Cargando…

Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy

PURPOSE: To present the implementation of a magnetic resonance imaging (MRI) pre-planning technique in multi-interstitial perineal and endocavitary gynecological brachytherapy. MATERIAL AND METHODS: We used a new fully MRI-compatible applicator that is capable to engage titanium needles, and an intr...

Descripción completa

Detalles Bibliográficos
Autores principales: Rodriguez, Silvia, Otal, Antonio, Richart, Jose, Perez-Calatayud, Jose, Santos, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705827/
https://www.ncbi.nlm.nih.gov/pubmed/29204168
http://dx.doi.org/10.5114/jcb.2017.70710
_version_ 1783282101936717824
author Rodriguez, Silvia
Otal, Antonio
Richart, Jose
Perez-Calatayud, Jose
Santos, Manuel
author_facet Rodriguez, Silvia
Otal, Antonio
Richart, Jose
Perez-Calatayud, Jose
Santos, Manuel
author_sort Rodriguez, Silvia
collection PubMed
description PURPOSE: To present the implementation of a magnetic resonance imaging (MRI) pre-planning technique in multi-interstitial perineal and endocavitary gynecological brachytherapy. MATERIAL AND METHODS: We used a new fully MRI-compatible applicator that is capable to engage titanium needles, and an intrauterine tandem, developed in our department for the treatment of gynecological cervical cancer patients. This applicator is an attempt to combine the technical advantages of the Martinez universal perineal interstitial template (MUPIT) with the improvement in dose distribution by adding an intrauterine probe with the imaging advantages of MRI-based brachytherapy, thus preserving the stability, geometry, and robustness of the implant, avoiding possible errors of free-hand needle placement. A pre-brachytherapy MRI T2 acquisition is carried out with the template in place 3-5 days before the implant. On this image set, clinical target volume (CTV) is drawn. The required needles and their depths are selected accordingly to encompass the CTV (as conformal as possible). To facilitate this task, a Java based application linked to the treatment planning system has been developed. From this procedure, each needle identification and its depth are obtained previously to the implantation. With this information, the radiation oncologist proceeds with implant and then, a post-implant MRI is carried out, in which the contouring, needles, tandem reconstruction, and optimization are established. RESULTS: This pre-planning procedure has been successfully applied in 10 patients. An excellent reproduction of the virtual pre-planning has been achieved. CONCLUSIONS: We describe a virtual pre-planning technique using a multi-interstitial and endocavitary perineal template. It is based on a virtual work with MRI images. This procedure has shown to be feasible and efficient in clinical practice by facilitating the work of specialists, and reducing uncertainties of the application.
format Online
Article
Text
id pubmed-5705827
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Termedia Publishing House
record_format MEDLINE/PubMed
spelling pubmed-57058272017-12-04 Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy Rodriguez, Silvia Otal, Antonio Richart, Jose Perez-Calatayud, Jose Santos, Manuel J Contemp Brachytherapy Original Paper PURPOSE: To present the implementation of a magnetic resonance imaging (MRI) pre-planning technique in multi-interstitial perineal and endocavitary gynecological brachytherapy. MATERIAL AND METHODS: We used a new fully MRI-compatible applicator that is capable to engage titanium needles, and an intrauterine tandem, developed in our department for the treatment of gynecological cervical cancer patients. This applicator is an attempt to combine the technical advantages of the Martinez universal perineal interstitial template (MUPIT) with the improvement in dose distribution by adding an intrauterine probe with the imaging advantages of MRI-based brachytherapy, thus preserving the stability, geometry, and robustness of the implant, avoiding possible errors of free-hand needle placement. A pre-brachytherapy MRI T2 acquisition is carried out with the template in place 3-5 days before the implant. On this image set, clinical target volume (CTV) is drawn. The required needles and their depths are selected accordingly to encompass the CTV (as conformal as possible). To facilitate this task, a Java based application linked to the treatment planning system has been developed. From this procedure, each needle identification and its depth are obtained previously to the implantation. With this information, the radiation oncologist proceeds with implant and then, a post-implant MRI is carried out, in which the contouring, needles, tandem reconstruction, and optimization are established. RESULTS: This pre-planning procedure has been successfully applied in 10 patients. An excellent reproduction of the virtual pre-planning has been achieved. CONCLUSIONS: We describe a virtual pre-planning technique using a multi-interstitial and endocavitary perineal template. It is based on a virtual work with MRI images. This procedure has shown to be feasible and efficient in clinical practice by facilitating the work of specialists, and reducing uncertainties of the application. Termedia Publishing House 2017-10-10 2017-10 /pmc/articles/PMC5705827/ /pubmed/29204168 http://dx.doi.org/10.5114/jcb.2017.70710 Text en Copyright: © 2017 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ 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, 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.
spellingShingle Original Paper
Rodriguez, Silvia
Otal, Antonio
Richart, Jose
Perez-Calatayud, Jose
Santos, Manuel
Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
title Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
title_full Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
title_fullStr Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
title_full_unstemmed Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
title_short Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
title_sort pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705827/
https://www.ncbi.nlm.nih.gov/pubmed/29204168
http://dx.doi.org/10.5114/jcb.2017.70710
work_keys_str_mv AT rodriguezsilvia preplantechniquefeasibilityinmultiinterstitialendocavitaryperinealgynecologicalbrachytherapy
AT otalantonio preplantechniquefeasibilityinmultiinterstitialendocavitaryperinealgynecologicalbrachytherapy
AT richartjose preplantechniquefeasibilityinmultiinterstitialendocavitaryperinealgynecologicalbrachytherapy
AT perezcalatayudjose preplantechniquefeasibilityinmultiinterstitialendocavitaryperinealgynecologicalbrachytherapy
AT santosmanuel preplantechniquefeasibilityinmultiinterstitialendocavitaryperinealgynecologicalbrachytherapy