Uterine perforation during intracavitary brachytherapy for carcinoma of the cervix

The use of ultrasound-guidance during applicator placement may reduce the risk of uterine perforations. 1 The use of traditional x-ray simulations may make the planner oblivious to the true position of the central tandem, which if loaded in the intra-abdominal location could expose the small intestine to risk of serious radiation dosages. 3 The use of CT scan after application not only allows for volumetric dose-optimisation, but also allows the detection of applicator mal-placements, as illustrated by this report.