Calculation/comparison of dose to point “H” according to the ABS recommendations for HDR brachytherapy for carcinoma of the cervix to the dose to point “A” based on the revised manchester system

Howell, Rebecca M.; Prete, James J.; Wiatrowski, Wayne A.; Beat, M.; Blough, Melissa M.

doi:10.1016/s0360-3016(01)02432-4

Cited by 3 publications

(2 citation statements)

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“…These findings match the results of Howell et al . [7], showing that a plan normalized to new point A generated slightly higher doses. There is no literature describing the impact on clinical outcomes due to a 2-3% increase in overall dose.…”

Section: Discussionmentioning

confidence: 99%

Physics Contributions Dosimetric impact of point A definition on high-dose-rate brachytherapy for cervical cancer: evaluations on conventional point A and MRI-guided, conformal plans

Anderson¹,

Huang²,

Kim³

2012

jcb

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PurposeTo investigate the dosimetric impact of point A definitions on both conventional point A plans and MRI-guided conformal high-dose-rate (HDR) brachytherapy plans.Material and methodsFifty-five HDR plans of 36 patients with FIGO stage I to IV cervical cancer were retrospectively studied; these included 30 conventional treatments and 25 conformal plans. Two different point A definitions were explored: the revised Manchester point A and the new point A as recommended by the American Brachytherapy Society. Conventional plans were produced by varying only the point A definition and the normalized isodose lines. Conformal plans were retrospectively generated per GEC-ESTRO recommendations based upon 3.0 Tesla MRI data.ResultsSmall yet significant variations were found in point A locations (mean: 0.5 cm, maximum: 2.1 cm, p < 0.001). The use of a new point A caused minimal dose variation for both conventional and conformal plans. Conventional plans normalized to the new point A generated up to 12% (avg. 1-3%) higher overall dose in terms of higher total reference air kerma than plans normalized to other points. Dosimetric changes due to point A definitions were up to 11-12% (avg. less than 2%) on target volumes or organs-at-risk.ConclusionsFor both conventional and conformal plans, the new point A definition leads to smaller variations caused during implant and/or differences in patient anatomy. Using the new point A is expected to produce more consistent brachytherapy plans and improve outcome analysis.

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Section: Discussionmentioning

confidence: 99%

Physics Contributions Dosimetric impact of point A definition on high-dose-rate brachytherapy for cervical cancer: evaluations on conventional point A and MRI-guided, conformal plans

Anderson¹,

Huang²,

Kim³

2012

jcb

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“…The mean percentage difference of TRAK and V 100 (cc) values was 4.29% and 8.35%, respectively, which showed that A icru89 plan has higher values of these parameters than (24), also showed that the plan normalized to a new Point A generated slightly higher doses. These studies proved that the dose to V 100% increases with the increase in the TRAK value.…”

Section: Trak and V 100 (Cc)mentioning

confidence: 90%

A comparison between revised Manchester Point A and ICRU-89–recommended Point A definition absorbed-dose reporting using CT images in intracavitary brachytherapy for patients with cervical carcinoma

et al. 2021

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This study is a comparison between revised Manchester Point A and International Commission on Radiation Units and measurements (ICRU) 89 reporterecommended Point A absorbed-dose reporting in intracavitary brachytherapy for patients with cervical carcinoma. METHODS AND MATERIALS:The retrospective dosimetric study is based on the data of 32 patients with cervical carcinoma treated with high-dose-rate brachytherapy. Patients received 21 Gy in three fractions (7.0 Gy X three fractions) to Point A (A flange , revised Manchester definition). All the patients were replanned with a new Point A (A icru89 ) defined on CT images as per the American Brachytherapy Society/ICRU-89. The data collected were compared with the data obtained from Point A (A flange ). RESULTS: When using the A flange plan normalization method, the mean dose of 0.1 cc, 1 cc, and 2 cc bladder volumes was 820.79

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Three-dimensional dosimetric considerations from different point A definitions in cervical cancer low-dose-rate brachytherapy

Zhang¹,

Chen²,

Kim³

et al. 2013

jcb

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PurposeTo investigate the dosimetric difference due to the different point A definitions in cervical cancer low-dose-rate (LDR) intracavitary brachytherapy.Material and methodsTwenty CT-based LDR brachytherapy plans of 11 cervical patients were retrospectively reviewed. Two plans with point As following the modified Manchester system which defines point A being 2 cm superior to the cervical os along the tandem and 2 cm lateral (Aos), and the American Brachytherapy Society (ABS) guideline definition in which the point A is 2 cm superior to the vaginal fornices instead of os (Aovoid) were generated. Using the same source strength, two plans prescribed the same dose to Aos and Aovoid. Dosimetric differences between plans including point A dose rate, treatment volume encompassed by the prescription isodose line (TV), and dose rate of 2 cc of the rectum and bladder to the prescription dose were measured.ResultsOn average Aovoid was 8.9 mm superior to Aos along the tandem direction with a standard deviation of 5.4 mm. With the same source strength and arrangement, Aos dose rate was 19% higher than Aovoid dose rate. The average TV(Aovoid) was 118.0 cc, which was 30% more than the average TV(Aos) of 93.0 cc. D2cc/D(Aprescribe) increased from 51% to 60% for rectum, and increased from 89% and 106% for bladder, if the prescription point changed from Aos to Aovoid.ConclusionsDifferent point A definitions lead to significant dose differences. Careful consideration should be given when changing practice from one point A definition to another, to ensure dosimetric and clinical equivalency from the previous clinical experiences.

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Calculation/comparison of dose to point “H” according to the ABS recommendations for HDR brachytherapy for carcinoma of the cervix to the dose to point “A” based on the revised manchester system

Cited by 3 publications

References 0 publications

Physics Contributions Dosimetric impact of point A definition on high-dose-rate brachytherapy for cervical cancer: evaluations on conventional point A and MRI-guided, conformal plans

Physics Contributions Dosimetric impact of point A definition on high-dose-rate brachytherapy for cervical cancer: evaluations on conventional point A and MRI-guided, conformal plans

A comparison between revised Manchester Point A and ICRU-89–recommended Point A definition absorbed-dose reporting using CT images in intracavitary brachytherapy for patients with cervical carcinoma

Three-dimensional dosimetric considerations from different point A definitions in cervical cancer low-dose-rate brachytherapy

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