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A study to assess the feasibility of using CT (±diagnostic MRI) instead of MRI at brachytherapy in image guided brachytherapy in cervical cancer

Published online by Cambridge University Press:  13 February 2014

Bhavana Rai ,
Firuza D. Patel ,
Parsee Tomar ,
Oinam A. Singh ,
Vijai Simha ,
Bhaswanth Dhanireddy  and
Suresh C. Sharma
Bhavana Rai*
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
Firuza D. Patel
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
Parsee Tomar
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
Oinam A. Singh
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
Vijai Simha
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
Bhaswanth Dhanireddy
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
Suresh C. Sharma
Affiliation:
Post Graduate Institute of Medical Education and Research, Chandigarh, India
*
Correspondence to: Bhavana Rai, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Tel: +91-9814635706; +91-172-2735451, E-mail: bhavana1035@gmail.com
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Abstract

Purpose

To compare the contours and dose volume histograms (DVH) parameters of the high-risk clinical target volume (HRCTV) contoured on computed tomography (CT) using clinical findings at brachytherapy, clinical findings at brachytherapy with magnetic resonance imaging (MRI) at diagnosis and HRCTV defined on MRI at brachytherapy in cervical cancer patients.

Materials and methods

Fifteen patients undergoing MRI-guided image-based brachytherapy underwent both CT and MRI after applicator insertion. Two sets of contours were defined on CT. In the first set, the HRCTV was defined with the help of clinical findings at brachytherapy (CT-HRCTV). In the second set, HRCTV was defined with MRI at diagnosis and clinical findings at brachytherapy (CT-HRCTVdmri). This was compared with the HRCTV defined on MRI at brachytherapy (MR-HRCTV). The doses to the organs at risk (OARs) were compared for CT and MRI.

Results

A significant overestimation of the maximum width and width at point A was observed for CT-HRCTV (p −0·00; 0·00) and CT-HRCTVdmri (p −0·03; 0·01), respectively. The height was underestimated with CT-HRCTV in patients with intrauterine disease extension. For a single fraction, the mean difference in the D90 for the CT contours was <1 Gy. The doses to the OARs were comparable.

Conclusions

CT may be an alternative when facilities for MRI image-based brachytherapy are lacking, provided at least one MRI is available before brachytherapy.

Keywords

cervical cancercomputed tomographyimage-guided brachytherapymagnetic resonance imaging
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 13 , Issue 4 , December 2014 , pp. 438 - 446
Copyright
Copyright © Cambridge University Press 2014 

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