Vaginal displacement during course of adjuvant radiation for cervical cancer: results from a prospective IG-IMRT study

Chopra, Supriya; Patidar, Arvind Kumar; Dora, Tapas; Moirangthem, N.; Paul, Santanu; Mahantshetty, Umesh; Shrivastava, Shyam Kishore

doi:10.1259/bjr.20140428

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Chopra et al 22 reported that 4.1 mm, 10.6 mm and 10.3 mm, for left-right, craniocaudal and AP margins respectively, could encompass 95% of the observed displacements. Shih et al 23 reported clinical outcomes in endometrial cancer and Folkert MR et al 24 in cervical cancer treated with adjuvant pelvic IMRT.…”

Section: Discussionmentioning

confidence: 98%

Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

Vergés

Giraldo

Seoane

et al. 2018

Reports of Practical Oncology & Radiotherapy

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Section: Discussionmentioning

confidence: 98%

Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

Vergés

Giraldo

Seoane

et al. 2018

Reports of Practical Oncology & Radiotherapy

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“… 16 , 20 , 21 , 22 Translations exceeding 10 mm were more frequently observed in the posterior and superior directions, whereas smaller translations were observed in the right and left directions, consistent with previous findings. 23 , 24 Thus, the translations calculated using the algorithm were considered valid.…”

Section: Discussionmentioning

confidence: 99%

Organ‐contour‐driven auto‐matching algorithm in image‐guided radiotherapy

Kishigami,

Nakamura,

Okamoto

et al. 2023

J Applied Clin Med Phys

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PurposeThis study aimed to demonstrate the potential clinical applicability of an organ‐contour‐driven auto‐matching algorithm in image‐guided radiotherapy.MethodsThis study included eleven consecutive patients with cervical cancer who underwent radiotherapy in 23 or 25 fractions. Daily and reference magnetic resonance images were converted into mesh models. A weight‐based algorithm was implemented to optimize the distance between the mesh model vertices and surface of the reference model during the positioning process. Within the cost function, weight parameters were employed to prioritize specific organs for positioning. In this study, three scenarios with different weight parameters were prepared. The optimal translation and rotation values for the cervix and uterus were determined based on the calculated translations alone or in combination with rotations, with a rotation limit of ±3°. Subsequently, the coverage probabilities of the following two planning target volumes (PTV), an isotropic 5 mm and anisotropic margins derived from a previous study, were evaluated.ResultsThe percentage of translations exceeding 10 mm varied from 9% to 18% depending on the scenario. For small PTV sizes, more than 80% of all fractions had a coverage of 80% or higher. In contrast, for large PTV sizes, more than 90% of all fractions had a coverage of 95% or higher. The difference between the median coverage with translational positioning alone and that with both translational and rotational positioning was 1% or less.ConclusionThis algorithm facilitates quantitative positioning by utilizing a cost function that prioritizes organs for positioning. Consequently, consistent displacement values were algorithmically generated. This study also revealed that the impact of rotational corrections, limited to ±3°, on PTV coverage was minimal.

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“…19,20 However, the generation of ITV necessitates careful identification of targets on MVCT/KVCT scans. For the conduct of the present study, we hypothesized that the displacement characteristics of central recurrences may be different than that of uterus [21][22][23] and post-surgical vaginal remnant [24][25][26][27] and need prospective investigation. The methodology in the present study relied on evaluating COM displacement of recurrent tumour on daily MVCT images.…”

Section: Discussionmentioning

confidence: 99%

Internal target volume for post-hysterectomy vaginal recurrences of cervical cancers during image-guided radiotherapy

Upasani

Chopra

Mahantshetty

et al. 2015

BJR

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Objective: The outcome of post-surgical recurrences of cervical cancer may be improved through radiation dose escalation, which hinges on accurate identification and treatment of the target. The present study quantifies target motion during course of image-guided radiotherapy (IGRT) for vault cancers. Methods: All patients underwent planning CT simulation after bladder-filling protocol. A daily pre-treatment megavoltage CT was performed. All translations and rotations were recorded. Post-registration displacement of gross tumour volume (GTV) and centre of mass (COM) of GTV was independently recorded by two observers for fractions one to seven. Day 1 image sets served as reference images against which the displacements of COM were measured. We calculated the displacements of common volume (CV) and encompassing volume (EV) of GTV for both the observers. Results: A total of 90 image data sets of 15 patients were available for evaluation. Individual patient GTV and average GTV by both the observers were comparable. The average shifts for EV were 2.4 mm [standard deviation (SD) 6 1.2] in the mediolateral, 4.2 mm (SD 6 2.8) in the anteroposterior and 4.0 mm (SD 62.1) in superoinferior directions. Similarly, the average shifts for CV were 1.9 mm (SD 60.6) in the mediolateral, 3.7 mm (SD 62.7) in the anteroposterior and 4.4 mm (SD 62.7) in superoinferior directions. Using Stroom's/van Herk's formula, the minimum recommended margins would be 4.5/5.2, 8.2/9.4 and 7.3/8.3 mm, respectively, for lateral, anteroposterior and superoinferior directions. Conclusion: Differential directional internal margin is recommended in patients undergoing IGRT for postsurgical recurrence of cervical cancers. Advances in knowledge: Internal organ motion of vault cancers can be accounted for by a directional margin to the gross tumour.

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Vaginal displacement during course of adjuvant radiation for cervical cancer: results from a prospective IG-IMRT study

Cited by 9 publications

References 22 publications

Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

Organ‐contour‐driven auto‐matching algorithm in image‐guided radiotherapy

Internal target volume for post-hysterectomy vaginal recurrences of cervical cancers during image-guided radiotherapy

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