Preplanning magnetic resonance imaging (MRI) is routinely used in image-guided adaptive brachytherapy (IGABT) for cervical cancer. However, a preplanning MRI performed without an applicator does not have good accuracy of image fusion with a planning computed tomography (CT) performed with an applicator. This study aimed to evaluate the efficacy of laminaria tent insertion during pre-planning MRI for cervical cancer brachytherapy (BT).
METHODS AND MATERIALS
Sixteen patients with cervical cancer were enrolled in the study. Images obtained from a single preplanning MRI performed with a laminaria tent inserted into the cervix were fused with images from the planning CT performed with an applicator during each BT session. The alignment between the high-risk clinical target volume on MRI (HR-CTVMRI) and planning CT (HR-CTVCT) was assessed. Image fusion accuracy was classified as follows: maximum misalignment between HR-CTVMRI and HR-CTVCT <5 mm was excellent, 5–10 mm as available, and >10 mm as not available. Image fusion accuracy was reviewed by two radiation oncologists.
Fifty-nine BT sessions were analyzed. Fusion images for 39 (66%) sessions were categorized as excellent, and those for the remaining 12 (20%) sessions were available, and 8 (14%) were not available. Complications reported after laminaria tent insertion were grade-1 fever for 5 (8%) BT sessions in 5 patients and grade-1 pain for 8 (13%) sessions in 5 patients.
Laminaria tent insertion during pre-planning MRI may improve the accuracy of image fusion with planning CT and may help delineate the HR-CTV in CT-based IGABT for cervical cancer.
Abbreviations:ABS (American Brachytherapy Society), BT (Brachytherapy), CT (Computed tomography), D&C (Dilation and curettage), ICBT (Intracavitary brachytherapy), IGABT (Image-guided adaptive brachytherapy), ISBT (Interstitial brachytherapy), MRI (Magnetic resonance imaging), THA (Total hip arthroplasty), TPS (Treatment planning system)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Brachytherapy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (I): Concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV.Radiother Oncol. 2005; 74: 235-245
- Recommendations from gynaecological (GYN) GEC ESTRO working group (II): Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology.Radiother Oncol. 2006; 78: 67-77
- Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group: Considerations and pitfalls in commissioning and applicator reconstruction in 3D image-based treatment planning of cervix cancer brachytherapy.Radiother Oncol. 2010; 96: 153-160
- Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy.Radiother Oncol. 2012; 103: 113-122
- Image guided cervical brachytherapy: 2014 Survey of the American Brachytherapy Society.Int J Radiat Oncol Biol Phys. 2016; 94: 598-604
- National survey of intracavitary brachytherapy for intact uterine cervical cancer in Japan.J Radiat Res. 2018; 59: 469-476
- The use of Laminaria japonica in intracavitary radiation therapy when anesthesia is contraindicated.Int J Radiat Oncol Biol Phys. Sep 1983; 9: 1405-1406
- The use of laminarias for osmotic dilation of the cervix in gynecological brachytherapy applications.Int J Radiat Oncol Biol Phys. 1998; 42: 1049-1053
- Computed tomography versus magnetic resonance imaging-based contouring in cervical cancer brachytherapy: Results of a prospective trial and preliminary guidelines for standardized contours.Int J Radiat Oncol Biol Phys. 2007; 68: 491-498
- Comparison and consensus guidelines for delineation of clinical target volume for CT- and MR-based brachytherapy in locally advanced cervical cancer.Int J Radiat Oncol Biol Phys. 2014; 90: 320-328
Published online: December 18, 2021
Accepted: October 5, 2021
Received in revised form: September 26, 2021
Received: July 20, 2021
Disclosures: All the authors report no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
© 2021 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.