MRI-based Preplanning Using CT and MRI Data Fusion in Patients With Cervical Cancer Treated With 3D-based Brachytherapy: Feasibility and Accuracy Study

Doležel, Martin; Odrážka, Karel; Žižka, Ján; Vaňásek, J; Kohlová, Tereza; T, Kroulík; Spitzer, Dusan; Ryška, Pavel; Tichý, Michal; Kostal, Milan; Jalcova, Lubica

doi:10.1016/j.ijrobp.2011.11.003

Cited by 18 publications

(9 citation statements)

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“…Although only CT was used for image segmentation, the use of MRI has proven to modify tumor volumes and absorbed doses [29], therefore MRI with the applicator in place is the gold standard in real image for brachytherapy. Many institutions cannot carry this out in clinical routines, therefore other strategies have been developed, such as the use of CT/MR images on alternate applications [30] or the use of MRI acquired outside a radiotherapy protocol [31]. We do not believe that the use of MRI would modify rectum doses, because recently published results failed to demonstrate rectal and bladder dose differences related to the segmentation with CT or MRI [32,33].…”

Section: Discussionmentioning

confidence: 99%

The usefulness of fleet rectal enemas on high-dose-rate intracavitary cervical cancer brachytherapy. A prospective trial

Andrés

Gutierrez-Perez

Rodriguez-Vela

et al. 2017

jcb

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PurposeTo evaluate the effects of rectal enemas on rectal doses during radical high-dose-rate (HDR) intracavitary cervical brachytherapy (BT).Material and methodsTwenty patients suffering from cervical cancer and treated with external beam radiotherapy and HDR-BT were included in a prospective trial. The first brachytherapy fraction was considered the basal status, and patients were instructed to self-administer two rectal cleansing enemas before the second fraction. Dose-volume histogram (DVH) values were generated for the rectum and correlated with rectal volume variation. Brachytherapy was carried out with a Fletcher or Utrecht applicator.ResultsNo significant rectal volume differences were observed between fractions with or without rectal enemas (without, 52.64 ± 15.92 cc; with, 53.16 ± 19.28 cc). There was a significant correlation between both rectal volumes (r = 0.722, p = 0.001). No significant differences were observed in analyzed DVH parameters (median values: ΔD0.1cc, 4.17 vs. 3.61 Gy; ΔD1cc, 3.23 vs. 2.87 Gy; ΔD2cc, 2.9 vs. 2.54 Gy; ΔD5cc, 2.35 vs. 2.05 Gy, for no enema and enema fraction, respectively). No significant rectal volume differences nor DVH parameter differences were observed according the applicator type.ConclusionsOur rectal enemas protocol prior to HDR-BT was ineffective in significantly modifying rectal DVH parameters. No differences were observed according to the type of applicator used.

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Section: Discussionmentioning

confidence: 99%

The usefulness of fleet rectal enemas on high-dose-rate intracavitary cervical cancer brachytherapy. A prospective trial

Andrés

Gutierrez-Perez

Rodriguez-Vela

et al. 2017

jcb

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“…Current treatment standards involve external beam RT often followed by brachytherapy, and an integrated approach to volume dosimetry (Potter et al, 2006). In brachytherapy high dose rates require better tissue contrast to optimise target delineation and the sparing of organs at risk (bladder, vagina, rectum and sigmoid colon), which are better delineated with MRI (Barillot and Reynaud-Bougnoux, 2006, Dolezel et al, 2012, Eskander et al, 2010, Wanderas et al, 2012). The advantages of using MRI are more pronounced for smaller tumours (Zwahlen et al, 2009).…”

Section: Applications Current Status and Future Perspectivesmentioning

confidence: 99%

Radiotherapy planning using MRI

2015

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The use of magnetic resonance imaging (MRI) in radiotherapy (RT) planning is rapidly expanding. We review the wide range of image contrast mechanisms available to MRI and the way they are exploited for RT planning. However a number of challenges are also considered: the requirements that MR images are acquired in the RT treatment position, that they are geometrically accurate, that effects of patient motion during the scan are minimized, that tissue markers are clearly demonstrated, that an estimate of electron density can be obtained. These issues are discussed in detail, prior to the consideration of a number of specific clinical applications. This is followed by a brief discussion on the development of real-time MRI-guided RT.

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“…MRI is not routinely available in radiation oncology departments and requires specific applicators. CT-based BRA planning may involve only MRI fusion for planning, or post-EBRT pelvic MRI fusion for pre-planning [33, 34]. Second, BRA can be applied at an low dose rate (LDR) or HDR.…”

Section: Discussionmentioning

confidence: 99%

Radical radiotherapy in patients with cervix uteri carcinoma: experience of Ondokuz Mayis University

et al. 2019

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BackgroundRadical radiotherapy is the standard treatment for patients with locally advanced cervix uteri carcinoma (FIGO stage IB2–IVA). Worldwide, incidence and mortality rates vary among regions because of differences in lifestyles and treatment standards. Herein, we evaluated the outcomes of radical radiotherapy in patients with locally advanced cervix uteri carcinoma from the middle Black Sea region of Turkey.MethodsWe retrospectively reviewed the records of 64 consecutive patients with locally advanced cervix uteri carcinoma who were treated from January 2013 to 2016 in our radiation oncology department. All patients staging and radiotherapy planning were performed with modern imaging techniques including magnetic resonance imaging and positron-emission-tomography/computed tomography before radical radiotherapy. Thereafter, all of them were treated with external beam radiotherapy and concurrent cis-platinum-based chemotherapy followed by three-dimensional intra-cavitary high-dose-rate brachytherapy.ResultsThe median age at diagnosis was 54.5 years. The median follow-up period was 21 months. Acute grade 3 toxicity was detected in 3.1% of patients. Late toxicity was not detected in any patient. The 1- and 3-year progression-free survival rates were 83.6 and 67.5%, respectively. The 1- and 3-year overall survival rates were 95.7 and 76.9%, respectively. The most important prognostic factor was the FIGO stage. Distant metastasis was the most common cause of death in patients with locally advanced cervix uteri carcinoma despite radical radiotherapy.ConclusionsIn patients with locally-advanced cervix uteri carcinoma from the middle Black Sea region of our developing country, acceptable toxicity and survival rates are achieved similar to the recent literature from developed countries with using of modern staging, planning and radical radiotherapy techniques. However, recurrence was mostly in the form of distant metastases and further investigations on systemic therapies are required.

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MRI-based Preplanning Using CT and MRI Data Fusion in Patients With Cervical Cancer Treated With 3D-based Brachytherapy: Feasibility and Accuracy Study

Cited by 18 publications

References 20 publications

The usefulness of fleet rectal enemas on high-dose-rate intracavitary cervical cancer brachytherapy. A prospective trial

The usefulness of fleet rectal enemas on high-dose-rate intracavitary cervical cancer brachytherapy. A prospective trial

Radiotherapy planning using MRI

Radical radiotherapy in patients with cervix uteri carcinoma: experience of Ondokuz Mayis University

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