRpre and MRpost. However, the average volume difference between them was less than 1 cm(3). The average dice similarity coefficient between the MRpre and MRpost to compare the shape was more than 0.83. In addition, no clear correlation was confirmed between the volume change and the period from hydrogel spacer injection to CT simulation. Conclusions: A single day is an acceptable interval between hydrogel spacer injection and treatment planning for SBRT for prostate cancer. (c) 2022 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.