Contemporary image-guided cervical cancer brachytherapy: Consensus imaging recommendations from the Society of Abdominal Radiology and the American Brachytherapy Society

Jacobsen, Megan C.; Beriwal, Sushil; Dyer, Brandon A.; Klopp, Ann H.; Lee, Susanna I.; McGinnis, Gwendolyn J.; Robbins, Jessica B.; Rauch, Gaiane M.; Sadowski, Elizabeth A.; Simiele, Samantha J.; Stafford, R. Jason; Taunk, Neil K.; Yashar, Catheryn M.; Venkatesan, Aradhana M.

doi:10.1016/j.brachy.2022.04.005

Cited by 9 publications

(3 citation statements)

References 110 publications

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“…Within LMICs, X-rays continue to be the primary method for guiding the insertion of applicators and assuring the accurate and secure positioning of the applicator in the uterine canal. While it is not acknowledged for its precision and features like MRI, CT, or other advanced imaging techniques (as shown in Table 1, which compares imaging modalities used for treatment planning in cervical cancer), it does not currently represent a first choice in recommendations for use in conformal planning [46,47]. Federico [48] observed that TRUS and MR were equivalent in determining preBT tumour maximum width in FIGO stage I/II cervical cancer.…”

Section: Resultsmentioning

confidence: 99%

Integration of Ultrasound in Image-Guided Adaptive Brachytherapy in Cancer of the Uterine Cervix

Manea,

Chitoran,

Rotaru

et al. 2024

Bioengineering

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Cervical cancer continues to be a public health concern, as it remains the second most common cancer despite screening programs. It is the third most common cause of cancer-related death for women, and the majority of cases happen in developing nations. The standard treatment for locally advanced cervical cancer involves the use of external beam radiation therapy, along with concurrent chemotherapy, followed by an image-guided adaptive brachytherapy (IGABT) boost. The five-year relative survival rate for European women diagnosed with cervical cancer was 62% between 2000 and 2007. Updated cervical cancer treatment guidelines based on IGABT have been developed by the Gynecological working group, which is composed of the Group Européen de Curiethérapie–European Society for Therapeutic Radiology and Oncology. The therapeutic strategy makes use of three-dimensional imaging, which can be tailored to the target volume and at-risk organs through the use of computed tomography or magnetic resonance imaging. Under anaesthesia, the brachytherapy implantation is carried out. Ultrasonography is utilised to assess the depth of the uterine cavity and to facilitate the dilation of the uterine canal during the application insertion. In this study, we examine data from the international literature regarding the application of ultrasound in cervical cancer brachytherapy.

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Section: Resultsmentioning

confidence: 99%

Integration of Ultrasound in Image-Guided Adaptive Brachytherapy in Cancer of the Uterine Cervix

Manea,

Chitoran,

Rotaru

et al. 2024

Bioengineering

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“…Although not credited with the same accuracy and characteristics as MRI, CT or other sophisticated imaging modalities (Table 1. Comparison between imaging modalities used for treatment planning in cervical cancer) and not yet recommended in guidelines for use in conformal planning [38,39], ultrasound guidance has a wider availability and can enhance cervical cancer treatment planning especially in its state-of-the-art form (3-dimensional contrast enhanced ultrasound) and improve outcomes [40], but does require specialized training [41,42]. Regarding the association between different methods of treatment monitoring, the existing imaging combination strategies primarily include MRI/CT, US/CT, MRI/US, and MRI/PET.…”

Section: Resultsmentioning

confidence: 99%

Image-Guided Adaptive Brachytherapy in Cervical Cancer: Integration of Ultrasound

Manea,

Chitoran,

Rotaru

et al. 2023

Preprint

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Cervical cancer remains a major public health problem. Despite the screening programs, cervical cancer is the second most commonly diagnosed cancer. Most of the cases occur in less developed countries, and it is the third leading cause of cancer death among females. In 2000–2007, the five-year relative survival rate for European women diagnosed with cervical cancer was 62%.[1] Standard treatment for locally advanced cervical cancer reveals external beam radiotherapy (EBRT) with concurrent chemotherapy followed by image-guided adaptive brachytherapy (IGABT) boost [2, 3]. In the last years, the Gynaecological (GYN) working group composed of Group Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) has developed new recommendations for the treatment of cervical cancer based on IGABT. The treatment plan includes 3-dimensional (3D) imaging based on magnetic resonance imaging (MRI) or computed tomography (CT), adaptive to the target volume and organ at risk [4–6]. The brachytherapy insertion is made under anaesthesia. At the time of the application insertion, the ultrasound is used to guide the dilatation of the uterine canal and assess the depth of the uterine cavity. In this paper, we review the data available in international literature about the use of ultrasound (US) in brachytherapy treatment of cervical cancer.

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“…The target volume contoured on CT is well-known to be larger than that contoured on MRI because of the poor definition of parametrial tumor infiltration on the CT [ 25 ]. CT, unlike MRI, does not clearly differentiate tumors, and it may overestimate the volume in patients with parametrial extensions upon diagnosis that have a good response to EBRT [ 26 ]. In our study, we followed the NRG Oncology consensus guidelines published in 2014 to contour the CTV, comprising the whole cervix and parametrial extension [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes of Computer Tomography-Guided Brachytherapy in Cervical Cancer in Hong Kong: A Retrospective Review

Chan

Cheng

et al. 2022

Cancers

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(1) Background: To report the long-term clinical outcomes of computer-tomography (CT)-guided brachytherapy (BT) for locally advanced cervical cancer. (2) Methods: A total of 135 patients with FIGO stage IB-IVA cervical cancer treated with definitive radiotherapy +/− chemotherapy with an IGABT boost at Queen Mary Hospital, Hong Kong, between November 2013 and December 2019 were included. Treatment included pelvic radiotherapy 40 Gy/20 Fr/4 weeks +/− chemotherapy then CT-guided BT (7 Gy × 4 Fr) and a sequential parametrial boost. The primary outcome was local control. Secondary outcomes were pelvic control, distant metastasis-free survival, overall survival (OS) and late toxicities. (3) Results: The median follow-up was 53.6 months (3.0–99.6 months). The five-year local control, pelvic control, distant metastasis-free survival and OS rates were 90.7%, 84.3%, 80.0% and 87.2%, respectively. The incidence of G3/4 long-term toxicities was 6.7%, including proctitis (2.2%), radiation cystitis (1.5%), bowel perforation (0.7%), ureteric stricture (0.7%) and vaginal stenosis and fistula (0.7%). Patients with adenocarcinomas had worse local control (HR 5.82, 95% CI 1.84–18.34, p = 0.003), pelvic control (HR 4.41, 95% CI 1.83–10.60, p = 0.001), distant metastasis-free survival (HR 2.83, 95% CI 1.17–6.84, p = 0.021) and OS (HR 4.38, 95% CI: 1.52–12.67, p = 0.003) rates. Distant metastasis-free survival was associated with HR-CTV volume ≥ 30 cm3 (HR 3.44, 95% CI 1.18–9.42, p = 0.025) and the presence of pelvic lymph node (HR 3.44, 95% CI 1.18–9.42, p = 0.025). OS was better in patients with concurrent chemotherapy (HR 4.33, 95% CI: 1.40–13.33, p = 0.011). (4) Conclusions: CT-guided BT for cervical cancer achieved excellent long-term local control and OS. Adenocarcinoma was associated with worse clinical outcomes. (4) Conclusion: CT-guided BT for cervical cancer achieved excellent long-term local control and OS. Adenocarcinoma was associated with worse clinical outcomes.

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Contemporary image-guided cervical cancer brachytherapy: Consensus imaging recommendations from the Society of Abdominal Radiology and the American Brachytherapy Society

Cited by 9 publications

References 110 publications

Integration of Ultrasound in Image-Guided Adaptive Brachytherapy in Cancer of the Uterine Cervix

Integration of Ultrasound in Image-Guided Adaptive Brachytherapy in Cancer of the Uterine Cervix

Image-Guided Adaptive Brachytherapy in Cervical Cancer: Integration of Ultrasound

Treatment Outcomes of Computer Tomography-Guided Brachytherapy in Cervical Cancer in Hong Kong: A Retrospective Review

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