ArticleJournal of applied clinical medical physics2019
Clinical implementation, logistics and workflow guide for MRI image based interstitial HDR brachytherapy for gynecological cancers.
Article in Journal of applied clinical medical physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 20 citations in OpenAlex.
- Feasibility of 3D-Printed Brachytherapy Contrast Markers for Use With CT Planning of Interstitial Procedures.Cureus · 2026Article
- Commissioning of the Varian universal interstitial cylinder system for HDR brachytherapy of gynecological cancer.Journal of applied clinical medical physics · 2025Article
- Three-dimensional trans-rectal and trans-abdominal ultrasound image fusion for the guidance of gynecologic brachytherapy procedures: a proof of concept study.Scientific reports · 2024Article
- Development and clinical implementation of a digital system for risk assessments for radiation therapy.Zeitschrift fur medizinische Physik · 2024Article
- Integration of Ultrasound in Image-Guided Adaptive Brachytherapy in Cancer of the Uterine Cervix.Bioengineering (Basel, Switzerland) · 2024Review
- Dosimetric impact of applicator displacement on three-dimensional image-guided high-dose-rate brachytherapy treatments for cervical cancer.Journal of contemporary brachytherapy · 2023Article
- Article
- Verification of Guiding Needle Placement by Registered Ultrasound Image During Combined Intracavitary/Interstitial Gynecologic Brachytherapy.Cancer management and research · 2021Article
- Simple phantom fabrication for MRI-based HDR brachytherapy applicator commissioning.Journal of applied clinical medical physics · 2020Article
- Verification of needle guidance accuracy in pelvic phantom using registered ultrasound and MRI images for intracavitary/interstitial gynecologic brachytherapy.Journal of contemporary brachytherapy · 2020Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Interstitial brachytherapy (IBT) is often utilized to treat women with bulky endometrial or cervical cancers not amendable to intracavitary treatments. A modern trend in IBT is the utilization of magnetic resonance imaging (MRI) with a high dose rate (HDR) afterloader for conformal 3D image-based treatments. The challenging part of this procedure is to properly complete many sequenced and co-related physics preparations. We presented the physics preparations and clinical workflow required for implementing MRI-based HDR IBT (MRI-HDR-IBT) of gynecologic cancer patients in a high-volume brachytherapy center. The present document is designed to focus on the clinical steps required from a physicist's standpoint. Those steps include: (a) testing IBT equipment with MRI scanner, (b) preparation of templates and catheters, (c) preparation of MRI line markers, (d) acquisition, importation and registration of MRI images, (e) development of treatment plans and (f) treatment evaluation and documentation. The checklists of imaging acquisition, registration and plan development are also presented. Based on the TG-100 recommendations, a workflow chart, a fault tree analysis and an error-solution table listing the speculated errors and solutions of each step are provided. Our workflow and practice indicated the MRI-HDR-IBT is achievable in most radiation oncology clinics if the following equipment is available: MRI scanner, CT (computed tomography) scanner, MRI/CT compatible templates and applicators, MRI line markers, HDR afterloader and a brachytherapy treatment planning system capable of utilizing MRI images. The OR/procedure room availability and anesthesiology support are also important. The techniques and approaches adopted from the GEC-ESTRO (Groupe Européen de Curiethérapie - European Society for Therapeutic Radiology and Oncology) recommendations and other publications are proven to be feasible. The MRI-HDR-IBT program can be developed over time and progressively validated through clinical experience, this document is expected to serve as a reference workflow guideline for implementing and performing the procedure.
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