ArticleJournal of applied clinical medical physics2026
Dosimetric evaluation of systematic source position uncertainty along the source path and robust planning during MRI-only cervical HDR brachytherapy.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe knowledge of the dosimetric impact of systematic source position uncertainty and the use of a methodology for robust treatment planning against such uncertainty can help improve the quality of treatment plans, during MR-only cervical brachytherapy treatment. PURPOSE: To assess the dosimetric impact of systematic source position uncertainty along the source path and evaluate strategies to minimize it during MRI-only cervical high-dose-rate (HDR) brachytherapy treatment planning.
methodsTreatment plans from 22 cervical cancer patients (FIGO stages IB2-IVA; 11 intracavitary brachytherapy (ICBT), 11 interstitial brachytherapy (ISBT)) were retrospectively analyzed. Positional uncertainty was modeled by systematically shifting the source position (± 1 to ± 5 mm with 0 mm as the reference position) within applicators along the source path in the original plans. Dosimetric parameters, HRCTV_D90 and D
resultsSignificant dosimetric changes were observed for bladder, sigmoid (all shift positions; p ≤ 0.001) and rectum (1 to 5 mm; p ≤ 0.04) in ICBT, and for all OARs (all shift positions; p ≤ 0.003) in ISBT. HRCTV_D90 was significantly affected in ICBT from -2 to -5 mm (p ≤ 0.042) and at all shifts (p ≤ 0.033) except at -1 and -2 mm in ISBT. Within ± 5 mm shift range, the mean (maximum) drop in HRCTV_D90 and increase in OARs (bladder, bowel, rectum and sigmoid) D
conclusionSystematic source position uncertainty significantly influences dosimetry in MRI-only cervical HDR brachytherapy. Adjusting dwell times and gradients near the targeted OAR could minimize this effect.
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