Abstract Cervical cancer is one of the leading causes of death in women with malignancies worldwide. Brachytherapy plays an essential role in the radiation therapy for cervical cancer, and its combination with external beam radiation is indicated for previously untreated or recurrent cervical cancer at various stages without distant metastasis. Magnetic resonance imaging (MRI) has superior resolution of soft tissue, which allows for accurate delineation of target volume, protects organs at risk (OARs), and thus improves treatment outcomes. In recent years, many studies have demonstrated the feasibility and superiority of three-dimensional MRI-guided brachytherapy for cervical cancer. This article aims to elaborate on relevant MRI techniques, selection of applicators, delineation of target volume and OARs, evaluation of treatment plans, and the clinical effect of three-dimensional MRI-guided brachytherapy.
Corresponding Authors:
Cao Xinping,Email:caoxp@sysucc.org.cn
Cite this article:
Xiao Yao,Ouyang Yi,Chen Kai et al. Progress in three-dimensional MRI-guided brachytherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(8): 947-950.
Xiao Yao,Ouyang Yi,Chen Kai et al. Progress in three-dimensional MRI-guided brachytherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(8): 947-950.
[1] Allemani C,Weir HK,Carreira H,et al. Global surveillance of cancer survival 1995-2009:analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)[J].Lancet,2015,385(9972):977-1010.DOI:10.1016/S0140-6736(14)62038-9. [2] Landoni F,Maneo A,Colombo A,et al. Randomised study of radical surgery versus radiotherapy for stage Ⅰ b-Ⅱ a cervical cancer[J].Lancet,1997,350(9077):535-540.DOI:10.1016/S0140-6736(97)02250-2. [3] Han K,Milosevic M,Fyles A,et al. Trends in the utilization of brachytherapy in cervical cancer in the United States[J].Int J Radiat Oncol Biol Phys,2013,87(1):111-119.DOI:10.1016/j.ijrobp.2013.05.033. [4] Charra-Brunaud C,Levitchi M,Delannes M,et al.152 oral dosimetric and clinical results of a French prospective study of 3D brachytherapy for cervix carcinoma[J].Radiother Oncol,2011,99(Suppl 1):S57.DOI:10.1016/S0167-8140(11)70274-2. [5] Paulson ES,Erickson B,Schultz C,et al. Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning[J].Med Phys,2015,42(1):28-39.DOI:10.1118/1.4896096. [6] Tanderup K,Viswanathan AN,Kirisits C,et al. Magnetic resonance image guided brachytherapy[J].Semin Radiat Oncol,2014,24(3):181-191.DOI:10.1016/j.semradonc.2014.02.007. [7] Dimopoulos JCA,Petrow P,Tanderup K,et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV):Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy[J].Radiother Oncol,2012,103(1):113-122.DOI:10.1016/j.radonc.2011.12.024. [8] Kapur T,Egger J,Damato A,et al.3-T MR-guided brachytherapy for gynecologic malignancies[J].Magn Res Imag,2012,30(9):1279-1290.DOI:10.1016/j.mri.2012.06.003. [9] Hu YL,Esthappan J,Mutic S,et al. Improve definition of titanium tandems in MR-guided high dose rate brachytherapy for cervical cancer using proton density weighted MRI[J].Radiat Oncol,2013,8(1):16.DOI:10.1186/1748-717X-8-16. [10] Petit S,Wielopolski P,Rijnsdorp R,et al. MR guided applicator reconstruction for brachytherapy of cervical cancer using the novel titanium Rotterdam applicator[J].Radiother Oncol,2013,107(1):88-92.DOI:10.1016/j.radonc.2013.03.014. [11] Rauch GM,Kaur H,Choi H,et al. Optimization of MR imaging for pretreatment evaluation of patients with endometrial and cervical cancer[J].Radiographics,2014,34(4):1082-1098.DOI:10.1148/rg.344140001. [12] Hallac RR,Ding Y,Yuan Q,et al. Oxygenation in cervical cancer and normal uterine cervix assessed using blood oxygenation level-dependent (BOLD) MRI at 3T[J].NMR Biomed,2012,25(12):1321-1330.DOI:10.1002/nbm.2804. [13] Wang Y,Ye WJ,Du LH,et al. Dose-volume parameters and clinical outcome of CT-guided free-hand high-dose-rate interstitial brachytherapy for cervical cancer[J].Chin J Cancer,2012,31(12):598-604.DOI:10.5732/cjc.011.10452. [14] Yoshio K,Murakami N,Morota M,et al. Inverse planning for combination of intracavitary and interstitial brachytherapy for locally advanced cervical cancer[J].J Radiat Res,2013,54(6):1146-1152.DOI:10.1093/jrr/rrt072. [15] Haack S,Nielsen SK,Lindegaard JC,et al. Applicator reconstruction in MRI 3D image-based dose planning of brachytherapy for cervical cancer[J].Radiother Oncol,2009,91(2):187-193.DOI:10.1016/j.radonc.2008.09.002. [16] Dempsey C,Arm J,Best L,et al. Optimal single 3T MR imaging sequence for HDR brachytherapy of cervical cancer[J].J Contemp Brachytherapy,2014,6(1):3-9.DOI:10.5114/jcb.2014.41528. [17] Schindel J,Muruganandham M,Pigge FC,et al. Magnetic resonance imaging (MRI) markers for MRI-guided high-dose-rate brachytherapy:novel marker-flange for cervical cancer and marker catheters for prostate cancer[J].Int J Radiat Oncol Biol Phys,2013,86(2):387-393.DOI:10.1016/j.ijrobp.2012.12.026. [18] Haie-Meder C,Potter R,Van Limbergen E,et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group☆(I):concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV[J].Radiother Oncol,2005,74(3):235-245.DOI:10.1016/j.radonc.2004.12.015. [19] PetriP,Hudej R,Rogelj P,et al. Uncertainties of target volume delineation in MRI guided adaptive brachytherapy of cervix cancer:a multi-institutional study[J].Radiother Oncol,2013,107(1):6-12.DOI:10.1016/j.radonc.2013.01.014. [20] Ptter R,Haie-Meder C,Van Limbergen E,et al. Recommendations from gynaecological (GYN) GEC ESTRO working group (Ⅱ):Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy,radiation physics,radiobiology[J].Radiother Oncol,2006,78(1):67-77.DOI:10.1016/j.radonc.2005.11.014. [21] Georg P,Potter R,Georg D,et al. Dose effect relationship for late side effects of the rectum and urinary bladder in magnetic resonance image-guided adaptive cervix cancer brachytherapy[J].Int J Radiat Oncol Biol Phys,2012,82(2):653-657.DOI:10.1016/j.ijrobp.2010.12.029. [22] Simpson DR,Scanderbeg DJ,Carmona R,et al. Clinical outcomes of computed tomography—based volumetric brachytherapy planning for cervical cancer[J].Int J Radiat Oncol Biol Phys,2015,93(1):150-157.DOI:10.1016/j.ijrobp.2015.04.043. [23] Ptter R,Georg P,Dimopoulos JCA,et al. Clinical outcome of protocol based image (MRI) guided adaptive brachytherapy combined with 3D conformal radiotherapy with or without chemotherapy in patients with locally advanced cervical cancer[J].Radiother Oncol,2011,100(1):116-123.DOI:10.1016/j.radonc.2011.07.012. [24] Gill BS,Kim H,Houser CJ,et al. MRI-guided high-dose-rate intracavitary brachytherapy for treatment of cervical cancer:the University of Pittsburgh experience[J].Int J Radiat Oncol Biol Phys,2015,91(3):540-547.DOI:10.1016/j.ijrobp.2014.10.053. [25] Lindegaard JC,Fokdal LU,Nielsen SK,et al. MRI-guided adaptive radiotherapy in locally advanced cervical cancer from a Nordic perspective[J].Acta Oncol,2013,52(7):1510-1519.DOI:10.3109/0284186X.2013.818253. [26] Dolezel M,Odrazka K,Vanasek J,et al. MRI-based pre-planning in patients with cervical cancer treated with three-dimensional brachytherapy[J].Br J Radiol,2011,84(1005):850-856.DOI:10.1259/bjr/75446993. [27] Viswanathan AN,Szymonifka J,Tempany-Afdhal CM,et al. A prospective trial of real-time magnetic resonance-guided catheter placement in interstitial gynecologic brachytherapy[J].Brachytherapy,2013,12(3):240-247.DOI:10.1016/j.brachy.2012.08.006. [28] Mazeron R,Gilmore J,Dumas I,et al. Adaptive 3D image-guided brachytherapy:a strong argument in the debate on systematic radical hysterectomy for locally advanced cervical cancer[J].Oncologist,2013,18(4):415-422.DOI:10.1634/theoncologist.2012-0367. [29] Sturdza A,Ptter R,Fokdal LU,et al. Image guided brachytherapy in locally advanced cervical cancer:IMPROVED pelvic control and survival in RetroEMBRACE,a multicenter cohort study[J].Radiother Oncol,2016,120(3):428-433.DOI:10.1016/j.radonc.2016.03.011. [30] Viswanathan AN,Erickson B,Gaffney DK,et al. Comparison and consensus guidelines for delineation of clinical target volume for CT-and MR-based brachytherapy in locally advanced cervical cancer[J].Int J Radiat Oncol Biol Phys,2014,90(2):320-328.DOI:10.1016/j.ijrobp.2014.06.005. [31] Tanderup K,Eifel PJ,Yashar CM,et al. Curative radiation therapy for locally advanced cervical cancer:brachytherapy is NOT optional[J].Int J Radiat Oncol Biol Phys,2014,88(3):537-539.DOI:10.1016/j.ijrobp.2013.11.011.