Document Detail

Vaginal vault brachytherapy in endometrial cancer: verifying target coverage with image-guided applicator placement.
MedLine Citation:
PMID:  23407428     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This quality assurance study assesses whether CT image-guided verification has led to improvements in the technique when compared with previous studies.
METHODS: The CT images were studied from a cohort of 105 consecutive patients with endometrial cancer having adjuvant brachytherapy to the vaginal vault in 2010. Images were taken at first insertion, checked for air gaps and treatment delivered. Images were later transferred to the planning system and air gaps between vaginal mucosa and vaginal cylinder were measured. Comparisons were made with the 2008 results from this centre and the literature series.
RESULTS: Images from two patients were not assessable owing to artefacts from hip replacements. Air gaps >2 mm were seen in 11/103 patients. Repositioning or use of a larger cylinder reduced air gaps to 7/103 patients. In total, 96/103 patients (over 93%) were able to achieve good vaginal contact throughout the treatment volume. This shows a significant improvement in applicator positioning in our centre since 2008 and also a significant improvement over the total data published in 2010 (Pearson χ(2) test=46.19; p<0.0001).
CONCLUSION: The vaginal cylinder technique with CT imaging was proven to be effective for 96/103 patients. It is necessary to consider whether there is a better technique for the few patients with air gaps >2 mm.
ADVANCES IN KNOWLEDGE: For the vast majority of patients, this technique is well tolerated, without the need for analgesia, and will continue to be the first choice technique in this centre.
P Humphrey; P Cornes; H Al-Booz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of radiology     Volume:  86     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-14     Completed Date:  2013-04-04     Revised Date:  2014-03-06    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  20120428     Citation Subset:  AIM; IM    
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MeSH Terms
Brachytherapy / instrumentation,  methods*
Cohort Studies
Endometrial Neoplasms / radiotherapy*
Equipment Design
Radiography, Interventional
Radiotherapy Dosage
Tomography, X-Ray Computed
Vaginal Neoplasms / radiotherapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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