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Study of positional dependence of dose to bladder, pelvic wall and rectal points in High-Dose-Rate Brachytherapy in cervical cancer patients.

Talluri AK, Alluri KR, Gudipudi DK, Ahamed S, Sresty MM, Reddy AY - J Med Phys (2013)

Bottom Line: Students't-test was used to analyze the results.Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point.Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Andhra Pradesh, India.

ABSTRACT
The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rectal Points when a patient is simulated in Supine (S Position) and Lithotomy M shaped positions (LM Position), respectively as part of Intracavitary Brachytherapy in Cervical Cancer patients. Patients (n = 19) were simulated and orthogonal images were taken in S Position and LM Positions on a physical simulator. Digital orthogonal X-ray images were transferred to Brachyvision Treatment Planning System via Dicom to generate treatment plans. Radio opaque dye of 7 ml was injected into the Foley bulb for identification and digitization of International Commission on Radiological Units and Measurements (ICRU) Bladder point. Pelvic side wall points were marked in accordance with ICRU 38 recommendations. A Rectal tube containing dummy source marker wire was used to identify Rectal Point. Students't-test was used to analyze the results. Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point. It was observed that movement of applicator could be the reason for the variations in doses between the two positions. Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.

No MeSH data available.


Related in: MedlinePlus

Orthogonal digital X- ray image in Supine position
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Figure 3: Orthogonal digital X- ray image in Supine position

Mentions: Nineteen patients with Carcinoma of the Cervix of grade II and III, aged between 30 to 60 years were selected for this study. Two plans for each patient in two anatomical positions were created by treating each plan as independent of the other. All patients were imaged simultaneously in two positions, S Position and LM Position, on Acuity physical simulator (Varian, Palo Alto, CA, USA) to get orthogonal digital X-ray images [Figures 3 and 4] at gantry angles 0° and 90° after insertion of Henschke applicator (Mick Radio-Nuclear Instruments, Inc., NY, USA) and to confirm the adequacy of position and orientation of the applicator. After imaging, patient was shifted to HDR brachytherapy (Varisource iX, Palo Alto, CA, USA) room for treatment, which is not an integral part of operation theatre, and digital images [Figures 3 and 4] were sent via Dicom to Brachyvision Treatment Planning System (TPS) Version 7.3 (Varian, Palo Alto, CA, USA) through Varian ARIA (Varian, Palo Alto, CA, USA) network.


Study of positional dependence of dose to bladder, pelvic wall and rectal points in High-Dose-Rate Brachytherapy in cervical cancer patients.

Talluri AK, Alluri KR, Gudipudi DK, Ahamed S, Sresty MM, Reddy AY - J Med Phys (2013)

Orthogonal digital X- ray image in Supine position
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3958997&req=5

Figure 3: Orthogonal digital X- ray image in Supine position
Mentions: Nineteen patients with Carcinoma of the Cervix of grade II and III, aged between 30 to 60 years were selected for this study. Two plans for each patient in two anatomical positions were created by treating each plan as independent of the other. All patients were imaged simultaneously in two positions, S Position and LM Position, on Acuity physical simulator (Varian, Palo Alto, CA, USA) to get orthogonal digital X-ray images [Figures 3 and 4] at gantry angles 0° and 90° after insertion of Henschke applicator (Mick Radio-Nuclear Instruments, Inc., NY, USA) and to confirm the adequacy of position and orientation of the applicator. After imaging, patient was shifted to HDR brachytherapy (Varisource iX, Palo Alto, CA, USA) room for treatment, which is not an integral part of operation theatre, and digital images [Figures 3 and 4] were sent via Dicom to Brachyvision Treatment Planning System (TPS) Version 7.3 (Varian, Palo Alto, CA, USA) through Varian ARIA (Varian, Palo Alto, CA, USA) network.

Bottom Line: Students't-test was used to analyze the results.Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point.Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Andhra Pradesh, India.

ABSTRACT
The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rectal Points when a patient is simulated in Supine (S Position) and Lithotomy M shaped positions (LM Position), respectively as part of Intracavitary Brachytherapy in Cervical Cancer patients. Patients (n = 19) were simulated and orthogonal images were taken in S Position and LM Positions on a physical simulator. Digital orthogonal X-ray images were transferred to Brachyvision Treatment Planning System via Dicom to generate treatment plans. Radio opaque dye of 7 ml was injected into the Foley bulb for identification and digitization of International Commission on Radiological Units and Measurements (ICRU) Bladder point. Pelvic side wall points were marked in accordance with ICRU 38 recommendations. A Rectal tube containing dummy source marker wire was used to identify Rectal Point. Students't-test was used to analyze the results. Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point. It was observed that movement of applicator could be the reason for the variations in doses between the two positions. Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.

No MeSH data available.


Related in: MedlinePlus