Assessment of Bladder Motion for Clinical Radiotherapy Practice Using Cine–Magnetic Resonance Imaging

McBain, Catherine; Khoo, Vincent; Buckley, David L.; Sykes, J.; Green, Melanie; Cowan, Richard A; Hutchinson, Charles E.; Moore, Christopher; Price, Patricia M

doi:10.1016/j.ijrobp.2008.11.040

Cited by 45 publications

(35 citation statements)

References 23 publications

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“…The greater interfraction variability of bladder positioning due to variable filling precludes more aggressive optimisation of bladder dose without daily soft tissue imaging and adaptive radiotherapy planning. 33,34 A greater reduction in bladder dose was observed with IMRT over 3DCRT in the p + SVs target group.…”

Section: Discussionmentioning

confidence: 96%

“…The bladder doses were comparable for all plans in the p‐only target group; however, little emphasis was placed on reducing the dose to the bladder apart from reducing V50 Gy. The greater interfraction variability of bladder positioning due to variable filling precludes more aggressive optimisation of bladder dose without daily soft tissue imaging and adaptive radiotherapy planning 33,34 . A greater reduction in bladder dose was observed with IMRT over 3DCRT in the p + SVs target group.…”

Section: Discussionmentioning

confidence: 99%

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Rectal dose reduction with IMRT for prostate radiotherapy

et al. 2010

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Dose escalation in radiation therapy has led to increased control rates with some clinical trial evidence that rectal toxicity may be reduced when using intensity-modulated radiotherapy (IMRT) over 3D conformal radiotherapy (3DCRT) for dose-escalated prostate radiotherapy. However, IMRT for prostate patients is not yet standard in many Australian radiation oncology centres. This study investigates dosimetric changes that can be observed between IMRT and 3DCRT in prostate radiotherapy. Fifteen patients were selected for analysis. Two target definitions were investigated--prostate-only and prostate plus seminal vesicles (p + SVs). A five-field 3DCRT and seven-field IMRT plan were created for each patient and target definition. The planning target volume coverage was matched for both plans. Doses to the rectum, bladder and femoral heads were compared using dose volume histograms. The rectal normal tissue complication probabilities (NTCPs) were calculated and compared for the 3DCRT and IMRT plans. The delivery efficiency was investigated. The IMRT plans resulted in reductions in the V25, V50, V60, V70 and V75 Gy values for both the prostate-only and p + SVs targets. Rectal NTCP was reduced with IMRT for three different sets of model parameters. The reductions in rectal dose and NTCP were much larger for the p + SVs target. Delivery of IMRT plans was less efficient than for 3DCRT plans. IMRT resulted in superior plans based on dosimetric and biological endpoints. The dosimetric gains with IMRT were greater for the more complex p + SVs target. The gains made came at the cost of decreased delivery efficiency.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Rectal dose reduction with IMRT for prostate radiotherapy

et al. 2010

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“…Intrafraction motion and bladder filling is a concern if there is a significant daily treatment duration. Keeping the treatment time as short as possible is important to reduce intrafraction filling as a recent MRI based study has shown increased filling in intervals up to 28 minutes [5]. Studies using ultrasound [29] as well as MRI [30] have shown in certain cases filling and motion during time in the treatment bunker can be significant.…”

Section: Discussionmentioning

confidence: 99%

“…However, the potential negative of IMRT include the increased time required for RT delivery and the associated risk of bladder filling and changes in bladder shape and size. The magnitude of bladder filling during treatment delivery has recently been demonstrated to be approximately 1cm 3 per minute, but with wide inter patient variation [5]. It would be particularly problematic if highly conformal dose distributions are used which are typical for IMRT.…”

Section: Introductionmentioning

confidence: 99%

A dosimetric comparison of 3D conformal vs intensity modulated vs volumetric arc radiation therapy for muscle invasive bladder cancer

et al. 2012

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BackgroundTo compare 3 Dimensional Conformal radiotherapy (3D-CRT) with Intensity Modulated Radiotherapy (IMRT) with Volumetric-Modulated Arc Therapy (VMAT) for bladder cancer.MethodsRadiotherapy plans for 15 patients with T2-T4N0M0 bladder cancer were prospectively developed for 3-DCRT, IMRT and VMAT using Varian Eclipse planning system. The same radiation therapist carried out all planning and the same clinical dosimetric constraints were used. 10 of the patients with well localised tumours had a simultaneous infield boost (SIB) of the primary tumour planned for both IMRT and VMAT. Tumour control probabilities and normal tissue complication probabilities were calculated.ResultsMean planning time for 3D-CRT, IMRT and VMAT was 30.0, 49.3, and 141.0 minutes respectively. The mean PTV conformity (CI) index for 3D-CRT was 1.32, for IMRT 1.05, and for VMAT 1.05. The PTV Homogeneity (HI) index was 0.080 for 3D-CRT, 0.073 for IMRT and 0.086 for VMAT. Tumour control and normal tissue complication probabilities were similar for 3D-CRT, IMRT and VMAT. The mean monitor units were 267 (range 250–293) for 3D-CRT; 824 (range 641–1083) for IMRT; and 403 (range 333–489) for VMAT (P < 0.05). Average treatment delivery time were 2:25min (range 2:01–3:09) for 3D-CRT; 4:39 (range 3:41–6:40) for IMRT; and 1:14 (range 1:13–1:14) for VMAT. In selected patients, the SIB did not result in a higher dose to small bowel or rectum.ConclusionsVMAT is associated with similar dosimetric advantages as IMRT over 3D-CRT for muscle invasive bladder cancer. VMAT is associated with faster delivery times and less number of mean monitor units than IMRT. SIB is feasible in selected patients with localized tumours.

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“…This variation ranged from 2.1 to 15mL/min (Mean: 9 ± 3 mL/min). McBain et al [11] assessed the intra-fractional bladder movement using serial MR scans and demonstrated volume increase of 19%-108% associated with wall movement of up to 2.0cm occurring over a 28-min timeframe. It was estimated that the greatest bladder motion occurs in the superior direction and at the bladder dome.…”

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confidence: 99%

Re-evaluation of the value of adjunctive modern radiotherapy in muscle-invasive bladder cancer

Zaghloul

2012

JST

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A controlled prospective randomized study was recently published; comparing pre-and post-operative radiotherapy in bladder cancer patients [1] . This study was the first to compare these radical cystectomy adjunctive radiation methods. For decades left, both pre-and post-operative radiotherapy in bladder cancer had negative image for genitourinary oncologists. This unsatisfactory image was either due to insignificant improvement in the published survival rates or due to the fear of high and unacceptable late complications [2] . Abd El-Moneim et al. [1] achieved 5-year overall survival of 51% as 89% of their patients belonged to the clinical categories T3 and T4. They showed clearly that there was no difference between the 2 randomized groups; in overall survival, disease-free survival, local control and distant metastasis-free rates. It was clear from their results that both immediate postoperative complications and late serious gasterointestinal (GIT) sequalae were similar in both groups and of minimal amplitude. Late bowel complications were reported to be 4.5% in the post-operative setting and 2% in the pre-operative setting this was nearly similar to the percentages reported previously by Zaghloul et al. [3] who reported 4% and 5% grade 3+4 late bowel toxicity in conventional and hyper fractionated postoperative radiotherapy groups. In another retrospective study, a total of 12% of the patients who received PORT experienced chronic intestinal complications of different grades compared with 8% in the cystectomy alone group. There were four patients in each group (5.8% and 3.3%, respectively) that needed surgery for intestinal late complications [4] . On the other hand, much higher late GIT complications were reported by Reseinger et al. [5] . They experienced 37% late GIT complications with 22

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Assessment of Bladder Motion for Clinical Radiotherapy Practice Using Cine–Magnetic Resonance Imaging

Cited by 45 publications

References 23 publications

Rectal dose reduction with IMRT for prostate radiotherapy

Rectal dose reduction with IMRT for prostate radiotherapy

A dosimetric comparison of 3D conformal vs intensity modulated vs volumetric arc radiation therapy for muscle invasive bladder cancer

Re-evaluation of the value of adjunctive modern radiotherapy in muscle-invasive bladder cancer

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