Implementing MRI-based target delineation for cervical cancer treatment within a rapid workflow environment for image-guided brachytherapy: A practical approach for centers without in-room MRI

Brachytherapy
Daniel M TrifilettiTimothy N Showalter

Abstract

Magnetic resonance imaging (MRI)-based intracavitary brachytherapy offers several advantages over computed tomography (CT)-based brachytherapy, but many centers are unable to offer it at the time of brachytherapy because of logistic and/or financial considerations. We have implemented a method of integrating MRI into a CT-guided, high-dose-rate intracavitary brachytherapy workflow in clinics that do not have immediately available MRI capability. At our institution, patients receiving high-dose-rate intracavitary brachytherapy as a component of the definitive treatment of cervical cancer have a Smit sleeve placed during the first brachytherapy fraction in a dedicated suite with in-room CT-on-rails. After the first fraction of brachytherapy, an MRI is obtained with the Smit sleeve, but no applicator, in place. For each subsequent fraction, CT scans are coregistered to the MRI scan by the Smit sleeve. The gross target volume is defined by MRI and overlaid on the CT images for each brachytherapy treatment for dose optimization. This MRI-integrated workflow adds <5 minutes to the brachytherapy session for image fusion. Our initial clinical experience suggests that this approach is feasible and results in target volume reductions com...Continue Reading

References

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Citations

Oct 4, 2016·Brachytherapy·Grant HarmonMatthew M Harkenrider
Jul 10, 2018·Journal of Medical Imaging and Radiation Oncology·Sunil W DuttaTimothy N Showalter
Oct 11, 2019·Journal of Applied Clinical Medical Physics·Hualin ZhangVythialingam Sathiaseelan
Jun 14, 2019·Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznań and Polish Society of Radiation Oncology·Xavier DruetIsmael Membrive
Mar 25, 2021·Medical Physics·Hiroaki HayashiTakuya Hashizume

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