HDR brachytherapy tandem and ovoid titanium applicator safety assessment in 3T MRI

Evaluation of Artifacts and Distortions of Titanium Applicators on 3.0-Tesla MRI: Feasibility of Titanium Applicators in MRI-Guided Brachytherapy for Gynecological Cancer

“…We used allowable MR sequences to produce a maximum RF. No evidence of significant magnetic displacement or induced torque was found (8). As determined by the authors previously (8), we found no heating issues with titanium applicators.…”

“…Specific absorption rates have a quadratic relationship with the magnetic field (12). Based on the guidelines (19)(20)(21), we assessed the safety issues in 3.0-Tesla MR including RF heating, magnetic displacement, and induced torque, and found that the titanium T&O and T&R did not significantly increase in temperature (8). We found no more than a 2 C increase resulting from RF heating and no more than a 1.0 C above the control (without a titanium applicator) at the end of the MR sequence.…”

AAPM task group report 303 endorsed by the ABS: MRI implementation in HDR brachytherapy—Considerations from simulation to treatment

“…The main safety risks from the radiofrequency (RF) used under MR are tissue heating and burns. 156,157 Shellock's book 156 provides an excellent review of RF heating under MR.Titanium-based intracavitary applicators can be used for MRI-based and MRI-guided HDR BT, 37,57,63,158 along with plastic-based applicators. For commercially available nonferromagnetic metallic applicators, it is strongly recommended that QMPs verify the device is labeled MRI conditional, review the conditions in which it was tested (e.g., field strength, spatial gradient, RF fields, maximum SAR), 159 and that the applicator(s) is(are) used in accordance with the vendors instructions for use.…”

The dosimetric impact of vaginal balloon-packing on intracavitary high-dose-rate brachytherapy for gynecological cancer

“…Detailed 3.0 Tesla MRI scan parameters can be found in a previously published study [11]. Other studies have examined the issues surrounding the use of titanium applicators in a high-resolution (3.0 Tesla) MRI scanner including safety, artefacts, and distortions [11, 12]. Three HDR fractions in this study (3 out of 84) were planned using CT due to the unavailability of the MR scanner on the treatment day.…”