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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Bladder extension variability during pelvic external beam radiotherapy with a full or empty bladder.

Michael Pinkawa¹, Branka Asadpour, Jaroslav Siluschek

¹Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany. MPinkawa@ukaachen.de

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology

|May 15, 2007

Summary

Bladder wall movements during radiotherapy differ based on filling. Full bladder (FB) shows greater volume variability than empty bladder (EB), but displacement is similar except at anterior and superior borders.

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Area of Science:

Radiation oncology
Medical imaging
Pelvic anatomy

Background:

Bladder filling significantly impacts radiation dose distribution.
Variations in bladder volume during radiotherapy affect adjacent organ doses.

Purpose of the Study:

To compare bladder wall displacement during full bladder (FB) and empty bladder (EB) radiotherapy.
To analyze the impact of bladder filling on dose-volume load.

Main Methods:

50 prostate cancer patients underwent 340 serial CT scans.
Scans were performed with both full bladder (FB) and empty bladder (EB) conditions.
Bladder wall displacements were measured and correlated with volume changes.

Main Results:

Full bladder (FB) volume variability (124 cc) was significantly higher than empty bladder (EB) (56 cc).
Significant bladder wall displacement occurred at anterior and superior borders (15-21 mm) with FB.
Displacements at inferior, lateral, and posterior borders were < 5 mm for both FB and EB.

Conclusions:

Empty bladder (EB) reduces superior and anterior bladder wall displacement compared to full bladder (FB).
Bladder wall displacements are comparable between FB and EB at other borders.
Bladder filling strategy impacts pelvic radiotherapy precision.