Evidence map›Paper›PMID 40700854›Full record

ArticleGynecologic oncology2025

The use of transrectal ultrasound to improve gynecologic interstitial applicator implantation.

Katelyn Ragland, Joel Pogue, Eric Simiele, Samantha Simiele, Michael Soike, Rebecca C Arend, J Michael Straughn, Michael D Toboni, Warner K Huh, Charles A Leath and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gynecologic oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Katelyn RaglandDepartment of Radiation Oncology, University of Alabama at Birmingham, USA. Electronic address: kmragland@uabmc.edu.
Joel PogueDepartment of Radiation Oncology, University of Alabama at Birmingham, USA.
Eric SimieleDepartment of Radiation Oncology, University of Alabama at Birmingham, USA.
Samantha SimieleDepartment of Radiation Oncology, University of Alabama at Birmingham, USA.
Michael SoikeDepartment of Radiation Oncology, University of Alabama at Birmingham, USA.
Rebecca C ArendDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
J Michael StraughnDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
Michael D ToboniDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
Warner K HuhDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
Charles A LeathDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
Haller J SmithDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
Teresa K L BoitanoDivision of Gynecologic Oncology, University of Alabama at Birmingham, USA.
Samuel MarcromDepartment of Radiation Oncology, University of Alabama at Birmingham, USA.

Funding

NCTN Deep South Research ConsortiumUG1CA233330 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Charles A. Leath, Andrew M McDonald · 2019 to 2026
$3.7M
NCI NIH HHS UG1 CA233330
6 · The paper itself

Abstract

objectiveBrachytherapy is essential for treating locally advanced cervical cancer and vaginal recurrences post-hysterectomy. While MRI and CT have permitted volumetric planning, precise interstitial applicator placement remains crucial for optimal dosimetry. We evaluated the impact of transrectal ultrasound (TRUS) on interstitial gynecologic brachytherapy needle utilization and dosimetry.

methodsA retrospective single institute study was conducted of patients requiring interstitial brachytherapy between 2020 and 2023. Cases were categorized based on TRUS use. Endpoints included number of needles placed, removed, unloaded channels, and dosimetry to the high risk clinical target volume (CTV_HR) and organs at risk.

resultsA total of 142 implants were performed on 139 patients; 58 % did not utilize a tandem, representing post-hysterectomy recurrences or primary vaginal cancers. Mean CTV_HR volume was 59 cc. TRUS was used in 73 % of cases and was associated with 4-5 fewer needles per implant, independent of CTV_HR volume. With TRUS, needle removal at simulation decreased from 41 % to 3 % (p < 0.001), and plans with unloaded needle channels decreased from 76 % to 25 % (p < 0.001). Despite fewer needles, CTV_HR coverage among definitive cervical cancers remained comparable (D90 > 85 Gy EQD2 in 79 % with TRUS and 78 % without). The ABS rectal constraint of D2cc < 75 Gy was met more often with TRUS (92 % vs. 56 %, p < 0.001).

conclusionsTRUS improves interstitial needle placement efficiency and rectal dosimetry without compromising target coverage. Its accessibility supports broader integration into gynecologic brachytherapy workflows as a practical optimization tool for achieving disease control and minimizing toxicity.

Indexed as

BrachytherapyUltrasonography, InterventionalUterine Cervical NeoplasmsVaginal NeoplasmsAdultAgedFemaleHumansMiddle AgedRadiotherapy DosageRadiotherapy Planning, Computer-AssistedRectumRetrospective StudiesInterstitial brachytherapyLocally advanced cervical CancerRecurrent gynecologic cancerTransrectal ultrasound

Identifiers

PMID40700854
PMCPMC13623412

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.