Faculty Collaboration Database

Three-dimensional imaging in gynecologic brachytherapy: a survey of the American Brachytherapy Society. Int J Radiat Oncol Biol Phys 2010 Jan 01;76(1):104-9

Date

07/22/2009

Pubmed ID

19619956

DOI

10.1016/j.ijrobp.2009.01.043

Scopus ID

2-s2.0-72049083210 (requires institutional sign-in at Scopus site)   184 Citations

Abstract

PURPOSE: To determine current practice patterns with regard to three-dimensional (3D) imaging for gynecologic brachytherapy among American Brachytherapy Society (ABS) members.

METHODS AND MATERIALS: Registered physician members of the ABS received a 19-item survey by e-mail in August 2007. This report excludes physicians not performing brachytherapy for cervical cancer.

RESULTS: Of the 256 surveys sent, we report results for 133 respondents who perform one or more implantations per year for locally advanced cervical cancer. Ultrasound aids 56% of physicians with applicator insertion. After insertion, 70% of physicians routinely obtain a computed tomography (CT) scan. The majority (55%) use CT rather than X-ray films (43%) or magnetic resonance imaging (MRI; 2%) for dose specification to the cervix. However, 76% prescribe to Point A alone instead of using a 3D-derived tumor volume (14%), both Point A and tumor volume (7%), or mg/h (3%). Those using 3D imaging routinely contour the bladder and rectum (94%), sigmoid (45%), small bowel (38%), and/or urethra (8%) and calculate normal tissue dose-volume histogram (DVH) analysis parameters including the D2cc (49%), D1cc (36%), D0.1cc (19%), and/or D5cc (19%). Respondents most commonly modify the treatment plan based on International Commission on Radiation Units bladder and/or rectal point dose values (53%) compared with DVH values (45%) or both (2%).

CONCLUSIONS: More ABS physician members use CT postimplantation imaging than plain films for visualizing the gynecologic brachytherapy apparatus. However, the majority prescribe to Point A rather than using 3D image based dosimetry. Use of 3D image-based treatment planning for gynecologic brachytherapy has the potential for significant growth in the United States.

Author List

Viswanathan AN, Erickson BA

Author

Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Brachytherapy
Female
Health Care Surveys
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Practice Patterns, Physicians'
Radiation Oncology
Radiotherapy Dosage
Rectum
Societies, Medical
Tomography, X-Ray Computed
Tumor Burden
Ultrasonography, Interventional
United States
Urinary Bladder
Uterine Cervical Neoplasms