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. 2024 Jan-Mar;49(1):6-11.
doi: 10.4103/jmp.jmp_130_23. Epub 2024 Mar 30.

Single- versus Multi-computed Tomography Simulation for High-dose-rate Postoperative Gynecological Intracavitary Brachytherapy

Angeliki Douvara  1 , Nikolaos Kollaros  1 , Georgios Patatoukas  1 , Marina Chalkia  1 , Efrosini Kypraiou  2 , Nikolaos Trogkanis  2 , Vassileios Kouloulias  2 , Kalliopi Platoni  1
Affiliations

Single- versus Multi-computed Tomography Simulation for High-dose-rate Postoperative Gynecological Intracavitary Brachytherapy

Angeliki Douvara et al. J Med Phys. 2024 Jan-Mar.

Abstract

Introduction: This study aimed to investigate whether there is a dosimetric difference of implementing single instead of multi-computed tomography (CT) simulation treatment planning for high-dose-rate postoperative gynecological intracavitary brachytherapy (BT).

Materials and methods: Eighty patients were registered in the study. They received three BT fractions of 7 Gy/week (three CTs, three original plans). The organs at risk (OAR), the rectal wall, and the clinical target volume (CTV) were delineated. The delivered doses for the 2cc of OARs (D2cc), 1cc of rectal wall (D1cc), as well as for the 90% and 100% of CTV volume (DCTV90%, DCTV100%) were evaluated. To evaluate the values of the above parameters if the single-CT-simulation method has been chosen, the time of the first treatment plan was corrected for the decay and applied as the second and third CT, retrospectively, creating the next fractions (two revised plans).

Results: No statistically significant (P > 0.05) differences were found between the original and revised plans for the OARs and CTV. However, for the single-CT-simulation method, it was noted that the dose constraints for the total rectal dose were exceeded in some cases (36.3%).

Conclusion: The fact that rectal dose constraints were exceeded in 1/3 of patients with the single-CT-simulation method is dosimetrically significant.

Keywords: High-dose rate; intracavitary brachytherapy; single- versus multi-computed tomography simulation.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Isodose curves of a patient’s plan. (a) Original plan, (b) Revised plan
See this image and copyright information in PMC

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