Accuracy Of Mixed Reality Technology Combined With CT-guided Iodine-125I Seeds In The Treatment Of Intracranial Tumors And Analysis Of Risk Factors For Intracranial Hemorrhage

Objective This study aimed to investigate the accuracy and safety of mixed virtual reality technology combine with CT guided in intracranial tumor iodine-125 seeds therapy,and to analyze the risk factors for intracranial tumor iodine-125 seeds therapy complicated with intracranial hemorrhage based on the existing clinical data.Methods Part One:Included and analyzed 13 patients who underwent mixed virtual reality technology combined with CT-guided iodine-125 seeds implantation from August,2020 to September,2021 after clinically diagnosed with intracranial malignant tumors.3D reconstruction is performed on the preoperative image data of the patient,and the 3D virtual image is imported into the mixed reality wearable device.The preoperative plan was compared during the operation,and mixed reality technology combined with CT guidance was used to complete the seed implantation,and the postoperative dosimetry was verified.D90,V100,V150 before and after surgery were used as the main observation indicators,and short-term local control rate,complications,average hospital stay and average operation time were used as secondary observation indicators to evaluate mixed virtual reality technology combined with CT guidance.Accuracy and safety of iodine-125 seeds therapy in actual intracranial tumors.Part Two:Retrospectively analyzes the clinical data of patients with intracranial tumor 125 I particle therapy from March 2013 to November 2020 in the Interventional Medicine Center of Affiliated Hospital of Qingdao University,a total of 234 cases,according to whether postoperative intracranial hemorrhage is complicated,the patients are divided into hemorrhage group and non-bleeding group.Univariate analysis was performed on the included factors by binary logistic regression analysis,and then significant factors were included in multivariate logistic regression analysis to determine the independent risk factors of intracranial tumor iodine-125 seeds therapy complicated with intracranial hemorrhage.Results Part One:13 patients with intracranial tumors implanted with iodine-125 seeds were successfully operated under the guidance of mixed reality technology combined with CT.Compared with the preoperative plan,there was no significant difference in dosimetric parameters such as D90,V100,and V150 in the postoperative verification(P>0.05).During the 6-month follow-up period,the local control rate was 76.9 %,and the effective control rate was 46.2%.A small amount of epidural hemorrhage occurred during operation in 1 case,and symptomatic cerebral edema occurred in 3 cases after treatment.There were no cases of radiational toxicity related neurological impairment and no deaths.The average hospital stay was 10.5 days,and the average operation time was 118.5 minutes.Part Two:234 patients with intracranial tumor who received iodine-125 seeds therapy had postoperative intracranial hemorrhage,a total of 22 cases,the incidence of intracranial hemorrhage was 9.4 %.Univariate analysis showed that tumor type and history of anti-angiogenic drug treatment within the past 1 month may be the influencing factors of intracranial tumor iodine-125 seeds therapy complicated with intracranial hemorrhage(P<0.1).Multivariate logistic regression analysis showed that the history of anti-angiogenic drug therapy within the past 1 month was an independent risk factor for intracranial tumor iodine-125 seeds therapy complicated with intracranial hemorrhage(P<0.05).Conclusions 1.Mixed reality technology combined with CT-guided iodine-125 seeds implantation in the treatment of intracranial tumors has no difference between the postoperative dose indicators and the preoperative plan,and no serious adverse reactions occurred after operation.It is a precise and accurate method in the iodine-125 seeds therapy of intracranial tumors.2.The use of anti-angiogenic drugs within the past 1 month is an independent risk factor for intracranial tumor iodine-125 seeds therapy complicated with intracranial hemorrhage.Therefore,preoperative evaluation of this index has important clinical significance for the prevention and treatment of iodine-125 seeds therapy for intracranial tumor complicated with intracranial hemorrhage.