Clinical decision making tools for IVUS-based treatment planning clinical decision making tools for IVUS-based treatment planning

Intracoronary radiation therapy reduces the restenosis rate after coronary angioplasty. In the trials so far, the prescription of radiation has been done in many different ways. Different radioactive beta and gamma sources and delivery systems (5 Fr catheter, sizable centering balloons) have been used. This results in a very wide range of doses delivered in the arterial wall. In order to retrospectively estimate the dose delivered in a coronary segment on structures such as the lumen or the external elastic lamina, we have developed a PC-based 3-d treatment planning system for intravascular brachytherapy using IVUS pullbacks data (iPlan^TM). An anatomical segmentation tool is provided that also reads the outputs of commercially available IVUS analysis softwares. Dose-volume and surface histograms are calculated using the AAPM TG43 protocol formalism of sources used clinically. An application is illustrated with 27 patients treated by PTCA and β-brachytherapy