Cost-effectiveness analysis of 3D image-guided brachytherapy compared with 2D brachytherapy in the treatment of locally advanced cervical cancer

Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

doi:10.1016/j.brachy.2014.09.002

Cited by 43 publications

(48 citation statements)

References 30 publications

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“…To provide high quality brachytherapy to patients, it is necessary to set adequate brachytherapy fees that can cover the source replacement expense. In the Medicare reimbursement of the Unites States, the cost of radionuclide sources is charged in addition to fees for brachytherapy simulation, planning, image guidance, procedures, and medical physics consultation [ 15 ]. Korean radiation oncologists expressed in the current survey that the national reimbursement system needs to be similarly adjusted to cover the expenses of radionuclide sources.…”

Section: Discussionmentioning

confidence: 99%

Current status of brachytherapy in Korea: a national survey of radiation oncologists

Kim

et al. 2016

J Gynecol Oncol

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ObjectiveThe aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists.MethodsBetween October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea.ResultsThe response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using 192Ir (26 centers) or 60Co (two centers). Among the 26 centers using 192Ir sources, 11 treated fewer than 40 patients per year. In the two centers using 60Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement.ConclusionThe present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.

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Section: Discussionmentioning

confidence: 99%

Current status of brachytherapy in Korea: a national survey of radiation oncologists

Kim

et al. 2016

J Gynecol Oncol

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“…Kim et al have evaluated the cost-effectiveness of 3D imageguided brachytherapy for cervical cancer. They found that the use of MRI increased direct medical costs, but that treatment planning with an MRI at each fraction was a cost-effective option compared with 2D brachytherapy (16).…”

Section: Discussionmentioning

confidence: 98%

Implementing MRI-based target delineation for cervical cancer treatment within a rapid workflow environment for image-guided brachytherapy: A practical approach for centers without in-room MRI

et al. 2015

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“…On a global scale, high incidence rates of cervical cancer have been reported in countries with low and medium national income levels [8]. Although some studies have indicated that 3D IGBT is cost-effective when compared to conventional brachytherapy practices that use two-dimensional fluoroscopic images [9], the significant patient burden associated with cervical cancer and relatively high economic cost of introducing CT and/or MRI present challenges to the implementation of 3D IGBT.…”

Section: Purposementioning

confidence: 99%

The use of trans-applicator intracavitary ultrasonography in brachytherapy for cervical cancer: phantom study of a novel approach to 3D image-guided brachytherapy

Tamaki

Miyaura

Murakami

et al. 2017

jcb

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PurposeTo assess the feasibility of applying trans-applicator intracavitary ultrasonography to image-guided brachytherapy for cervical cancer.Material and methodsFor this experiment, a phantom was created and included a polyethylene tube, intended to simulate a tandem applicator, which was inserted into chicken meat and embedded in agar, along with magnetic resonance imaging (MRI)-compatible ovoid applicators. Three-dimensional images of the phantom were obtained using computed tomography (CT), MRI (T2-weighted), and intracavitary ultrasonography sectional images acquired at 1 mm slice intervals. Intracavitary ultrasonography images were acquired from within the simulated tandem applicator using a radial transducer. Magnetic resonance imaging and intracavitary ultrasonography images were manually registered onto CT images. The chicken meat was contoured as the target volume independently on the CT, MRI, and intracavitary ultrasonography images, and the Dice similarity coefficient was used to compare the target volumes. The dose distributions of a sample brachytherapy plan were also evaluated.ResultsComputed tomography, MRI, and intracavitary ultrasonography all visualized the three-dimensional phantom volumes. Intracavitary ultrasonography images depicted the meat with high echoic signals and a border clearly distinguishable from the surrounding agar. The Dice similarity coefficient values for the target volumes on CT vs. MRI, CT vs. intracavitary ultrasonography, and MRI vs. intracavitary ultrasonography were 0.966, 0.965, and 0.971, respectively, indicating similar contouring with the three modalities. Among the modalities, the differences in D50, D90, D98, and D100 values were 1.8%, 2.9%, 3.7%, and 2.9%, respectively.ConclusionsThree-dimensional reconstructed trans-applicator intracavitary ultrasonographic images clearly depicted meat tissue within the phantom, and could thus be used for brachytherapy planning. This study proves the concept of trans-applicator intracavitary ultrasonography for intracavitary brachytherapy. Further research such as development of intracavitary ultrasonography system, 3D reconstruction method, ultrasonography-compatible applicators, and ultrasonography-based target concept is warranted to assess the potential clinical application.

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Cost-effectiveness analysis of 3D image-guided brachytherapy compared with 2D brachytherapy in the treatment of locally advanced cervical cancer

Cited by 43 publications

References 30 publications

Current status of brachytherapy in Korea: a national survey of radiation oncologists

Current status of brachytherapy in Korea: a national survey of radiation oncologists

Implementing MRI-based target delineation for cervical cancer treatment within a rapid workflow environment for image-guided brachytherapy: A practical approach for centers without in-room MRI

The use of trans-applicator intracavitary ultrasonography in brachytherapy for cervical cancer: phantom study of a novel approach to 3D image-guided brachytherapy

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