High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes

James W Anderson; Junyi Xia; Ryan T Flynn; Joseph M Modrick; Sudershan K Bhatia; Geraldine M Jacobson; Yusung Kim

doi:10.5114/jcb.2013.36180

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High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes

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High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes

James W Anderson, Junyi Xia, Ryan T Flynn, Joseph M Modrick, Sudershan K Bhatia, Geraldine M Jacobson and Yusung Kim

Journal of contemporary brachytherapy, Vol.5(2), pp.101-109

06/2013

DOI: 10.5114/jcb.2013.36180

PMCID: PMC3708151

PMID: 23878555

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Abstract

Purpose: To evaluate conventional brachytherapy (BT) plans using dose-volume parameters and high resolution (3 Tesla) MRI datasets, and to quantify dosimetric benefits and limitations when MRI-guided, conformal BT (MRIG-CBT) plans are generated. Material and methods: Fifty-five clinical high-dose-rate BT plans from 14 cervical cancer patients were retrospectively studied. All conventional plans were created using MRI with titanium tandem-and-ovoid applicator (T&O) for delivery. For each conventional plan, a MRIG-CBT plan was retrospectively generated using hybrid inverse optimization. Three categories of high risk (HR)-CTV were considered based on volume: non-bulky (< 20 cc), low-bulky (> 20 cc and < 40 cc) and bulky (≥ 40 cc). Dose-volume metrics of D90 of HR-CTV and D2cc and D0.1cc of rectum, bladder, and sigmoid colon were analyzed. Results: Tumor coverage (HR-CTV D90) of the conventional plans was considerably affected by the HR-CTV size. Sixteen percent of the plans covered HR-CTV D90 with the prescription dose within 5%. At least one OAR had D2cc values over the GEC-ESTRO recommended limits in 52.7% of the conventional plans. MRIG-CBT plans showed improved target coverage for HR-CTV D90 of 98 and 97% of the prescribed dose for non-bulky and low-bulky tumors, respectively. No MRIG-CBT plans surpassed the D2cc limits of any OAR. Only small improvements (D90 of 80%) were found for large targets (> 40 cc) when using T&O applicator approach. Conclusions: MRIG-CBT plans displayed considerable improvement for tumor coverage and OAR sparing over conventional treatment. When the HR-CTV volume exceeded 40 cc, its improvements were diminished when using a conventional intracavitary applicator.

Cervical Cancer

Original Paper

high-dose-rate brachytherapy

MRI-guided brachytherapy

brachytherapy

Details

Title: Subtitle: High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes
Creators: James W Anderson - Radiation Oncology Department, Rush University, Chicago
Junyi Xia - Radiation Oncology Department, University of Iowa, Iowa City
Ryan T Flynn - Radiation Oncology Department, University of Iowa, Iowa City
Joseph M Modrick - Radiation Oncology Department, University of Iowa, Iowa City
Sudershan K Bhatia - Radiation Oncology Department, University of Iowa, Iowa City
Geraldine M Jacobson - Radiation Oncology Department, West Virginia University, Morgantown, USA
Yusung Kim - Radiation Oncology Department, University of Iowa, Iowa City
Resource Type: Journal article
Publication Details: Journal of contemporary brachytherapy, Vol.5(2), pp.101-109
DOI: 10.5114/jcb.2013.36180
PMID: 23878555
PMCID: PMC3708151
NLM abbreviation: J Contemp Brachytherapy
ISSN: 1689-832X
eISSN: 2081-2841
Publisher: Termedia Publishing House
Language: English
Date published: 06/2013
Academic Unit: Radiation Oncology
Record Identifier: 9984047717702771

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