Novel use of ViewRay MRI guidance for high-dose-rate brachytherapy in the treatment of cervical cancer

Brachytherapy
Huaising C KoKristin A Bradley

Abstract

To characterize image quality and feasibility of using ViewRay MRI (VR)-guided brachytherapy planning for cervical cancer. Cervical cancer patients receiving intracavitary brachytherapy with tandem and ovoids, planned using 0.35T VR MRI at our institution, were included in this series. The high-risk clinical target volume (HR-CTV), visible gross tumor volume, bladder, sigmoid, bowel, and rectum contours for each fraction of brachytherapy were evaluated for dosimetric parameters. Typically, five brachytherapy treatments were planned using the T2 sequence on diagnostic MRI for the first and third fractions, and a noncontrast true fast imaging with steady-state precession sequence on VR or CT scan for the remaining fractions. Most patients received 5.5 Gy × 5 fractions using high-dose-rate Ir-192 following 45 Gy of whole-pelvis radiotherapy. The plan was initiated at 5.5 Gy to point A and subsequently optimized and prescribed to the HR-CTV. The goal equivalent dose in 2 Gy fractions for the combined external beam and brachytherapy dose was 85 Gy. Soft-tissue visualization using contrast-to-noise ratios to distinguish normal tissues from tumor at their interface was compared between diagnostic MRI, CT, and VR. One hundred and forty...Continue Reading

Citations

Dec 12, 2018·Current Opinion in Obstetrics & Gynecology·Puja S VenkatPhillip Beron
Apr 2, 2019·The British Journal of Radiology·Ingrid M WhiteShreerang Bhide
Nov 11, 2020·Clinical Oncology : a Journal of the Royal College of Radiologists·M Ingle, S Lalondrelle

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