Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: Report from Image-Guided Brachytherapy Working Group

Nag, Subir; Cárdenes, Higinia R.; Chang, Silvia D.; Das, Indra J.; Erickson, Beth; Ibbott, Geoffrey S.; Lowenstein, Jessica; Roll, J.; Thomadsen, Bruce R.; Varia, Mahesh A.

doi:10.1016/j.ijrobp.2004.04.032

Cited by 205 publications

(123 citation statements)

References 69 publications

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“…Therefore image based brachytherapy technique can optimize and individualize treatment planning. Previous studies have shown that CT based brachytherapy is feasible and several guidelines for image based brachytherapy have already been published in the literature (Nag et al, 2004;Potter et al, 2006).…”

Section: Comparative Evaluation Of Two-dimensional Radiography Andmentioning

confidence: 99%

Comparative Evaluation of Two-dimensional Radiography and Three Dimensional Computed Tomography Based Dose-volume Parameters for High-dose-rate Intracavitary Brachytherapy of Cervical Cancer: A Prospective Study

Madan

Pathy²,

Subramani³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Section: Comparative Evaluation Of Two-dimensional Radiography Andmentioning

confidence: 99%

Comparative Evaluation of Two-dimensional Radiography and Three Dimensional Computed Tomography Based Dose-volume Parameters for High-dose-rate Intracavitary Brachytherapy of Cervical Cancer: A Prospective Study

Madan

Pathy²,

Subramani³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…This produces fast spin‐echo sequences with 3 mm slice thickness in different orientation of slice acquisition. As a part of EMBRACE protocol of GEC‐ESTRO recommendation guideline, 1 , 2 four MR image sequences consist of paratransverse, parasagittal, and paracoronal images containing the tandem and the whole ring and another transverse MR image sequence were acquired.

T_{2}

weighted transverse MR images were use for the contouring of target volumes in Oncentra MasterPlan treatment planning system (Nucletron).…”

Section: Methodsmentioning

confidence: 99%

“…

T_{2}

weighted transverse MR images were use for the contouring of target volumes in Oncentra MasterPlan treatment planning system (Nucletron). Target volumes and organs at risk (OARs) were contoured on transverse MR image according to GEC‐ESTRO recommendation guideline 1 , 2 with the help of paratransverse, parasagittal, and paracoronal images containing the tandem and the whole ring. The OARs, contoured on the transverse MR images in this study, were sigmoid, bladder, and rectum.…”

Section: Methodsmentioning

confidence: 99%

CT and MR image fusion of tandem and ring applicator using rigid registration in intracavitary brachytherapy planning

Oinam

Tomar

Patel

et al. 2014

J Applied Clin Med Phys

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The purpose of this study is to find the uncertainties in the reconstruction of MR compatible ring‐tandem intracavitary applicators of high‐dose rate image‐based brachytherapy treatment planning using rigid registration of 3D MR and CT image fusion. Tandem and ring reconstruction in MR image based brachytherapy planning was done using rigid registration of CT and MR applicator geometries. Verifications of registration for applicator fusion were performed in six verification steps at three different sites of tandem ring applicator set. The first site consists of three errors at the level of ring plane in (1) cranio–caudal shift (Cranial Shift) of ring plane along tandem axis, (2) antero–posterior shift (AP Shift) perpendicular to tandem axis on the plane containing the tandem, and (3) lateral shift (Lat Shift) perpendicular to the plane containing the tandem at the level of ring plane. The other two sites are the verifications at the tip of tandem and neck of the ring. The verification at the tip of tandem consists of two errors in (1) antero–posterior shift (AP Shift) perpendicular to tandem axis on the plane containing the tandem, and (2) lateral shift (Lat Shift) perpendicular to the plane containing the tandem. The third site of verification at the neck of the ring is the error due to the rotation of ring about tandem axis. The impact of translational errors from −5 mm to 5 mm in the step of 1 mm along x‐, y‐, and z‐axis and three rotational errors about these axes from −19.1° to 19.1° in the step of 3.28° on dose‐volume histogram parameters (normalD2cc,normalD1cc,normalD0.1cc, and normalD5cc of bladder, rectum, and sigmoid, and D90 and D98 of HRCTV were also analyzed. Maximum registration errors along cranio–caudal direction was 2.2 mm (1 case), whereas the errors of 31 out of 34 cases of registration were found within 1.5 mm, and those of two cases were less than 2 mm but greater than 1.5 mm. Maximum rotational error of ring about tandem axis was 3.15° (1.1 mm). In other direction and different sites of the ring applicator set, the errors were within 1.5 mm. The impacts of registration errors on DVH parameters of bladder, rectum, and sigmoid were very sensitive to antero–posterior shift. Cranio‐caudal errors of registration also largely affected the rectum DVH parameters. Largest change of 17.95% per mm and 20.65% per mm in all the DVH parameters of all OARs and HRCTV were observed for ϕ and normalΨ rotational errors as compare to other translational and rotational errors. Catheter reconstruction in MR image using rigid registration of applicator geometries of CT and MR images is a feasible technique for MR image‐based intracavitary brachytherapy planning. The applicator registration using the contours of tandem and neck of the ring of CT and MR images decreased the rotational error about tandem axis. Verification of CT MR image fusion using applicator registration which consists of six steps of verification at three different sites in ring applicator set can report all the errors due to translation and rota...

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“…Because MRI provides superior soft tissue resolution compared to CT and because electron density does not play a role in dose calculation in brachytherapy, the Gynaecological (GYN) GEC-ESTRO Working Group and the American Image-Guided Brachytherapy Working Group have proposed that T2-weighted MRI be used for imaging using a pelvic surface coil with image-compatible brachytherapy applicators in place for cervical implants. Since 2000, these two groups have been working on recommendations for recording and reporting 3D image-based brachytherapy (BT) for cervical cancer [23,24] . The recommendations on definition and delineation of GTV and CTV are based on clinical experience and different dosimetric concepts.…”

Section: Mri In Planning Radiotherapy For Patients Treated With Brachmentioning

confidence: 99%

The use of MRI in planning radiotherapy for gynaecological tumours

Barillot

Reynaud-Bougnoux²

2006

Cancer Imaging

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Parameters that significantly influence results in radiation treatment of gynaecological malignancies are mainly related to the tumour characteristics and the radiotherapy technique used. High-dose radiotherapy requires accurate localisation of the tumour volume and its relationship to surrounding normal tissues. For many years the standard technique used for irradiation of the pelvic area was the four-field box technique which offered the potential benefit of the lateral fields to shield the rectum and small bowel. However, this conventional technique was designed according to bony landmarks and offered limited information regarding the topography of the tumour and the flexion of the uterus which are influenced by the tumour burden and bladder and rectal filling. CT and MRI enable the visualisation of the cervix, uterus, vagina, iliac vessels and organs at risk, but MRI allows tumour depiction in all planes. In the early 1990s, several studies reported on the value of pelvic MRI in designing the lateral fields of the box technique. They demonstrated that conventional lateral portals would have resulted in a marginal tumour miss and incomplete coverage of the uterine fundus in more than 50% of cases, thus leading to the conclusion that if a box technique is used its design should be based on sagittal MRI. CT-based 3D planning systems are now routinely used in the vast majority of radiotherapy departments. Target volumes and organs at risk are delineated by the physician on each CT slice in order to conform the radiotherapy fields to the tumour volume. For several reasons, such as distortion and lack of electron density which is essential for dose calculation, the implementation of MRI into radiation treatment planning has its limitations. However, MRI can still be used if planning systems integrate tools for CT/MR image registration. There is little experience in the literature for gynaecological malignancies demonstrating that image fusion allows an improvement of the definition of the target and the organ at risk compared to CT alone. Only a few papers in the literature report on the use of CT/MR image registration in planning the external irradiation of gynaecological tumours. Most demonstrate feasibility, but they fail to quantify the improvement for volume definition compared to the use of CT alone. Finally, recent possibilities offered by MRI technology are promising in the area of brachytherapy planning as the full potential of individually defining and evaluating GTV and CTV based on tumour extent and anatomical structures is exploited.

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Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: Report from Image-Guided Brachytherapy Working Group

Cited by 205 publications

References 69 publications

Comparative Evaluation of Two-dimensional Radiography and Three Dimensional Computed Tomography Based Dose-volume Parameters for High-dose-rate Intracavitary Brachytherapy of Cervical Cancer: A Prospective Study

Comparative Evaluation of Two-dimensional Radiography and Three Dimensional Computed Tomography Based Dose-volume Parameters for High-dose-rate Intracavitary Brachytherapy of Cervical Cancer: A Prospective Study

CT and MR image fusion of tandem and ring applicator using rigid registration in intracavitary brachytherapy planning

The use of MRI in planning radiotherapy for gynaecological tumours

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