title: Ultrasound use in gynecologic brachytherapy: Time to focus the beam.
abstract: There is wide disparity in the practice of brachytherapy for cervical cancer around the world. Although select well-resourced centers advocate use of MRI for all insertions, planar X-ray imaging remains the most commonly used imaging modality to assess intracavitary implants, particularly where the burden of cervical cancer is high. Incorporating soft tissue imaging into brachytherapy programs has been shown to improve the technical accuracy of implants, which in turn has led to improved local control and decreased toxicity. These improvements have a positive effect on the quality of life of patients undergoing brachytherapy for cervical cancer. Finding an accessible soft tissue imaging modality is essential to enable these improvements to be available to all patients. A modality that has good soft tissue imaging capabilities, is widely available, portable, and economical, is needed. Ultrasound fulfils these requirements and offers the potential of soft tissue image guidance to a much wider brachytherapy community. Although use of ultrasound is the standard of care in brachytherapy for prostate cancer, it only seems to have limited uptake in gynecologic brachytherapy. This article reviews the role of ultrasound in gynecologic brachytherapy and highlights the potential applications for use in brachytherapy for cervical cancer.
authors.affiliation: Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. Electronic address: sylvia.vandyk@petermac.org.
authors.forename: Sylvia
authors.initials: S
authors.lastname: van Dyk
authors.affiliation: Department of Medical Imaging and Radiation Science, Monash University, Clayton, Victoria, Australia.
authors.forename: Michal
authors.initials: M
authors.lastname: Schneider
authors.affiliation: Rural Clinical School, University of Queensland, Toowoomba, Queensland, Australia.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Kondalsamy-Chennakesavan
authors.affiliation: Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Bernshaw
authors.affiliation: Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Department of Obstetrics and Gynaecology, Melbourne University, Melbourne, Victoria, Australia.
authors.forename: Kailash
authors.initials: K
authors.lastname: Narayan
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011788:Quality of Life; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D014595:Uterine Perforation / Q000000981:diagnostic imaging / Q000209:etiology
keywords: Brachytherapy; Cervical cancer; Gynecologic cancers; Ultrasound