Radiation
Prospective Paired Comparison of MRI- and CT-Based Planning for Adjuvant Vaginal Cuff Brachytherapy in Endometrial Cancer: An Exploratory Study
By Iustin-Mihai Pirsan, Aleksandra Winkler, Claudia Gösenbauer and 3 others.
Abstract
Objectives
To assess the impact of magnetic resonance imaging (MRI) versus computed tomography (CT) on target delineation and dosimetry in adjuvant vaginal cuff brachytherapy (VBT) for endometrial cancer.
Methods
Twenty-five consecutive patients receiving adjuvant high-dose-rate VBT after hysterectomy were prospectively included. All underwent standardized treatment of 4 × 5 Gy in 5 mm tissue depth using a vaginal cylinder with a fixed loading pattern; individualized optimization was permitted for suboptimal coverage or proximity of organs at risk (OARs). For each patient, clinical target volume (CTV) and OARs (bladder, rectum, sigmoid, bowel) were contoured on both CT and MRI of the first fraction. Dosimetric parameters (CTV D90, D98, D50; OAR D2cc) were compared. Treatment characteristics and outcomes were analyzed retrospectively.
