Implementation and validation of a combined MRI-CT-based cervical cancer brachytherapy program using existing...

Area of Science:

• Oncology
• Radiotherapy
• Medical Imaging

Background:

• Cervical cancer brachytherapy (BT) planning traditionally relies on Point A.
• Three-dimensional (3D) imaging, particularly MRI, offers improved visualization of tumors and organs at risk (OARs).
• Integrating MRI-CT into BT planning can enhance treatment precision.

Purpose of the Study:

• To describe the implementation of an MRI-CT-based cervical cancer brachytherapy program.
• To evaluate the impact of this integrated approach on treatment planning and adherence to guidelines.

Main Methods:

• A step-wise implementation using a process map and prospective risk analysis.
• Review of patient charts (January 2013-December 2014) with MRI during BT planning.
• Dosimetric comparison between traditional Point A and 3D-based prescriptions, and between MRI-planned and CT-planned treatments.

Main Results:

• The MRI-CT planning program was successfully implemented using existing infrastructure.
• Eighty percent of treatments were prescribed to a point other than Point A.
• Plans met GEC-ESTRO recommendations for high-risk clinical target volume coverage and OAR dose constraints, with no major differences between MRI-planned and CT-planned (with MRI guidance) treatments.

Conclusions:

• An MRI-CT-based cervical cancer brachytherapy planning program is feasible with existing resources.
• The implemented program ensures treatment plans adhere to GEC-ESTRO guidelines, optimizing patient care.