Abstract
PURPOSE
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.
RESULTS
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.
CONCLUSION
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.
Keywords
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
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References
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Article info
Publication history
Published online: December 18, 2021
Accepted:
October 5,
2021
Received in revised form:
September 26,
2021
Received:
July 20,
2021
Footnotes
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.
Identification
Copyright
© 2021 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
