A prospective study to assess the bladder distension effects on dosimetry in intracavitary brachytherapy of cervical cancer via computed tomography-assisted techniques

Sun, Li‐Min; Huang, Han-Yao; Huang, Eng‐Yen; Wang, Chong‐Jong; Ko, Sheung-Fat; Lin, Hao; Song, J.

doi:10.1016/j.radonc.2005.03.010

Cited by 29 publications

(26 citation statements)

References 20 publications

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“…In a study with 20 patients undergoing intracavitary treatment, bladder volume was not found to have a notable effect on rectal dose, but the median bladder wall was significantly affected (3) . Increased bladder volume was also found to increase ICRU‐38 bladder base maximum dose point (4) .…”

Section: Discussionmentioning

confidence: 95%

“…The anatomy and topography of bladder has a substantial influence on bladder dose values in cervical cancer brachytherapy 3 , 4 , 5 , 6 , 7 , 8 . In order to reduce the dose to small intestine in gynecological (GYN) brachytherapy, treating the patient with a refilled bladder is often practiced (2) .…”

Section: Introductionmentioning

confidence: 99%

“…We also follow a protocol in our center (explained further in the text) in which the patient's bladder is refilled before the treatment. In the literature, the effect of bladder volume on dose to OARs has been studied 3 , 4 , 5 , 6 . We chose to investigate how keeping the bladder full during our treatments affects the dose to the bladder and other OARs, namely rectum and sigmoid.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of organs at risk doses in GYN intracavitary brachytherapy for different tandem lengths and bladder volumes

Siavashpour

Aghamiri

Jaberi

et al. 2016

J Applied Clin Med Phys

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The purpose of this study was to investigate the concurrent effects of tandem length and bladder volume on dose to pelvic organs at risk (OARs) in HDR intracavitary brachytherapy treatment of cervical cancer. Twenty patients with locally advanced cervical cancer were selected for brachytherapy using Rotterdam applicators. The patients were CT scanned twice with empty and full bladder. Two treatment plans were prepared on each of the image sets. Patients were categorized into two groups; those treated with a tandem length of 4 cm or smaller false(T≤4 cmfalse) and those with tandem length larger than 4 cm (T>4 cm). Only one tandem tip angle of 30° was studied. Dose‐volume histograms (DVHs) of OARs were calculated and compared. Bladder dose was significantly affected by both bladder volume and tandem physical length for T≤4 cm. This was reflected on the values obtained for normalD2cm3, normalD1cm3, and normalD0.1cm3 for both empty and full bladder cases. When T>4 cm, no correlation could be established between variations in bladder dose and bladder volume. Rectum dose was generally lower when the bladder was empty and T>4 cm. Dose to sigmoid was increased when T>4 cm; this increase was larger when the bladder was full. Our results suggest that, for tandems longer than 4 cm, keeping the bladder empty may reduce the dose to rectum and sigmoid. This is contrary to cases where a shorter than 4 cm tandem is used in which a full bladder (about 50–120 cm3) tends to result in a lower dose to rectum and sigmoid. Attention should be given to doses to sigmoid with long tandem lengths, as a larger tandem generally results in a larger dose to sigmoid.PACS number(s): 87.53.Jw

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comparison of organs at risk doses in GYN intracavitary brachytherapy for different tandem lengths and bladder volumes

Siavashpour

Aghamiri

Jaberi

et al. 2016

J Applied Clin Med Phys

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“…31,32 These studies required placement of a urinary catheter to facilitate bladder filling and emptying and for ICRU 38 dose point estimation. Sun et al found a statistically significant decrease in the V50 as contoured on a planning CT when a median of 220 cc of water was instilled into the bladder before intracavitary cervix implant.…”

Section: Discussionmentioning

confidence: 99%

Prospective Clinical Trial of Bladder Filling and Three-Dimensional Dosimetry in High-Dose-Rate Vaginal Cuff Brachytherapy

Stewart

Cormack

Lee

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To investigate the impact of bladder filling state on dosimetry and determine the best bladder dosimetric parameter in vaginal-cuff brachytherapy.Materials and Methods-Twenty women received vaginal cylinder high-dose-rate (HDR) brachytherapy with each fraction followed by a planning CT scan on a prospective clinical trial. The bladder was full for fraction 2 and empty for fraction 3. Dose volume histogram (DVH) and dose surface histogram (DSH) values were generated for the bladder, rectum, and urethra. The midline maximum bladder point (MBP) and the midline maximum rectal point (MRP) were recorded. Paired t-tests, Pearson correlations, and regression analyses were performed.Results-The volume and surface area of bladder irradiated were significantly smaller when the bladder was empty than when full. Of several DVH and DSH parameters evaluated, the bladder D2cc, V50, V70 and SA50 significantly predicted the difference in empty versus full filling states. The V70 and D2cc were significantly correlated with the MBP. Bladder filling did not alter the volume or surface area of rectum irradiated. However, an empty bladder did result in the nearest point of bowel being significantly closer to the vaginal cylinder than when the bladder was full.Conclusions-In order to minimize radiation dose to the bladder, patients receiving vaginal-cuff HDR brachytherapy should be treated with an empty bladder if feasible. The MBP correlates well with the volumetric assessments of bladder dose and provides a non-invasive method for reporting maximum bladder point dose using 3D imaging. The MBP can therefore be used as a surrogate for complex dosimetry in the clinic.

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“…Metal implants, such as dental implants, hip prostheses, and spine fixation devices in patients, raise concerns in radiation therapy because they potentially lead to an inaccurate patient dose calculation in three ways: 1) they permit metal‐induced artifacts in the CT images; 2) they interact with the treatment beam and are poorly modeled by some dose prediction algorithms; and 3) they lead to the formation of cold and hot spots, 3 , 4 , 5 which is particularly important in the image‐guided, intensity‐modulation radiation therapy (IG‐IMRT) era which combines inverse optimization with daily alignment.…”

Section: Introductionmentioning

confidence: 99%

On the accuracy of dose prediction near metal fixation devices for spine SBRT

Cheng

Bromley

Oborn

et al. 2016

J Applied Clin Med Phys

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The metallic fixations used in surgical procedures to support the spine mechanically usually consist of high‐density materials. Radiation therapy to palliate spinal cord compression can include prophylactic inclusion of potential tumor around the site of such fixation devices. Determination of the correct density and shape of the spine fixation device has a direct effect on the dose calculation of the radiation field. Even with the application of modern computed tomography (CT), under‐ or overestimation of dose, both immediately next to the device and in the surrounding tissues, can occur due to inaccuracies in the dose prediction algorithm. In this study, two commercially available dose prediction algorithms (Eclipse AAA and ACUROS), EGSnrc Monte Carlo, and GAFchromic film measurements were compared for a clinical spine SBRT case to determine their accuracy. An open six‐field plan and a clinical nine‐field IMRT plan were applied to a phantom containing a metal spine fixation device. Dose difference and gamma analysis were performed in and around the tumor region adjacent to the fixation device. Dose calculation inconsistency was observed in the open field plan. However, in the IMRT plan, the dose perturbation effect was not observed beyond 5 mm. Our results suggest that the dose effect of the metal fixation device to the spinal cord and the tumor volume is not observable, and all dose calculation algorithms evaluated can provide clinically acceptable accuracy in the case of spinal SBRT, with the tolerance of 95% for gamma criteria of 3%/3 mm.PACS number(s): 87.53.bn, 87.53.Ly, 87.55.kd

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A prospective study to assess the bladder distension effects on dosimetry in intracavitary brachytherapy of cervical cancer via computed tomography-assisted techniques

Cited by 29 publications

References 20 publications

A comparison of organs at risk doses in GYN intracavitary brachytherapy for different tandem lengths and bladder volumes

A comparison of organs at risk doses in GYN intracavitary brachytherapy for different tandem lengths and bladder volumes

Prospective Clinical Trial of Bladder Filling and Three-Dimensional Dosimetry in High-Dose-Rate Vaginal Cuff Brachytherapy

On the accuracy of dose prediction near metal fixation devices for spine SBRT

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