Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.
Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):104-9. doi: 10.1016/j.ijrobp.2009.01.043.
To determine current practice patterns with regard to three-dimensional (3D) imaging for gynecologic brachytherapy among American Brachytherapy Society (ABS) members.
Registered physician members of the ABS received a 19-item survey by e-mail in August 2007. This report excludes physicians not performing brachytherapy for cervical cancer.
Of the 256 surveys sent, we report results for 133 respondents who perform one or more implantations per year for locally advanced cervical cancer. Ultrasound aids 56% of physicians with applicator insertion. After insertion, 70% of physicians routinely obtain a computed tomography (CT) scan. The majority (55%) use CT rather than X-ray films (43%) or magnetic resonance imaging (MRI; 2%) for dose specification to the cervix. However, 76% prescribe to Point A alone instead of using a 3D-derived tumor volume (14%), both Point A and tumor volume (7%), or mg/h (3%). Those using 3D imaging routinely contour the bladder and rectum (94%), sigmoid (45%), small bowel (38%), and/or urethra (8%) and calculate normal tissue dose-volume histogram (DVH) analysis parameters including the D2cc (49%), D1cc (36%), D0.1cc (19%), and/or D5cc (19%). Respondents most commonly modify the treatment plan based on International Commission on Radiation Units bladder and/or rectal point dose values (53%) compared with DVH values (45%) or both (2%).
More ABS physician members use CT postimplantation imaging than plain films for visualizing the gynecologic brachytherapy apparatus. However, the majority prescribe to Point A rather than using 3D image based dosimetry. Use of 3D image-based treatment planning for gynecologic brachytherapy has the potential for significant growth in the United States.
确定美国近距离放射治疗协会（ABS）成员在妇科近距离放射治疗中三维（3D）成像的当前实践模式。
2007 年 8 月，ABS 的注册医师成员通过电子邮件收到了一份 19 项的调查。本报告不包括不进行宫颈癌近距离放射治疗的医生。
在发送的 256 份调查中，我们报告了每年进行一次或多次植入术治疗局部晚期宫颈癌的 133 名应答者的结果。超声辅助 56%的医生进行施源器插入。插入后，70%的医生常规获得计算机断层扫描（CT）扫描。大多数（55%）医生使用 CT 而不是 X 射线胶片（43%）或磁共振成像（MRI；2%）来确定宫颈的剂量。然而，76%的医生只规定了 A 点，而不是使用 3D 衍生的肿瘤体积（14%）、A 点和肿瘤体积（7%）或 mg/h（3%）。那些使用 3D 成像的医生通常会描绘膀胱和直肠（94%）、乙状结肠（45%）、小肠（38%）和/或尿道（8%），并计算正常组织剂量体积直方图（DVH）分析参数，包括 D2cc（49%）、D1cc（36%）、D0.1cc（19%）和/或 D5cc（19%）。应答者最常根据国际辐射单位委员会膀胱和/或直肠点剂量值（53%）而不是 DVH 值（45%）或两者（2%）修改治疗计划。
与普通胶片相比，更多的 ABS 医师成员在植入后使用 CT 成像来观察妇科近距离放射治疗设备。然而，大多数医生规定了 A 点，而不是使用基于 3D 图像的剂量学。在美国，使用基于 3D 图像的妇科近距离放射治疗计划有很大的发展潜力。
