Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy.
Conclusions: We describe a virtual pre-planning technique using a multi-interstitial and endocavitary perineal template. It is based on a virtual work with MRI images. This procedure has shown to be feasible and efficient in clinical practice by facilitating the work of specialists, and reducing uncertainties of the application. PMID: 29204168 [PubMed]
To evaluate the optimal concentration of an Magnetic Resonance Imaging (MRI) marker agent used for Vienna applicator reconstruction in MRI-guided High-Dose-Rate brachytherapy (HDR-BT) for cervical cancer.
For cervical brachytherapy planning, magnetic resonance imaging (MRI) is preferable to computed tomography (CT) for target delineation. However, due to logistical and financial restrictions, in-room MRI is not routinely available in brachytherapy centers in the United States. Our institution has created a workflow that integrates MRI based target delineation with an in-room CT scanner. After the initial fraction of CT guided brachytherapy is delivered, an MRI is acquired and fused to subsequent planning CT ’s (fractions 2-5) with the aim of improving target coverage and improving conformality.
International brachytherapy consortia are advocating for the incorporation of magnetic resonance imaging (MRI) into the cervical brachytherapy process as a standard-of-care. Although some evaluations have been performed to quantify the effect on procedural time, little is known about the views and experiences of key stakeholders during the transition from CT to MR-guided brachytherapy. This qualitative research project explored insights from key stakeholders related to a change in the gynaecological brachytherapy process.
We present the first prospective study comparing CT-based target delineation with incorporation of trans-rectal ultrasonography at BT and gold standard approach of MR-based target delineation and report comparable results. These findings have a potential impact on brachytherapy practice for cervical cancers across the globe.
Abstract Imaging has probably been the most important driving force for the development of brachytherapy treatments the last 20 years. Due to implementation of three-dimensional imaging, brachytherapy is nowadays a highly accurate and reliable treatment option for many cancer patients. To be able to optimize the dose distribution in brachytherapy the anatomy and the applicator(s) or sources should be correctly localised in the images. For computed tomography (CT) the later criteria is easily fulfilled for most brachytherapy sites. However, for many sites, like cervix and prostate, CT is not optimal for delineation...
To compare CT- and MRI-based brachytherapy (BT) target volumes for patients with advanced cervical cancer so as to identify those who benefit most from MRI-based planning. We also studied how the natural mobility of the organ at risks (OARs) affects the given doses.
Image-guided adaptive brachytherapy (IGABT) is the new gold standard for cervix cancer brachytherapy. A survey of UK practice showed that the proportion of centres offering computed tomography or magnetic resonance imaging (MRI)-based IGABT rose from 26% in 2008 to 71% in 2011 . This interest is reflected worldwide, with>250 publications on the subject over the past 5 years according to PubMed. The uptake of IGABT is particularly notable as it has occurred without the benefit of a single randomised clinical trial.
Conclusion: These findings indicate that 3D-based ICR plans improve tumor coverage while satisfying the dose constraints for OARs. 3D-based ICR should be considered in patients with tumors> 4 cm size at the time of brachytherapy or> 5 cm initially. PMID: 29713255 [PubMed - in process]
Conclusions: A curative intent strategy including brachytherapy is feasible in patients with CCBI, with VVF occurrence in 24% of the patients. MRI patterns help predicting VVF occurrence. Methods: Patients with locally advanced CCBI treated with (chemo)radiation ± brachytherapy in our institute from 1989 to 2015 were analyzed. Reviews of baseline magnetic resonance imaging (MRI) scans were carried out blind to clinical data, retrieving potential parameters correlated to VVF formation (including necrosis and tumor volume). PMID: 29507691 [PubMed]
International brachytherapy consortiums are advocating for the incorporation of magnetic resonance imaging (MRI) into the cervical brachytherapy process as a standard-of-care. Although some evaluations have been performed to quantify the effect on procedural time, little is known about the views and experiences of key stakeholders during the transition from CT to MR-guided brachytherapy. This qualitative research project explored insights from key stakeholders related to a change in the gynaecological brachytherapy process.