title: Image-Based Brachytherapy for the Treatment of Cervical Cancer.
abstract: Cervical cancer is a disease that requires considerable multidisciplinary coordination of care and labor in order to maximize tumor control and survival while minimizing treatment-related toxicity. As with external beam radiation therapy, the use of advanced imaging and 3-dimensional treatment planning has generated a paradigm shift in the delivery of brachytherapy for the treatment of cervical cancer. The use of image-based brachytherapy, most commonly with magnetic resonance imaging (MRI), requires additional attention and effort by the treating physician to prescribe dose to the proper volume and account for adjacent organs at risk. This represents a dramatic change from the classic Manchester approach of orthogonal radiographic images and prescribing dose to point A. We reviewed the history and currently evolving data and recommendations for the clinical use of image-based brachytherapy with an emphasis on MRI-based brachytherapy.
authors.affiliation: Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois. Electronic address: mharkenrider@lumc.edu.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Harkenrider
authors.affiliation: Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois.
authors.forename: Fiori
authors.initials: F
authors.lastname: Alite
authors.affiliation: Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Silva
authors.affiliation: Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois.
authors.forename: William
authors.initials: W
authors.lastname: Small
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods*; D002986:Clinical Trials as Topic; D012809:Colon, Sigmoid / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008488:Medical Illustration; D058958:Organs at Risk / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D011859:Radiography; D011879:Radiotherapy Dosage; D012007:Rectum / Q000033:anatomy & histology; D016896:Treatment Outcome; D035501:Uncertainty; D001743:Urinary Bladder / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*