Anatomical relationships in intracavitary irradiation demonstrated by computed tomography.

Wang, Yu; Sagerman, Robert H.; Chung, C T; King, Gerald A.; Dalal, P S; Bassano, Daniel A.; Ames, Thomas E.

doi:10.1148/radiology.143.2.7071361

Cited by 24 publications

(5 citation statements)

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“…As both point doses and dose rate can be calculated for the dose-limiting pelvic organs, a maximum and mean dose rate can be obtained for each organ, providing more information than a single point dose calculation alone (83). Useful information can be obtained such as cervical diameter (81,82,86,91,95,111); the thickness of the rectovaginal septum (86,89,91); uterine perforation (83,88,90,115); the location of the tandem in the uterus, uterine size and shape, uterine wall thickness (81,82,91,100,116,117); and the proximity of the tandem to the bladder and rectosigmoid (88,92,94). Dose at the periphery of the cervix can also be assessed and has correlated with local control (81,82,111).…”

Section: Contemporary Dosimetrymentioning

confidence: 99%

“…Use of applicators without the standard metal and rectal shields has been reported with no increase in complications (71,105,162). To eliminate beamhardening artifacts, plastic and other CT-and MRI-compatible applicators have been tested with resultant improvement in the quality of the images obtained (71,86,95,96,100,105,111,162). CT-compatible applicators made of plastic and/or carbon or other low Z materials are recommended (95,96,118,(163)(164)(165)(166).…”

Section: Applicatorsmentioning

confidence: 99%

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The sculpted pear: An unfinished brachytherapy tale

Erickson

2003

Brachytherapy

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Section: Contemporary Dosimetrymentioning

confidence: 99%

Section: Applicatorsmentioning

confidence: 99%

The sculpted pear: An unfinished brachytherapy tale

Erickson

2003

Brachytherapy

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“…This dose sparing 4 is considered essential by many practitioners to maintain normal tissue injury at acceptable levels. Attempts to circumvent metal artifacts on CT images include the use of plastic unshielded applicators 5 and use of bone-imaging window and level settings, 2 which diminish visualization of soft-tissue organ boundaries. Also, custom-made Fletcher-Suit applicators with afterloading tungsten shields can be fabricated.…”

Section: Introductionmentioning

confidence: 99%

Prospects for quantitative computed tomography imaging in the presence of foreign metal bodies using statistical image reconstruction

et al. 2002

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X-ray computed tomography (CT) images of patients bearing metal intracavitary applicators or other metal foreign objects exhibit severe artifacts including streaks and aliasing. We have systematically evaluated via computer simulations the impact of scattered radiation, the polyenergetic spectrum, and measurement noise on the performance of three reconstruction algorithms: conventional filtered backprojection (FBP), deterministic iterative deblurring, and a new iterative algorithm, alternating minimization (AM), based on a CT detector model that includes noise, scatter, and polyenergetic spectra. Contrary to the dominant view of the literature, FBP streaking artifacts are due mostly to mismatches between FBP's simplified model of CT detector response and the physical process of signal acquisition. Artifacts on AM images are significantly mitigated as this algorithm substantially reduces detector-model mismatches. However, metal artifacts are reduced to acceptable levels only when prior knowledge of the metal object in the patient, including its pose, shape, and attenuation map, are used to constrain AM's iterations. AM image reconstruction, in combination with object-constrained CT to estimate the pose of metal objects in the patient, is a promising approach for effectively mitigating metal artifacts and making quantitative estimation of tissue attenuation coefficients a clinical possibility.

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“…Another approach to overcome the problem of streak artifact commonly encountered with standard Fletcher-Suit-Delclos applicators is to use a CT-compatible device. Yu et al [12] obtained CT images using a plastic applicator which enabled better visualization of anterior rectal and posterior bladder surfaces by avoiding artifact production commonly encountered with standard Fletcher-Suit applicators. This applicator did not have bladder or rectal shielding.…”

Section: Discussionmentioning

confidence: 99%

“…One of the reasons for this lag has been the lack of a good CT-compatible tandem and ovoid device. The first CT-compatible applicators were made of plastic [12][13][14][15] with significantly different geometrical properties than the more commonly used Fletcher-Suit-Delclos device. At Duke University Medical Center, a CT-compatible tandem and ovoid applicator with the same geometric dimensions of a standard Fletcher-Suit-Delclos device was developed using an aluminum alloy [16].…”

Section: Introductionmentioning

confidence: 99%

Computed axial tomography tandem and ovoids (CATTO) dosimetry: Threedimensional assessment of bladder and rectal doses

Gebara

Weeks

Hahn

et al. 1998

Radiat. Oncol. Investig.

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SUMMARY The purpose of this work is to compare bladder and rectal dose rates in brachytherapy for carcinoma of the cervix using two different dosimetry systems: traditional orthogonal radiograph-based dosimetry vs. computed axial tomography tandem and ovoids (CATTO) dosimetry. Twenty-two patients with carcinoma of the uterine cervix received the brachytherapy component of their radiotherapy with a computedtomography compatible Fletcher-Suit-Delclos device. A total of 27 implants were performed. The average maximum bladder dose (B max ) for the implants was 85.8 cGy/hr using the CATTO system as compared to 42.6 cGy/hr using traditional dosimetry, (P < 0.005). The average maximum rectal dose (R max ) using the CATTO system was 59.2 cGy/hr as compared with 46.3 cGy/hr using the traditional system (P < 0.05). The traditional methods for choosing points to determine bladder and rectal dose rates underestimated the true B max in all cases and the R max in most. Based on the complication rates published in the literature, it is likely that the maximum tolerance dose of both the rectum and bladder, but especially the bladder, is higher than previously thought.

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Anatomical relationships in intracavitary irradiation demonstrated by computed tomography.

Cited by 24 publications

References 0 publications

The sculpted pear: An unfinished brachytherapy tale

The sculpted pear: An unfinished brachytherapy tale

Prospects for quantitative computed tomography imaging in the presence of foreign metal bodies using statistical image reconstruction

Computed axial tomography tandem and ovoids (CATTO) dosimetry: Threedimensional assessment of bladder and rectal doses

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