scholarly journals The Fusion of MRI and CT in the Planning of Brachytherapy for Cancer of the Uterine Cervix

2022 ◽  
Vol 12 (2) ◽  
pp. 634
Author(s):  
Roland Merten ◽  
Mirko Fischer ◽  
Hans Christiansen ◽  
Kristina I. Ringe ◽  
Rüdiger Klapdor ◽  
...  
Keyword(s):  
Uterine Cervix ◽  
Clinical Target Volume ◽  
External Beam Radiotherapy ◽  
Target Volume ◽  
Practical Application ◽  
Volumetric Mri ◽  
Hannover Medical School ◽  
Image Guided ◽  
Contrast Enhanced ◽  
Ct And Mri

Introduction: tumors of the uterine cervix are among the most common carcinomas in women. Intracervical brachytherapy is an indispensable part of curative treatment. Although the tumor is significantly more recognizable in MRI than in CT, the practical application of MRI in brachytherapy planning is still difficult. The present study examines the technical possibilities of merging CT and MRI. Materials and Methods: the treatment files and imaging of all 53 patients who had been irradiated by image-guided adaptive brachytherapy (IGABT) between January 2019 and August 2021 at the Department of Radiotherapy of the Hannover Medical School were evaluated, retrospectively. Patients were treated first with an external beam radiotherapy (EBRT) combined with simultaneous chemotherapy. After an average of 4.2 weeks, the preparation for IGABT began. The clinical target volume (CTV) for brachytherapy was contoured first in an MRI acquired before starting EBRT (MRI 1) and once more in a second MRI just before starting IGABT (MRI 2). Then, after inserting the intravaginal applicator, a CT-scan was acquired, and the CTV was contoured in the CT. Finally, the recordings of MRI 1, MRI 2, and the CT were merged, and the congruence of CTVs was quantitatively evaluated. Results: the CTV delineated in MRI 2 was, on average, 28% smaller than that in MRI 1 after an average applied radiation dose of 42 Gy. The CTV delineated in the CT covered an average of no more than 80.8% of the CTV delineated in MRI 2. The congruence of CTVs was not superior in patients with a smit sleeve in the cervical channel, with a 3D-volumetric MRI or with a contrast-enhanced sequence for MRI. Conclusion: the anatomical shape and position of the uterus is significantly changed by introducing a vaginal applicator. Despite the superior delimitability of the tumor in MRI, brachytherapy cannot be reliably planned by the image fusion of an MRI without a vaginal applicator.

scholarly journals Comparison of CT and MRI-Based Clinical Target Volume Contours at the Time of Brachytherapy for Cervical Cancer

2015 ◽  
Vol 93 (3) ◽  
pp. E282
Author(s):  
C.W. Swanick ◽  
K.O. Castle ◽  
S. Vedam ◽  
L.M. Turner ◽  
J. Yang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Clinical Target Volume ◽  
Target Volume ◽  
Ct And Mri

Novel irradiation techniques in the treatment of solid tumours. Radiotherapy of metastases

2014 ◽  
Vol 155 (8) ◽  
pp. 283-290
Author(s):  
Árpád Mayer ◽  
Zsuzsa Póti
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Clinical Target Volume ◽  
Primary Tumour ◽  
Target Volume ◽  
Solid Tumours ◽  
Cone Beam ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Technical Developments

Novel developments in percutaneous radiotherapy, such as positron emission tomography/computed tomography, adaptive radiation planning, intensity modulation radiotherapy and intensity modulated arc therapy (RapidArc), as well as the newer generation of image control (cone-beam computed tomography) and image guided radiotherapy ensure increased dosages of planning target volume and clinical target volume of solid tumours without damaging surrounding tissues and providing maximal protection. By raising the dosages of planned target volume and clinical target volume, these novel technical developments have created new indications in the treatment of solid tumours. With the aid of the cone-beam computed tomography and image guided radiotherapy the organ metastasis (lung, liver, spinal cord) and the primary tumour can be treated safety and effectively. Hypofractionation, dose escalation and the use of stereotactic devices can probably decrease radiation damage. The authors review the most common forms of evidence-based fractionation schemes used in irradiation therapy. Orv. Hetil., 2014, 155(8), 283–290.

scholarly journals Image Guided Radiotherapy by CBCT based Position Verification in High Risk Carcinoma Prostate - an Indian experience and review of literature

2013 ◽  
Vol 5 (2) ◽  
pp. 14-20
Author(s):  
Rashi Agrawal ◽  
Dinesh Singh ◽  
Sudarsan De ◽  
Sweety Gupta
Keyword(s):  
External Beam Radiotherapy ◽  
Treatment Options ◽  
Locally Advanced ◽  
Medical Science ◽  
Intensity Modulated Radiotherapy ◽  
Target Volume ◽  
Rectal Toxicity ◽  
Image Guided Radiotherapy ◽  
Image Guided

Introduction-External beam radiotherapy is one of the principle treatment options for locally advanced prostate cancer. Over the past several decades, RT techniques have evolved to allow higher doses of radiation to be administered safely. We report our experience of Image guided intensity modulated radiotherapy (IGRT) and CBCT based position verification. Material and methods- In this study we are presenting data of 17 consecutive patients that were treated from august 2009 to october 2010. All patients received 76 -78 Gy Gy to clinical target volume for primary disease. Daily online matching was performed by using KV CBCT scan before treatment. In each patient, soft tissue (prostate) matching was done by the radiation oncologist. Results – Median Follow up of our patients is 16 months with minimum follow up of 13 months. 3(17.6%) patients developed grade 2 acute rectal toxicity and 4 (23.5%) bladder toxicity. Till date none of our patients had late bladder or rectal toxicity. None of our patient developed local recurrence. Conclusion-Our study concludes that we can follow the dose escalation with CBCT based position verification .With CBCT we can consider entire prostate and normal structures volume for localization. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8382 Asian Journal of Medical Science, Volume-5(2014): 14-20

Five-year results for image-guided brachytherapy (IGBT) for cervical carcinoma: a report from single institute of Thailand

2016 ◽  
Vol 16 (1) ◽  
pp. 38-45
Author(s):  
Ekkasit Tharavichitkul ◽  
Somvilai Chakrabandhu ◽  
Pitchayaponne Klunklin ◽  
Wimrak Onchan ◽  
Bongkot Jia-Mahasap ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Local Control ◽  
Clinical Target Volume ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Target Volume ◽  
Long Term Results ◽  
Image Guided ◽  
Grade 3

AbstractAimTo report of long-term results and toxicity profiles using image-guided brachytherapy (IGBT) combined with whole pelvic radiation therapy (WPRT) for cervical carcinoma.Materials and MethodsIn total, 52 patients with locally advanced cervical carcinoma were enrolled into the study. WPRT was used to treat the clinical target volume (CTV) with a dose of 45–50·4 Gy in 23–28 fractions. IGBT using computed tomography was performed at the dose of 6·5–7 Gy×4 fractions to the minimum dose covering 90% of target volume (D90) of high-risk clinical target volume (HR-CTV).ResultsThe mean cumulative dose in equivalent doses of 2 Gy for the D90 of HR-CTV, dose at 2% at refereed volume (D2cc) of bladder, D2cc of rectum and D2cc of sigmoid colon were 92·4, 87·9, 69·6, and 72 Gy, respectively. At the median follow-up time of 61 months, the 5-year local control, disease-free survival, and overall survival rates were 96·2, 75 and 84·6% respectively. Two patients (3·8%) developed grade 3–4 gastrointestinal and two patients (3·8%) developed grade 3–4 genitourinal toxicities.ConclusionThe combination of WPRT plus IGBT showed very promising long-term results with excellent local control and toxicity profiles.

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