title: Image Guided Cervical Brachytherapy: 2014 Survey of the American Brachytherapy Society.
abstract: OBJECTIVE
  To provide an update of the 2007 American brachytherapy survey on image-based brachytherapy, which showed that in the setting of treatment planning for gynecologic brachytherapy, although computed tomography (CT) was often used for treatment planning, most brachytherapists used point A for dose specification.
  
  
  METHODS
  A 45-question electronic survey on cervical cancer brachytherapy practice patterns was sent to all American Brachytherapy Society members and additional radiation oncologists and physicists based in the United States between January and September 2014. Responses from the 2007 survey and the present survey were compared using the χ(2) test.
  
  
  RESULTS
  There were 370 respondents. Of those, only respondents, not in training, who treat more than 1 cervical cancer patient per year and practice in the United States, were included in the analysis (219). For dose specification to the target (cervix and tumor), 95% always use CT, and 34% always use MRI. However, 46% use point A only for dose specification to the target. There was a lot of variation in parameters used for dose evaluation of target volume and normal tissues. Compared with the 2007 survey, use of MRI has increased from 2% to 34% (P<.0001) for dose specification to the target. Use of volume-based dose delineation to the target has increased from 14% to 52% (P<.0001).
  
  
  CONCLUSIONS
  Although use of image-based brachytherapy has increased in the United States since the 2007 survey, there is room for further growth, particularly with the use of MRI. This increase may be in part due to educational initiatives. However, there is still significant heterogeneity in brachytherapy practice in the United States, and future efforts should be geared toward standardizing treatment.
authors: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Surbhi.grover@uphs.upenn.edu.
authors: Surbhi
authors: S
authors: Grover
authors: Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois.
authors: Matthew M
authors: MM
authors: Harkenrider
authors: Department of Radiation Oncology, Brigham & Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts.
authors: Linda P
authors: LP
authors: Cho
authors: Department Radiation Oncology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Beth
authors: B
authors: Erickson
authors: Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois.
authors: Christina
authors: C
authors: Small
authors: Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois.
authors: William
authors: W
authors: Small
authors: Department of Radiation Oncology, Brigham & Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts.
authors: Akila N
authors: AN
authors: Viswanathan
mesh_terms: D001918:Brachytherapy / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D058958:Organs at Risk; D010818:Practice Patterns, Physicians'; D018787:Radiation Oncology; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*