Three-dimensional image-based planning for cervix brachytherapy with bilateral hip prostheses: a solution using MVCT...

Area of Science:

• Medical Physics
• Oncology
• Radiotherapy

Background:

• Bilateral metal hip prostheses pose challenges for traditional imaging in cervical cancer treatment planning.
• Kilovoltage computed tomography (kVCT) produces artifacts that obscure critical structures, hindering accurate radiotherapy planning.

Purpose of the Study:

• To present a novel method for three-dimensional (3D) image-based planning for cervix high-dose-rate (HDR) brachytherapy.
• To evaluate the utility of megavoltage computed tomography (MVCT) imaging in patients with bilateral metal hip prostheses.

Main Methods:

• Developed and applied a 3D treatment planning approach using MVCT imaging.
• Treated two patients with bilateral hip prostheses using standard HDR brachytherapy fractionation and tolerance limits.
• Utilized MVCT to overcome kVCT-induced artifacts and visualize organs at risk.

Main Results:

• MVCT imaging provided sufficient contrast for accurate contouring of organs at risk.
• Digitization of HDR applicators was successfully performed using MVCT data.
• Achieved successful HDR brachytherapy treatment planning for both patients based on MVCT images.

Conclusions:

• MVCT imaging effectively eliminates streak artifacts, significantly improving image quality for treatment planning.
• MVCT offers a viable alternative for 3D planning in cervix brachytherapy for patients with bilateral hip prostheses.