Evaluation of an MR-only interstitial gynecologic brachytherapy workflow using MR-line marker for catheter reconstruction.
Brachytherapy
; 19(5): 642-650, 2020.
Article
em En
| MEDLINE
| ID: mdl-32712027
ABSTRACT
PURPOSE:
Magnetic resonance imaging (MRI) offers excellent soft-tissue contrast enabling the contouring of targets and organs at risk (OARs) during gynecological interstitial brachytherapy procedure. Despite its benefit, one of the main challenges toward MRI-only workflows is that the implanted catheters are not reliably visualized on MR images. This study aims to evaluate the feasibility of MR-only workflow using an in-house MR line marker during interstitial gynecological high-dose-rate (HDR) brachytherapy. METHODS AND MATERIALS Ten patients diagnosed with locally advanced cervical cancer treated with HDR brachytherapy were included in this study. The hybrid CT/MR-treated plan was used as the study reference plan. Five users manually reconstructed the catheter's path on MR images (3D T1- and T2-weighted). Subsequently, the dwell positions from the users' plans were superimposed on the reference plans to evaluate the dosimetric impact of the using MR-only for catheter reconstruction in comparison with hybrid CT/MR approach. Variability of dwell positions between users and reconstruction time was also evaluated.RESULTS:
More than 96.90% of catheter reconstruction variations were < 2 mm. No statistical differences were reported between MR-only and hybrid CT/MR in gross tumor volume D98 and high-risk clinical target volume D90, respectively. For the OARs (bladder, sigmoid, rectum, and bowel), no significant changes were observed in any dose metrics between MR-only and hybrid CT/MR. The average reconstruction time was 51 ± 10 minutes across all ten patients.CONCLUSION:
The feasibility of MR-only workflow using MR line marker during interstitial gynecological HDR brachytherapy has been validated in this study. The results show that the MR-only workflow is equivalent to the conventional hybrid CT/MR approach in terms of gross tumor volume and high-risk clinical target volume coverage and respecting of OARs dose limits.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Vaginais
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Planejamento da Radioterapia Assistida por Computador
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Braquiterapia
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Neoplasias do Colo do Útero
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Neoplasias do Endométrio
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Catéteres
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article