title: Trans-abdominal ultrasound (US) and magnetic resonance imaging (MRI) correlation for conformal intracavitary brachytherapy in carcinoma of the uterine cervix.
abstract: OBJECTIVE
  Trans-abdominal ultrasonography (US) is capable of determining size, shape, thickness, and diameter of uterus, cervix and disease at cervix or parametria. To assess the potential value of US for image-guided cervical cancer brachytherapy, we compared US-findings relevant for brachytherapy to the corresponding findings obtained from MR imaging.
  
  
  METHODS
  Twenty patients with biopsy proven cervical cancer undergoing definitive radiotherapy with/without concomitant Cisplatin chemotherapy and suitable for brachytherapy were invited to participate in this study. US and MR were performed in a similar reproducible patient positioning after intracavitary application. US mid-sagittal and axial image at the level of external cervical os was acquired. Reference points D1 to D9 and distances were identified with respect to central tandem and flange, to delineate cervix, central disease, and external surface of the uterus.
  
  
  RESULTS
  Thirty-two applications using CT/MR compatible applicators were evaluable. The D1 and D3 reference distances which represent anterior surface had a strong correlation with R=0.92 and 0.94 (p<0.01). The D2 and D4 reference distances in contrast, which represent the posterior surface had a moderate (D2) and a strong (D4) correlation with R=0.63 and 0.82 (p<0.01). Of all, D2 reference distance showed the least correlation of MR and US. The D5 reference distance representing the fundal thickness from tandem tip had a correlation of 0.98. The reference distances for D6, D7, D8, and D9 had a correlation of 0.94, 0.82, 0.96, and 0.93, respectively.
  
  
  CONCLUSIONS
  Our study evaluating the use of US, suggests a reasonably strong correlation with MR in delineating uterus, cervix, and central disease for 3D conformal intracavitary brachytherapy planning.
authors: Department of Radiation Oncology and Medical Physics, Tata Memorial Hospital, Mumbai, India. drumeshm@gmail.com
authors: Umesh
authors: U
authors: Mahantshetty
authors: Nehal
authors: N
authors: Khanna
authors: Jamema
authors: J
authors: Swamidas
authors: Reena
authors: R
authors: Engineer
authors: Meenakshi H
authors: MH
authors: Thakur
authors: Nikhil H
authors: NH
authors: Merchant
authors: Deepak D
authors: DD
authors: Deshpande
authors: Shyamkishore
authors: S
authors: Shrivastava
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D009367:Neoplasm Staging; D056888:Patient Positioning; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin