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. 2013 Oct;38(4):178-84.
doi: 10.4103/0971-6203.121195.

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

Anil Kumar Talluri  1 , Krishnam Raju Alluri  1 , Deleep Kumar Gudipudi  1 , Shabbir Ahamed  1 , Madhusudhana M Sresty  1 , Aparna Yarrama Reddy  2
Affiliations

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

Anil Kumar Talluri et al. J Med Phys. 2013 Oct.

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.

Keywords: Bladder; lithotomy; rectum; supine.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Patient in Supine Position
Figure 2
Figure 2
Patient in Lithotomy M Shape Position
Figure 3
Figure 3
Orthogonal digital X- ray image in Supine position
Figure 4
Figure 4
Orthogonal digital X- ray image in Lithotomy M Shape position
Figure 5
Figure 5
Dose distribution in Supine position
Figure 6
Figure 6
Dose distribution in Lithotomy M Shape position
Figure 7
Figure 7
Dose to bladder point in two positions
Figure 8
Figure 8
Dose to right pelvic wall point in two positions
Figure 9
Figure 9
Dose to left pelvic wall point in two positions
Figure 10
Figure 10
Dose to rectal point in two positions
See this image and copyright information in PMC

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