title: Necessity of CT-MRI based treatment planning for cervical tumors with retroverted uterus: A case report with review of literature.
abstract: Treatment of carcinoma cervix is a complex issue influenced by numerous factors, including the patient's age, clinical stage of the disease, position of the uterus, comorbidities, etc. The major drawback of the conventional four-field box technique is the lack of complete information about the flexion of the uterus and topography of the tumor. These are further influenced by bladder and rectal filling, which may lead to geographical miss of the clinical target volume (CTV). This problem was noticed mainly in the anterior and posterior borders of the lateral fields and in the superior and lateral borders of the anteroposterior fields. We demonstrate the need for computed tomographic-magnetic resonance imaging (MRI)-based 3D planning of each patient and necessity of sagittal MRI for designing lateral portal in case of conventional four-field technique through an example of a patient's sagittal MRI of pelvis showing retroverted uterus.
authors.affiliation: Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Institute, Sardar Patel Medical College and Associated Group of Hospitals, Bikaner, Rajasthan, India.
authors.forename: Daleep
authors.initials: D
authors.lastname: Singh
authors.forename: Hema
authors.initials: H
authors.lastname: Latha
authors.forename: Akhil
authors.initials: A
authors.lastname: Kapoor
authors.forename: Athiyaman
authors.initials: A
authors.lastname: Mayilvaganan
authors.forename: Shankar Lal
authors.initials: SL
authors.lastname: Jakhar
authors.forename: Harvindra Singh
authors.initials: HS
authors.lastname: Kumar
mesh_terms: D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011880:Radiotherapy Planning, Computer-Assisted; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D060725:Uterine Retroversion / Q000000981:diagnostic imaging*