Three-Dimensional Dosimetry of the Full and Empty Bladder in High Dose Rate Vaginal Cuff Brachytherapy

Kobzda, J.; Cikowska-Woźniak, E.; Michalska, Magdalena; Makarewicz, Roman

doi:10.1097/igc.0000000000000127

Cited by 8 publications

(27 citation statements)

References 9 publications

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“…In some of the studies, we noticed that the filling method was not reliable enough since patients were not catheterized during application. [2,4] In these studies, it was seen that the variability in bladder volumes reached up to 13.4 and 16 times among patients in the case of the empty and full bladder, respectively. [2,4] In other studies, as in ours, BF was achieved by giving a certain amount of fluid through FC and ensuring more reliable and standardized BF.…”

Section: Applicationmentioning

confidence: 88%

“…[2,4] In these studies, it was seen that the variability in bladder volumes reached up to 13.4 and 16 times among patients in the case of the empty and full bladder, respectively. [2,4] In other studies, as in ours, BF was achieved by giving a certain amount of fluid through FC and ensuring more reliable and standardized BF. [3,5,6] Calculated bladder volumes were reported in only one [3] of two studies [3,6] performed in the era of 3-D BRT.…”

Section: Applicationmentioning

confidence: 88%

“…We observed that bowel was contoured as bowel loops, instead of ''bowel bag'' in some studies. [2,3,6] Due to the absence of oral contrast during CTsimulation in our retrospective study, it was possible to distinguish small and large bowel clearly. Additionally, bowel segments may be displaced intra-and interfractionally during BRT.…”

Section: Contouringmentioning

confidence: 90%

“…On the other hand, sigmoid was contoured being included in the bowel in Kobzda et al's study. [2] However, since tolerance doses of sigmoid and small bowel differ from each other, it was more relevant to contour these organs separately. In our study, the bowel was defined as small and large bowel segments above the lower level of sacroiliac joint except for rectum and sigmoid; these segments were contoured as ''bowel bag'' together with surrounding omentum.…”

Section: Contouringmentioning

confidence: 99%

“…There is sufficient knowledge about the potential effects of BF on OAR doses in BRT in definitive RT of cervix cancer. However, few studies exist examining the effects of BF on OAR doses in vaginal cuff (VC) BRT where bowels fall into the pelvis due to the removal of the uterus, [2][3][4][5][6] which remained under-researched.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of the Amount of Bladder Filling on Normal Tissue Doses in 3-dimensional HDR Vaginal Cuff Brachy Therapy

Er¹

2019

TJ Oncol

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This study aimed to compare the dose-volume parameters of organs at risk (OAR) (bladder, rectum, sigmoid and bowel) for the bladder filling of 50cc versus 150cc in high-dose-rate (HDR) (3-D) vaginal cuff (VC) brachytherapy (BRT). METHODS The treatment data of eight hysterectomized patients with gynecological malignancy who received postoperative pelvic external radiotherapy (RT)+3-D HDR VC-BRT were analyzed. Recontouring was performed on CT images, and BRT plans were reformed. Proximal 1/3 vagina was treated in all patients using a cylinder. A total dose of 18 Gy (3x6Gy) was given (0.5 cm depth from the vaginal mucosa). OAR and clinical target volume (CTV) were recontoured in a 3-D manner. Afterwards, treatment planning was performed by a medical physicist using the BRT treatment planning system. Bladder V50%, D50% and D2cc, rectum D2cc, sigmoid D2cc, bowel D50% and D2cc were recorded from the dose-volume histograms obtained in the treatment planning system. Paired comparisons were made for the parameters above for the bladder filling of 50cc versus 150cc. Two different amounts of bladder filling were compared using the Wilcoxon Signed-Rank Test in the SPSS 15.0 statistics program. RESULTS Bladder D50% decreased (p=0.012) while bladder D2cc increased (p=0.025) in the case of 150cc bladder filling instead of 50cc. Rectum D2cc showed a statistical trend for increase (p=0.05); however, bowel D50% decreased (p=0.012) in 150cc bladder filling compared to 50cc. CONCLUSION The statistically significant decrease in bladder and especially bowel D50% parameters supports filling the bladder with 150cc instead of 50cc in 3-D VC-BRT.

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Section: Applicationmentioning

confidence: 88%

Section: Applicationmentioning

confidence: 88%

Section: Contouringmentioning

confidence: 90%

Section: Contouringmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Effects of the Amount of Bladder Filling on Normal Tissue Doses in 3-dimensional HDR Vaginal Cuff Brachy Therapy

Er¹

2019

TJ Oncol

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The vaginal cylinder: Misunderstood, misused, or trivial? An in-depth dosimetric and multiinstitutional outcome investigation

et al. 2019

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Impact of CT-based planning and bladder volume changes on the dosimetry of vaginal vault brachytherapy

et al. 2021

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Aim: To compare dose to target and organs at risk (OARs) in conventional plan (2D) versus computed tomography (CT)-based three-dimensional (3D) plan in vaginal cuff brachytherapy (VBT) and to compare the effect of bladder distension on target and OARs dosimetry. Materials and methods: Post-hysterectomy patients with an indication for VBT were included in the study. All patients underwent planning CT scans with a full bladder and an empty bladder protocol. For each CT, two plans were generated—one library-based 2D plan and another CT-based 3D plan. Dosimetric parameters were recorded for clinical target volume (CTV) and OARs. Results: A total of 92 observations were made from data collected from 46 patients. Difference between CTV dose in terms of 2D and 3D plans were not statistically significant for CTV (p = 0·11). Significant reduction in D0·1cc, D1cc and D2cc dose parameters were observed in bladder, rectum, sigmoid and bowel doses with the 3D plan (p < 0·001). Bladder distension showed a 20% reduction in dose for bowel (p < 0·001). Bladder distension also showed a 6·12% (p = 0·047) increase in D2cc, but there was a significant reduction in the mean dose to the bladder. Conclusion: Our study demonstrates the dosimetric benefits with 3D CT-based planning for VBT over 2D-based conventional planning and benefit of bladder distension in the reduction of bowel dose without compromising dose to the target volume.

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Three-Dimensional Dosimetry of the Full and Empty Bladder in High Dose Rate Vaginal Cuff Brachytherapy

Cited by 8 publications

References 9 publications

The Effects of the Amount of Bladder Filling on Normal Tissue Doses in 3-dimensional HDR Vaginal Cuff Brachy Therapy

The Effects of the Amount of Bladder Filling on Normal Tissue Doses in 3-dimensional HDR Vaginal Cuff Brachy Therapy

The vaginal cylinder: Misunderstood, misused, or trivial? An in-depth dosimetric and multiinstitutional outcome investigation

Impact of CT-based planning and bladder volume changes on the dosimetry of vaginal vault brachytherapy

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