MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report

  • Primoz Petric National Center for Cancer Care and Research
  • Robert Hudej Institute of Oncology Ljubljana
  • Omar Hanuna Institute of Oncology Ljubljana
  • Primož Marolt Institute of Oncology Ljubljana
  • Nora Mohammed Al-Hammadi National Center for Cancer Care and Research
  • Mohamed Riyas National Center for Cancer Care and Research
  • Barbara Šegedin Institute of Oncology Ljubljana

Abstract

Background and Purpose: Optimal applicator insertion is a precondition for the success of cervix cancer brachytherapy (BT). We aimed to assess feasibility and efficacy of MRI-assisted pre-planning, based on applicator insertion in para-cervical anaesthesia (PCA).

Materials and Methods: Five days prior to BT, the pre-planning procedure was performed in 18 cervix cancer patients: tandem-ring applicator was inserted under PCA, pelvic MRI obtained and applicator removed. Procedure tolerability was assessed. High Risk Clinical Target Volume (HR CTV) and organs at risk were delineated on the pre-planning MRI, virtual needles placed at optimal positions, and dose planning performed. At BT, insertion was carried out in subarachnoidal anesthesia according to pre-planned geometry. Pre-planned and actual treatment parameters were compared.

Results: Pre-planning procedure was well tolerated. Median difference between the pre-planned and actual needle insertion depth and position were 2 (0-10) mm and 4 (0-30) degrees, respectively. The differences between the pre-planned and actual geometric and dosimetric parameters were statistically non-significant. All actual needles were positioned inside the HR CTV and outside the OAR.

Conclusions: Our pre-planning approach is well tolerated and effective. Pre-planned geometry and dose distribution can be reproduced at BT.

Author Biographies

Primoz Petric, National Center for Cancer Care and Research
Senior consultant radiation oncologist Radiotherapy department
Robert Hudej, Institute of Oncology Ljubljana
Medical physicist, Department of brachytherapy
Omar Hanuna, Institute of Oncology Ljubljana
Dosimetrist, Department of brachytherapy
Primož Marolt, Institute of Oncology Ljubljana
Dosimetrist, Department of brachytherapy
Nora Mohammed Al-Hammadi, National Center for Cancer Care and Research
Chairperson and Senior consultant radiation oncologist, Radiotherapy department
Mohamed Riyas, National Center for Cancer Care and Research
Consultant radiation oncologist, Radiotherapy department
Barbara Šegedin, Institute of Oncology Ljubljana

Radiation oncologist, Department of Brachytherapy

Published
2014-08-27
How to Cite
Petric, P., Hudej, R., Hanuna, O., Marolt, P., Mohammed Al-Hammadi, N., Riyas, M., & Šegedin, B. (2014). MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report. Radiology and Oncology, 48(3). Retrieved from https://radioloncol.com/index.php/ro/article/view/2068
Section
Clinical oncology