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

Authors

James W. Anderson, Rush University
Junyi Xia, University of Iowa
Ryan T. Flynn, University of Iowa
Joseph M. Modrick, University of Iowa
Sudershan K. Bhatia, University of Iowa
Geraldine M. Jacobson, West Virginia University
Yusung Kim, University of Iowa

Author ORCID Identifier

N/A

N/A

https://orcid.org/0000-0002-8604-6047

https://orcid.org/0000-0002-2006-885X

https://orcid.org/0000-0003-2760-531X

https://orcid.org/0000-0002-1737-221X

https://orcid.org/0000-0002-8528-4465

Document Type

Article

Publication Date

2013

College/Unit

School of Medicine

Department/Program/Center

Radiation Oncology

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 D_2cc and D_0.1cc 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 D_2cc 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 D_2cc 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.

Digital Commons Citation

Anderson, James W.; Xia, Junyi; Flynn, Ryan T.; Modrick, Joseph M.; Bhatia, Sudershan K.; Jacobson, Geraldine M.; and Kim, Yusung, "High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes" (2013). Faculty & Staff Scholarship. 2668.
https://researchrepository.wvu.edu/faculty_publications/2668

Source Citation

Anderson, J., Xia, J., Flynn, R., Modrick, J., Bhatia, S., & Jacobson, G. et al. (2013). Original paper
High resolution (3 Tesla) MRI-guided conformal brachytherapy for cervical cancer: consequences of different high-risk CTV sizes. Journal of Contemporary Brachytherapy, 5(2), 101-109. https://doi.org/10.5114/jcb.2013.36180

Comments

© 2013 Termedia Sp. z o. o. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.