3-T MR-guided brachytherapy for gynecologic malignancies

Tina Kapur, Jan Egger, Antonio Damato, Ehud Schmidt, Akila Viswanathan

Research output: Contribution to journalArticle

Abstract

Gynecologic malignancies are a leading cause of death in women worldwide. Standard treatment for many primary and recurrent gynecologic cancer cases includes external-beam radiation followed by brachytherapy. Magnetic resonance (MR) imaging is beneficial in diagnostic evaluation, in mapping the tumor location to tailor radiation dose and in monitoring the tumor response to treatment. Initial studies of MR guidance in gynecologic brachytherapy demonstrate the ability to optimize tumor coverage and reduce radiation dose to normal tissues, resulting in improved outcomes for patients. In this article, we describe a methodology to aid applicator placement and treatment planning for 3 Tesla (3-T) MR-guided brachytherapy that was developed specifically for gynecologic cancers. This methodology has been used in 18 cases from September 2011 to May 2012 in the Advanced Multimodality Image Guided Operating (AMIGO) suite at Brigham and Women's Hospital. AMIGO comprises state-of-the-art tools for MR imaging, image analysis and treatment planning. An MR sequence using three-dimensional (3D)-balanced steady-state free precession in a 3-T MR scanner was identified as the best sequence for catheter identification with ballooning artifact at the tip. 3D treatment planning was performed using MR images. Items in development include software designed to support virtual needle trajectory planning that uses probabilistic bias correction, graph-based segmentation and image registration algorithms. The results demonstrate that 3-T MR image guidance has a role in gynecologic brachytherapy. These novel developments have the potential to improve targeted treatment to the tumor while sparing the normal tissues.

Original languageEnglish (US)
Pages (from-to)1279-1290
Number of pages12
JournalMagnetic Resonance Imaging
Volume30
Issue number9
DOIs
StatePublished - Nov 2012
Externally publishedYes

Fingerprint

Brachytherapy
Magnetic resonance
Magnetic Resonance Spectroscopy
Tumors
Planning
Neoplasms
Magnetic resonance imaging
Dosimetry
Radiation
Tissue
Therapeutics
Magnetic Resonance Imaging
Applicators
Catheters
Image registration
Needles
Image analysis
Software engineering
Artifacts
Trajectories

Keywords

  • Bias correction
  • Brachytherapy
  • MR susceptibility artifact
  • Registration
  • Segmentation
  • Visualization

ASJC Scopus subject areas

  • Biophysics
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging

Cite this

3-T MR-guided brachytherapy for gynecologic malignancies. / Kapur, Tina; Egger, Jan; Damato, Antonio; Schmidt, Ehud; Viswanathan, Akila.

In: Magnetic Resonance Imaging, Vol. 30, No. 9, 11.2012, p. 1279-1290.

Research output: Contribution to journalArticle

Kapur, Tina ; Egger, Jan ; Damato, Antonio ; Schmidt, Ehud ; Viswanathan, Akila. / 3-T MR-guided brachytherapy for gynecologic malignancies. In: Magnetic Resonance Imaging. 2012 ; Vol. 30, No. 9. pp. 1279-1290.
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