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The departmental impact of magnetic resonance imaging in the management of cervical cancer brachytherapy: a discussion paper

Published online by Cambridge University Press:  28 November 2011

M.J. Warren  and
A. Eddy
M.J. Warren*
Affiliation:
Radiotherapy Group, North West Medical Physics, Christie NHS Foundation Trust, Wilmslow Road, Manchester, UK
A. Eddy
Affiliation:
Radiotherapy Group, North West Medical Physics, Christie NHS Foundation Trust, Wilmslow Road, Manchester, UK
*
Correspondence to: Warren MJ, BSc (Hons) Radiotherapy, Bsc (Hons) Physics, Radiotherapy Group, North West Medical Physics, Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX Tel: 0161 446 8429. E-mail: markjwarren@hotmail.co.uk
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Abstract

This discussion paper will explore the impact of using Magnetic Resonance Imaging (MRI) in the treatment of cervical cancer with brachytherapy. It is written from the perspective of current departmental practice in the UK and aims to highlight the issues associated with using MRI as a tool for image guided brachytherapy planning. To support the discussion, a literature review was undertaken focussing specifically on the use of MRI in brachytherapy treatment planning for cervical cancer. Results from planning case studies and clinical series were analysed, and the literature showed that image guided brachytherapy treatment planning is a promising development. MRI assisted planning could theoretically be implemented in centres that have access to a MRI scanner. Alternative brachytherapy technologies (e.g. Computed Tomography (CT) assisted planning), and alternative radiotherapy modalities (e.g. an external beam radiotherapy boost), were not found to be superior in effect or of implementation. Although MRI shows great promise, the evidence base for MRI in brachytherapy planning for cervical cancer is currently limited and therefore careful implementation and evaluation is required. It is suggested by the authors that new methods of working are devised to ensure consistency and quality in implementation and delivery, and that outcomes are measured and audited to evaluate efficacy.

Keywords

Brachytherapymagnetic resonance imaging (MRI)cervical cancerplanning
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 11 , Issue 4 , December 2012 , pp. 201 - 208
Copyright
Copyright © Cambridge University Press 2011

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References

Radstone, D, Kunkler, I. Cervix, body of uterus, ovary, vagina, vulva, gestational trophoblastic tumours. In: Bomford, CK, Kunkler, IH (eds), Walter and Miller’s Textbook of Radiotherapy, Radiation Physics Therapy And Oncology, 6th edn. London, Churchill Livingstone, 2003, pp. 456–487.Google Scholar
Dewitt, KD, Hsu, IC, Speight, J, Weinberg, VK, Lessard, E, Pouliot, J. 3D inverse treatment planning for the tandem and ovoid applicator in cervical cancer. Int J Radiat Oncol Biol Phys 2005; 63:1270–1274.CrossRefGoogle ScholarPubMed
National Institute for Health and Clinical Excellence. Interventional procedures overview of high dose rate brachytherapy for carcinoma of the cervix. London, National Institute for Clinical Excellence, 2005.Google Scholar
The Royal College of Radiologists. Implementing image-guided brachytherapy for cervix cancer in the UK. London, The Royal College of Radiologists, 2009.Google Scholar
Chajon, E, Dumas, I, Touleimat, M, Magné, N, Coulot, J, Verstraet, R, Lefkopoulos, D, Haie-Meder, C. Inverse planning approach for 3-D MRI-based pulse-dose rate intracavitary brachytherapy in cervix cancer. Int J Radiat Oncol Biol Phys 2007; 69:955–961.CrossRefGoogle ScholarPubMed
Sankaranarayanan, R, Ferlay, J. Worldwide burden of gynaecological cancer: the size of the problem. Best Pract Res Clin Obstet Gynaecol 2006; 20:207–225.CrossRefGoogle ScholarPubMed
Patrick, P, Michel, R. Diagnosis and management of cervical cancer. BMJ 2007; 345:765–768.Google Scholar
Kehoe, S. Treatments for gynaecological cancers. Best Pract Res Clin Obstet Gynaecol 2006; 20:985–1000.Google Scholar
Logsdon, MD, Eifel, PJ. Figo IIIB squamous cell carcinoma of the cervix: an analysis of prognostic factors emphasizing the balance between external beam and intracavitary radiation therapy. Int J Radiat Oncol Biol Phys 1999; 43:763–775.CrossRefGoogle ScholarPubMed
Pötter, R, Dimopoulos, J, Georg, P, Lang, S, Waldhäusl, C, Wachter-Gerstner, N, Weitmann, H, Reinthaller, A, Knocke, TH, Wachter, S, Kirisits, C. Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer. Radiother Oncol 2007; 83:148–155.Google Scholar
Viswanathan, AN. The Frank Ellis memorial lecture: the use of three-dimensional imaging in gynaecological radiation therapy. Clin Oncol (R Coll Radiol) 2008; 20:1–5.CrossRefGoogle ScholarPubMed
Khoo, VS, Dearnaley, DP, Finnigan, DJ, Padhani, A, Tanner, SF, Leach, MO. Magnetic resonance imaging (MRI): considerations and applications in radiotherapy treatment planning. Radiother Oncol 1997; 42:1–15.CrossRefGoogle Scholar
Barillot, I, Reynaud-Bougnoux, A. The use of MRI in planning radiotherapy for gynaecological tumours. Cancer Imaging 2006; 6:100–106.CrossRefGoogle ScholarPubMed
Dimopoulos, JC, Schard, G, Berger, D, Lang, S, Goldner, G, Helbich, T, Pötter, R. Systematic evaluation of MRI findings in different stages of treatment of cervical cancer: potential of MRI on delineation of target, pathoanatomic structures, and organs at risk. Int J Radiat Oncol Biol Phys 2006; 64:1380–1388.CrossRefGoogle ScholarPubMed
Haie-Meder, C, Pötter, R, Van Limbergen, E, Briot, E, De Brabandere, M, Dimopoulos, J, Dumas, I, Hellebust, TP, Kirisits, C, Lang, S, Muschitz, S, Nevinson, J, Nulens, A, Petrow, P, Wachter-Gerstner, N; Gynaecological (GYN) GEC-ESTRO Working Group. 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.CrossRefGoogle Scholar
Pötter, R, Haie-Meder, C, Van Limbergen, E, Barillot, I, De Brabandere, M, Dimopoulos, J, Dumas, I, Erickson, B, Lang, S, Nulens, A, Petrow, P, Rownd, J, Kirisits, C; GEC ESTRO Working Group. 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.CrossRefGoogle Scholar
Anderson, C, Beenstock, V, Bryant, L, Chapman, C et al. HDR brachytherapy of the cervix: The Mount Vernon Experience. Brachytherapy User Group Meeting, Leeds; 2008.Google Scholar
Haack, S, Nielsen, SK, Lindegaard, JC, Gelineck, J, Tanderup, K. Applicator reconstruction in MRI 3D image-based dose planning of brachytherapy for cervical cancer. Radiother Oncol 2009; 91:187–193.Google Scholar
Huh, SJ, Park, W, Han, Y. Interfractional variation in position of the uterus during radical radiotherapy for cervical cancer. Radiother Oncol 2004; 71:73–79.Google Scholar
Hellebust, TP, Tanderup, K, Bergstrand, ES, Knutsen, BH, Røislien, J, Olsen, DR. Reconstruction of a ring applicator using CT imaging: impact of the reconstruction method and applicator orientation. Phys Med Biol 2007; 52:4893–4904.CrossRefGoogle ScholarPubMed
Duan, J, Kim, RY, Elassal, S, Lin, HY, Shen, S. Conventional high-dose-rate brachytherapy with concomitant complementary IMRT boost: a novel approach for improving cervical tumor dose coverage. Int J Radiat Oncol Biol Phys 2008; 71:765–771.CrossRefGoogle ScholarPubMed
Kirisits, C, Lang, S, Dimopoulos, J, Berger, D, Georg, D, Pötter, R. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: design, application, treatment planning, and dosimetric results. Int J Radiat Oncol Biol Phys 2006; 65:624–630.CrossRefGoogle ScholarPubMed
Viswanathan, AN, Dimopoulos, J, Kirisits, C, Berger, D, Pötter, R. 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.CrossRefGoogle ScholarPubMed
Berger, D, Dimopoulos, J, Georg, P, Georg, D, Pötter, R, Kirisits, C. Uncertainties in assessment of the vaginal dose for intracavitary brachytherapy of cervical cancer using a tandem-ring applicator. Int J Radiat Oncol Biol Phys 2007; 67:1451–1459.CrossRefGoogle ScholarPubMed
De Brabandere, M, Mousa, AG, Nulens, A, Swinnen, A, Van Limbergen, E. Potential of dose optimisation in MRI-based PDR brachytherapy of cervix carcinoma. Radiother Oncol 2008; 88:217–226.CrossRefGoogle ScholarPubMed
Lindegaard, JC, Tanderup, K, Nielsen, SK, Haack, S, Gelineck, J. MRI-guided 3D optimization significantly improves DVH parameters of pulsed-dose-rate brachytherapy in locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 2008; 71:756–764.CrossRefGoogle ScholarPubMed
Langa, S, Nulensb, A, Briotc, E et al. Intercomparison of treatment concepts for MR image assisted brachytherapy of cervical carcinoma based on GYN GEC-ESTRO recommendations. Radiother Oncol 2006; 78:185–193.Google Scholar
Narayan, K, van Dyk, S, Bernshaw, D, Rajasooriyar, C, Kondalsamy-Chennakesavan, S. Comparative study of LDR (Manchester system) and HDR image-guided conformal brachytherapy of cervical cancer: patterns of failure, late complications, and survival. Int J Radiat Oncol Biol Phys 2009; 74:1529–1535.Google Scholar
Tan, LT, Coles, CE, Hart, C, Tait, E. Clinical impact of computed tomography-based image-guided brachytherapy for cervix cancer using the tandem-ring applicator – the Addenbrooke’s experience. Clin Oncol (R Coll Radiol) 2009; 21:175–182.Google Scholar
Barraclough, LH, Swindell, R, Livsey, JE, Hunter, RD, Davidson, SE. External beam boost for cancer of the cervix uteri when intracavitary therapy cannot be performed. Int J Radiat Oncol Biol Phys 2008; 71:772–778.CrossRefGoogle ScholarPubMed
Georg, D, Kirisits, C, Hillbrand, M, Dimopoulos, J, Pötter, R. Image-guided radiotherapy for cervix cancer: high-tech external beam therapy versus high-tech brachytherapy. Int J Radiat Oncol Biol Phys 2008; 71:1272–1278.Google Scholar
Assenholt, MS, Petersen, JB, Nielsen, SK, Lindegaard, JC, Tanderup, K. A dose planning study on applicator guided stereotactic IMRT boost in combination with 3D MRI based brachytherapy in locally advanced cervical cancer. Acta Oncol 2008; 47:1337–1343.CrossRefGoogle Scholar
van de Bunt, L, Jurgenliemk-Schulz, IM, de Kort, GAP, Roesink, JM, Terteeg, RJHA, van der Heide, UA. Motion and deformation for cervical cancer: what margins do we need? Radiother Oncol 2008; 88:234–240.Google Scholar
Petereit, DG, Sarkaria, JN, Potter, DM, Schink, JC. High-dose-rate versus low-dose-rate brachytherapy in the treatment of cervical cancer: analysis of tumor recurrence–the University of Wisconsin experience. Int J Radiat Oncol Biol Phys 1999; 45:1267–1274.CrossRefGoogle ScholarPubMed
The Royal College of Radiologists. The Role and Development of Brachytherapy Services in the United Kingdom. London: The Royal College of Radiologists, 2007.Google Scholar
Dimopoulos, JCA, Kirisits, C, Petric, P et al. The Vienna Applicator and interstitial brachytherapy of cervical cancer: clinical feasibility and preliminary results. Int J Radiat Oncol Biol Phys 2006; 64:5.Google Scholar