The use of modern imaging technologies in radiation therapy of cervical cancer

Angel I. Blanco, Larissa A. Meyer, George Verghese, Bin Teh, Adan Rios, Kara Ferachi, Matthew Rodriguez, Anneliese Gonzalez, John Dalrymple

Research output: Contribution to journalArticle

Abstract

Over the past century, definitive management of unresectable cervical cancer has evolved and currently employs high-dose radiation treatment with teletherapy and intracavitary brachytherapy (ICBT) components, combined with concurrent chemotherapy. Reflecting high disease prevalence among developing nations, the International Federation of Gynecology and Obstetrics (FIGO) staging of cervical cancer relies on clinical assessment, with limited radiographic
studies. However, multiple clinicopathologic analyses describe
suboptimal correlation between clinical examination findings and pathologic stage. Over the past two decades, systematic evaluation of volumetric and functional imaging modalities including CT, MRI, and PET-CT has refined our
ability to define disease extent and provide posttreatment surveillance.
Similarly, traditional ICBT techniques relied on two-dimensional (2D) data for evaluation of target dose coverage and offered limited assessment of exposure to critical structures including the bladder, rectum, and sigmoid colon.
During the last several years, investigators at leading European centers have enhanced the capabilities of existing ICBT techniques through dose optimization [high-dose rate (HDR) and pulsed dose rate (PDR)] and by incorporating volumetric imaging methods. Early results are encouraging, from both
toxicity and tumor control perspectives. These techniques are currently being adopted in multiple centers. Pertinent aspects are summarized in the body of this report.
Original languageEnglish (US)
Article numberDOI 10.1007/s13566-014-0178-z
Pages (from-to)1-10
Number of pages10
JournalJournal of Radiation Oncology
Volume4
StatePublished - Jan 6 2015

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