Dosimetric evaluation of rectum and bladder using image-based CT planning and orthogonal radiographs with ICRU 38 recommendations in intracavitary brachytherapy

Swamidas, Jamema; Saju, Sherly; Mahantshetty, Umesh; Pallad, Siddanna; Deshpande, Deepak D.; Shrivastava, SK; Dinshaw, K A

doi:10.4103/0971-6203.39417

Cited by 37 publications

(31 citation statements)

References 41 publications

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“…[12] (62 HDR applications), Jamema et al . [13], (22 HDR applications) (both authors prescribed 7 Gy dose at Point A) as well as with Tan et al . [14] (55 applications with 5.3 Gy to Point A).…”

Section: Discussionmentioning

confidence: 94%

Clinical Investigations Non isocentric film-based intracavitary brachytherapy planning in cervical cancer: a retrospective dosimetric analysis with CT planning

Tyagi¹,

Mukundan²,

Mukherjee³

et al. 2012

jcb

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PurposeTo compare intracavitary brachytherapy dose estimation for organs at risk (bladder and rectum) based on semi-orthogonal reconstruction of radiographs on non-isocentric X-ray unit and Computed Tomography (CT) – based volumetric planning in cervical cancer.Material and methodsBladder and rectal points as per International Commission on Radiation Units and Measurements (ICRU) report 38, were retrospectively evaluated on 15 high dose rate intracavitary brachytherapy applications for cervical cancer cases. With the same source configuration as obtained during planning on radiographs performed on a non-isocentric X-ray unit, the mean doses to 2cc of most irradiated part of bladder and rectum were computed by CT planning and these estimates were compared with the doses at ICRU bladder and rectal points.ResultsThe mean ICRU point dose for bladder was 3.08 Gy (1.9-5.9 Gy) and mean dose to 2 cc (D2cc) bladder was 6.91 Gy (2.9-12.2 Gy). ICRU rectal dose was 3.8 Gy (2.4-4.45 Gy) and was comparable with D2cc rectum dose 4.2 Gy (2.8-5.9 Gy). Comparison of mean total dose (ICRU point vs. D2cc) for each patient was found to be significantly different for bladder (p = 0.000), but not for rectum (p = 0.08).ConclusionsOn comparison of ICRU point based planning with volumetric planning on CT, it was found that bladder doses were underestimated by the film based method. However, the rectal doses were found to be similar to the D2cc doses. The results with non isocentric film based treatment planning were similar to the existing literature on orthogonal film based simulator planning.

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Section: Discussionmentioning

confidence: 94%

Clinical Investigations Non isocentric film-based intracavitary brachytherapy planning in cervical cancer: a retrospective dosimetric analysis with CT planning

Tyagi¹,

Mukundan²,

Mukherjee³

et al. 2012

jcb

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“…A major drawback of orthogonal x-rayYbased 2D planning is the inability to calculate and estimate dose to upper rectum and rectosigmoid, and these regions are known for late morbidity. 12,19,24 To date, these regions can only be evaluated by 3D DVH analysis using either CT or MRI. In our study, the rectal DVH parameters are lower than those reported (Table 3).…”

Section: Rectal and Sigmoid Dosesmentioning

confidence: 99%

Reporting and Validation of Gynaecological Groupe Euopeen de Curietherapie European Society for Therapeutic Radiology and Oncology (ESTRO) Brachytherapy Recommendations for MR Image-Based Dose Volume Parameters and Clinical Outcome With High Dose-Rate Brachytherapy in Cervical Cancers

Mahantshetty

Swamidas

Khanna

et al. 2011

International Journal of Gynecological Cancer

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“…[7] However, these facilities are limited to only a few urban centers. Rural centers in particular lack these facilities.…”

Section: Discussionmentioning

confidence: 99%

Rectal dosimetry in intracavitary brachytherapy by HDR at rural center of Maharashtra: Comparison of two methods

Shrivastava¹,

Umbarkar²,

Sarje³

et al. 2009

J Med Phys

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The purpose of this study was to calculate the radiation dose at the anterior rectal wall as per the International Commission on Radiation Units and Measurements (ICRU 38) recommendations and compare it with the dose calculated by the commonly used intrarectal catheter. Dose delivery by brachytherapy to the cervix is limited by the critical structure of the bladder and rectum. In this study the ICRU-38 rectal point was derived by using a radio-opaque gauze piece on the posterior vaginal wall, and the intrarectal point was derived by inserting a rubber catheter with a wire, inside the rectum. A total of 146 applications were performed in 81 patients. Rectal doses were compared for complementary rectal points R1 and R5, R2 and R6, R3 and R7, and R4 and R8, obtained by both methods. The rectal doses at each complementary pair were compared with each other. The average dose at R1 was 5% higher than at R5 (60.57% vs. 55.57%). The average dose at R2 was 1% higher than at R6 (58% vs. 57%). The average dose at R3 was 1.29% higher than at R7 (52.71% vs. 51.42%), and the average dose at R4 was 1.15% higher than at R8 (43% vs. 41.85%). There were many instances where the rectal dose exceeded by more than 15%, from the R1 to R4 points (43, 22, 21, and 11 times, respectively, for R1-R5, R2-R6, R3-R7, and R4-R8 pairs). The difference in dose between R1 and R5 was significant as seen on the statistical tests, i.e., Pair T test, Wilcoxan Signed Ranks test, and Sign test (p value 0.002). The rectal dose obtained by the intrarectal wire method underestimates the actual dose to the rectum when compared to the ICRU-38 method. Thus ICRU-38 recommendations should be strictly adhered to, to reduce late complications.

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Dosimetric evaluation of rectum and bladder using image-based CT planning and orthogonal radiographs with ICRU 38 recommendations in intracavitary brachytherapy

Cited by 37 publications

References 41 publications

Clinical Investigations Non isocentric film-based intracavitary brachytherapy planning in cervical cancer: a retrospective dosimetric analysis with CT planning

Clinical Investigations Non isocentric film-based intracavitary brachytherapy planning in cervical cancer: a retrospective dosimetric analysis with CT planning

Reporting and Validation of Gynaecological Groupe Euopeen de Curietherapie European Society for Therapeutic Radiology and Oncology (ESTRO) Brachytherapy Recommendations for MR Image-Based Dose Volume Parameters and Clinical Outcome With High Dose-Rate Brachytherapy in Cervical Cancers

Rectal dosimetry in intracavitary brachytherapy by HDR at rural center of Maharashtra: Comparison of two methods

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