Three-dimensional image-based planning for cervix brachytherapy with bilateral hip prostheses: A solution using MVCT with helical tomotherapy
Received 24 December 2008; received in revised form 26 June 2009; accepted 16 July 2009. published online 02 March 2010.
Abstract
Purpose
We present a method of three-dimensional image-based planning for cervix high-dose-rate (HDR) brachytherapy for patients with bilateral metal hip prostheses using megavoltage computed tomography (MVCT) imaging.
Methods and Materials
Two patients with bilateral metal hip prostheses were treated with our standard HDR brachytherapy fractionation and critical structure tolerance limits for cervical cancer. MVCT imaging was used for treatment planning because of artifacts present in kilovoltage computed tomography (kVCT), which did not allow visualization of the organs of interest.
Results
The MVCT images provided adequate contrast to allow the contouring of organs at risk and the digitization of HDR applicators. HDR brachytherapy treatment planning was successfully accomplished based on MVCT images for 2 patients with bilateral metal hip prostheses.
Conclusions
Using MVCT imaging eliminated streak artifacts, which improved the image quality for treatment planning. MVCT offers an option for three-dimensional planning for cervix brachytherapy in patients with bilateral hip prostheses.
1Department of Physics & Engineering, London Regional Cancer Program, London, Ontario, Canada
2Department of Oncology, University of Western Ontario, London, Ontario, Canada
3Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
4Department of Medical Physics, Odette Cancer Centre, Toronto, Ontario, Canada
5Department of Epidemiology/Biostatistics, University of Western Ontario, London, Ontario, Canada
Corresponding author: Department of Medical Physics, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Tel.: +416-480-6100 ext. 83758; fax: +416-480-6801.
ABSTRACT