Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System
Purpose: The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for...
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| Veröffentlicht in: | Technology in cancer research & treatment 2017-06, Vol.16 (3), p.257-266 |
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| creator | Fan, Qiyong Yeung, Anamaria R. Amdur, Robert Helmig, Richard Park, Justin Li, Jonathan Kahler, Darren Liu, Chihray Lu, Bo |
| description | Purpose:
The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively.
Methods:
The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter. Contrast agent (10) cm3 is injected into the inflatable end, which is affixed to the tandem and ring applicator, to displace the posterior vaginal wall. The belt immobilization system consists of a specially designed bracket that can hold and fix itself to the applicator, a diaper-like Velcro fastener package used for connecting the patient’s pelvis to the bracket, and a buckle that holds the fasteners to stabilize the whole system. The treatment data for 21 patients with cervical cancer using both balloon catheter and belt immobilization system were retrospectively analyzed. Computed tomography and magnetic resonance images, acquired about 30 minutes apart, were registered to evaluate the effectiveness of the immobilization system.
Results:
In comparison with a virtual rectal blade, the balloon decreased the rectal point dose by 34% ± 4.2% (from 276 ± 57 to 182 ± 38 cGy), corresponding to an extra sparing distance of 7.9 ± 1.1 mm. The maximum sparing distance variation per patient is 1.4 ± 0.6 mm, indicating the high interfractional reproducibility for rectum sparing. With the immobilization system, the mean translational and rotational displacements of the applicator set are |
| doi_str_mv | 10.1177/1533034616631122 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_AFRWT</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5616039</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1533034616631122</sage_id><sourcerecordid>1826657007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-b49177342994e75951ec43a49a6cbdf8acc29a35117588f9251ac528a4bc24153</originalsourceid><addsrcrecordid>eNp1kc1vEzEQxS0Eoh9w54Qscellqb_XviCRUNpIlZCAnq1Zr5O42l0He7ci_evrKCWUSpxseX7zxm8eQu8o-UhpXZ9TyTnhQlGlOKWMvUDHu6eKcK5fHu5CHaGTnG8JYTvuNTpiSiutJTlGedHDyleXU2h9i6_Cal19idnj7zB6PEvg1ttx7RNstjgMeO7TXfiN55BcGGIP-CaHYYVn0HUxljIUdvQJw9Dime9GvOj72IQu3MMYCvBjm0ffv0GvltBl__bxPEU3Xy9-zq-q62-Xi_nn68oJxcaqEaZ45IIZI3wtjaTeCQ7CgHJNu9TgHDPAZdmE1HppmKTgJNMgGsdE8X6KPu11N1PT-9b5YUzQ2U0KPaStjRDsv5UhrO0q3llZFkq4KQJnjwIp_pp8Hm0fsvNdB4OPU7ZUl4XKmpC6oB-eobdxSkOxZ5lgtTCKSlYosqdcijknvzx8hhK7S9Q-T7S0vH9q4tDwJ8ICVHsglyD_Tv2v4ANq3Kg2</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2427496152</pqid></control><display><type>article</type><title>Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System</title><source>Sage Journals GOLD Open Access 2024</source><creator>Fan, Qiyong ; Yeung, Anamaria R. ; Amdur, Robert ; Helmig, Richard ; Park, Justin ; Li, Jonathan ; Kahler, Darren ; Liu, Chihray ; Lu, Bo</creator><creatorcontrib>Fan, Qiyong ; Yeung, Anamaria R. ; Amdur, Robert ; Helmig, Richard ; Park, Justin ; Li, Jonathan ; Kahler, Darren ; Liu, Chihray ; Lu, Bo</creatorcontrib><description>Purpose:
The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively.
Methods:
The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter. Contrast agent (10) cm3 is injected into the inflatable end, which is affixed to the tandem and ring applicator, to displace the posterior vaginal wall. The belt immobilization system consists of a specially designed bracket that can hold and fix itself to the applicator, a diaper-like Velcro fastener package used for connecting the patient’s pelvis to the bracket, and a buckle that holds the fasteners to stabilize the whole system. The treatment data for 21 patients with cervical cancer using both balloon catheter and belt immobilization system were retrospectively analyzed. Computed tomography and magnetic resonance images, acquired about 30 minutes apart, were registered to evaluate the effectiveness of the immobilization system.
Results:
In comparison with a virtual rectal blade, the balloon decreased the rectal point dose by 34% ± 4.2% (from 276 ± 57 to 182 ± 38 cGy), corresponding to an extra sparing distance of 7.9 ± 1.1 mm. The maximum sparing distance variation per patient is 1.4 ± 0.6 mm, indicating the high interfractional reproducibility for rectum sparing. With the immobilization system, the mean translational and rotational displacements of the applicator set are <3 mm and <1.5°, respectively, in all directions.
Conclusions:
The rectal balloon provides significant dose reduction to the rectum and it may potentially minimize patient discomfort. The immobilization system permits almost no movement of the applicator during treatment. This work has the potential to be promoted as a standardized solution for high-dose rate treatment of cervical cancer.</description><identifier>ISSN: 1533-0346</identifier><identifier>EISSN: 1533-0338</identifier><identifier>DOI: 10.1177/1533034616631122</identifier><identifier>PMID: 26868850</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Balloon catheters ; Brachytherapy ; Brachytherapy - methods ; Catheters ; Cervical cancer ; Cervical carcinoma ; Cervix Uteri - diagnostic imaging ; Cervix Uteri - pathology ; Cervix Uteri - radiation effects ; Computed tomography ; Contrast Media - administration & dosage ; Female ; Humans ; Immobilization ; Magnetic Resonance Imaging ; Pelvis ; Radiation therapy ; Radiotherapy Dosage ; Rectum ; Rectum - diagnostic imaging ; Rectum - pathology ; Rectum - radiation effects ; Tomography, X-Ray Computed ; Uterine Cervical Neoplasms - diagnostic imaging ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - radiotherapy ; Vagina</subject><ispartof>Technology in cancer research & treatment, 2017-06, Vol.16 (3), p.257-266</ispartof><rights>The Author(s) 2016</rights><rights>The Author(s) 2016. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><rights>The Author(s) 2016 2016 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-b49177342994e75951ec43a49a6cbdf8acc29a35117588f9251ac528a4bc24153</citedby><cites>FETCH-LOGICAL-c462t-b49177342994e75951ec43a49a6cbdf8acc29a35117588f9251ac528a4bc24153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5616039/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5616039/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,21945,27830,27901,27902,44921,45309,53766,53768</link.rule.ids><linktorsrc>$$Uhttps://journals.sagepub.com/doi/full/10.1177/1533034616631122?utm_source=summon&utm_medium=discovery-provider$$EView_record_in_SAGE_Publications$$FView_record_in_$$GSAGE_Publications</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26868850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Qiyong</creatorcontrib><creatorcontrib>Yeung, Anamaria R.</creatorcontrib><creatorcontrib>Amdur, Robert</creatorcontrib><creatorcontrib>Helmig, Richard</creatorcontrib><creatorcontrib>Park, Justin</creatorcontrib><creatorcontrib>Li, Jonathan</creatorcontrib><creatorcontrib>Kahler, Darren</creatorcontrib><creatorcontrib>Liu, Chihray</creatorcontrib><creatorcontrib>Lu, Bo</creatorcontrib><title>Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System</title><title>Technology in cancer research & treatment</title><addtitle>Technol Cancer Res Treat</addtitle><description>Purpose:
The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively.
Methods:
The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter. Contrast agent (10) cm3 is injected into the inflatable end, which is affixed to the tandem and ring applicator, to displace the posterior vaginal wall. The belt immobilization system consists of a specially designed bracket that can hold and fix itself to the applicator, a diaper-like Velcro fastener package used for connecting the patient’s pelvis to the bracket, and a buckle that holds the fasteners to stabilize the whole system. The treatment data for 21 patients with cervical cancer using both balloon catheter and belt immobilization system were retrospectively analyzed. Computed tomography and magnetic resonance images, acquired about 30 minutes apart, were registered to evaluate the effectiveness of the immobilization system.
Results:
In comparison with a virtual rectal blade, the balloon decreased the rectal point dose by 34% ± 4.2% (from 276 ± 57 to 182 ± 38 cGy), corresponding to an extra sparing distance of 7.9 ± 1.1 mm. The maximum sparing distance variation per patient is 1.4 ± 0.6 mm, indicating the high interfractional reproducibility for rectum sparing. With the immobilization system, the mean translational and rotational displacements of the applicator set are <3 mm and <1.5°, respectively, in all directions.
Conclusions:
The rectal balloon provides significant dose reduction to the rectum and it may potentially minimize patient discomfort. The immobilization system permits almost no movement of the applicator during treatment. This work has the potential to be promoted as a standardized solution for high-dose rate treatment of cervical cancer.</description><subject>Balloon catheters</subject><subject>Brachytherapy</subject><subject>Brachytherapy - methods</subject><subject>Catheters</subject><subject>Cervical cancer</subject><subject>Cervical carcinoma</subject><subject>Cervix Uteri - diagnostic imaging</subject><subject>Cervix Uteri - pathology</subject><subject>Cervix Uteri - radiation effects</subject><subject>Computed tomography</subject><subject>Contrast Media - administration & dosage</subject><subject>Female</subject><subject>Humans</subject><subject>Immobilization</subject><subject>Magnetic Resonance Imaging</subject><subject>Pelvis</subject><subject>Radiation therapy</subject><subject>Radiotherapy Dosage</subject><subject>Rectum</subject><subject>Rectum - diagnostic imaging</subject><subject>Rectum - pathology</subject><subject>Rectum - radiation effects</subject><subject>Tomography, X-Ray Computed</subject><subject>Uterine Cervical Neoplasms - diagnostic imaging</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - radiotherapy</subject><subject>Vagina</subject><issn>1533-0346</issn><issn>1533-0338</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1vEzEQxS0Eoh9w54Qscellqb_XviCRUNpIlZCAnq1Zr5O42l0He7ci_evrKCWUSpxseX7zxm8eQu8o-UhpXZ9TyTnhQlGlOKWMvUDHu6eKcK5fHu5CHaGTnG8JYTvuNTpiSiutJTlGedHDyleXU2h9i6_Cal19idnj7zB6PEvg1ttx7RNstjgMeO7TXfiN55BcGGIP-CaHYYVn0HUxljIUdvQJw9Dime9GvOj72IQu3MMYCvBjm0ffv0GvltBl__bxPEU3Xy9-zq-q62-Xi_nn68oJxcaqEaZ45IIZI3wtjaTeCQ7CgHJNu9TgHDPAZdmE1HppmKTgJNMgGsdE8X6KPu11N1PT-9b5YUzQ2U0KPaStjRDsv5UhrO0q3llZFkq4KQJnjwIp_pp8Hm0fsvNdB4OPU7ZUl4XKmpC6oB-eobdxSkOxZ5lgtTCKSlYosqdcijknvzx8hhK7S9Q-T7S0vH9q4tDwJ8ICVHsglyD_Tv2v4ANq3Kg2</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Fan, Qiyong</creator><creator>Yeung, Anamaria R.</creator><creator>Amdur, Robert</creator><creator>Helmig, Richard</creator><creator>Park, Justin</creator><creator>Li, Jonathan</creator><creator>Kahler, Darren</creator><creator>Liu, Chihray</creator><creator>Lu, Bo</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PKEHL</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170601</creationdate><title>Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System</title><author>Fan, Qiyong ; Yeung, Anamaria R. ; Amdur, Robert ; Helmig, Richard ; Park, Justin ; Li, Jonathan ; Kahler, Darren ; Liu, Chihray ; Lu, Bo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-b49177342994e75951ec43a49a6cbdf8acc29a35117588f9251ac528a4bc24153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Balloon catheters</topic><topic>Brachytherapy</topic><topic>Brachytherapy - methods</topic><topic>Catheters</topic><topic>Cervical cancer</topic><topic>Cervical carcinoma</topic><topic>Cervix Uteri - diagnostic imaging</topic><topic>Cervix Uteri - pathology</topic><topic>Cervix Uteri - radiation effects</topic><topic>Computed tomography</topic><topic>Contrast Media - administration & dosage</topic><topic>Female</topic><topic>Humans</topic><topic>Immobilization</topic><topic>Magnetic Resonance Imaging</topic><topic>Pelvis</topic><topic>Radiation therapy</topic><topic>Radiotherapy Dosage</topic><topic>Rectum</topic><topic>Rectum - diagnostic imaging</topic><topic>Rectum - pathology</topic><topic>Rectum - radiation effects</topic><topic>Tomography, X-Ray Computed</topic><topic>Uterine Cervical Neoplasms - diagnostic imaging</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - radiotherapy</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Qiyong</creatorcontrib><creatorcontrib>Yeung, Anamaria R.</creatorcontrib><creatorcontrib>Amdur, Robert</creatorcontrib><creatorcontrib>Helmig, Richard</creatorcontrib><creatorcontrib>Park, Justin</creatorcontrib><creatorcontrib>Li, Jonathan</creatorcontrib><creatorcontrib>Kahler, Darren</creatorcontrib><creatorcontrib>Liu, Chihray</creatorcontrib><creatorcontrib>Lu, Bo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Technology in cancer research & treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Fan, Qiyong</au><au>Yeung, Anamaria R.</au><au>Amdur, Robert</au><au>Helmig, Richard</au><au>Park, Justin</au><au>Li, Jonathan</au><au>Kahler, Darren</au><au>Liu, Chihray</au><au>Lu, Bo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System</atitle><jtitle>Technology in cancer research & treatment</jtitle><addtitle>Technol Cancer Res Treat</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>16</volume><issue>3</issue><spage>257</spage><epage>266</epage><pages>257-266</pages><issn>1533-0346</issn><eissn>1533-0338</eissn><abstract>Purpose:
The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively.
Methods:
The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter. Contrast agent (10) cm3 is injected into the inflatable end, which is affixed to the tandem and ring applicator, to displace the posterior vaginal wall. The belt immobilization system consists of a specially designed bracket that can hold and fix itself to the applicator, a diaper-like Velcro fastener package used for connecting the patient’s pelvis to the bracket, and a buckle that holds the fasteners to stabilize the whole system. The treatment data for 21 patients with cervical cancer using both balloon catheter and belt immobilization system were retrospectively analyzed. Computed tomography and magnetic resonance images, acquired about 30 minutes apart, were registered to evaluate the effectiveness of the immobilization system.
Results:
In comparison with a virtual rectal blade, the balloon decreased the rectal point dose by 34% ± 4.2% (from 276 ± 57 to 182 ± 38 cGy), corresponding to an extra sparing distance of 7.9 ± 1.1 mm. The maximum sparing distance variation per patient is 1.4 ± 0.6 mm, indicating the high interfractional reproducibility for rectum sparing. With the immobilization system, the mean translational and rotational displacements of the applicator set are <3 mm and <1.5°, respectively, in all directions.
Conclusions:
The rectal balloon provides significant dose reduction to the rectum and it may potentially minimize patient discomfort. The immobilization system permits almost no movement of the applicator during treatment. This work has the potential to be promoted as a standardized solution for high-dose rate treatment of cervical cancer.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>26868850</pmid><doi>10.1177/1533034616631122</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | Sage Journals GOLD Open Access 2024 |
| subjects | Balloon catheters Brachytherapy Brachytherapy - methods Catheters Cervical cancer Cervical carcinoma Cervix Uteri - diagnostic imaging Cervix Uteri - pathology Cervix Uteri - radiation effects Computed tomography Contrast Media - administration & dosage Female Humans Immobilization Magnetic Resonance Imaging Pelvis Radiation therapy Radiotherapy Dosage Rectum Rectum - diagnostic imaging Rectum - pathology Rectum - radiation effects Tomography, X-Ray Computed Uterine Cervical Neoplasms - diagnostic imaging Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - radiotherapy Vagina |
| title | Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System |
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