Radiation Therapy Services, Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
Clin Oncol (R Coll Radiol). 2021 Sep;33(9):e403-e411. doi: 10.1016/j.clon.2021.02.011. Epub 2021 Mar 11.
Radiotherapy and brachytherapy are the definitive treatments for locally advanced cervix cancer. The use of soft-tissue imaging, particularly magnetic resonance imaging, has enhanced their effectiveness and improved clinical outcomes. However, the use of magnetic resonance imaging is largely restricted to well-resourced centres in both the first and developing world and remains elusive to many less advantaged centres, particularly those in areas with a high burden of cervix cancer. Ultrasound is an accessible, affordable and accurate imaging modality that can be used throughout the brachytherapy procedure. Ultrasound is primarily used to ensure safe insertion of the applicator but can also be used to guide planning. The methods used to utilise ultrasound images for planning are described. Ultrasound is particularly useful as a verification aid to confirm applicator placement after patients are moved and transferred around the radiotherapy department. It can also be used to verify the dimensions of treatment volumes over the course of brachytherapy. There is a crucial unmet need for an accessible economical soft-tissue imaging modality in cervical brachytherapy. Ultrasound has the potential to meet this need.
放射治疗和近距离治疗是局部晚期宫颈癌的确定性治疗方法。软组织成像的应用，特别是磁共振成像，提高了它们的疗效并改善了临床结果。然而，磁共振成像的应用在资源丰富的第一世界和发展中国家中心得到了广泛的应用，而许多资源较少的中心，特别是那些宫颈癌负担较重的地区的中心，仍然难以实现。超声是一种可及、经济且准确的成像方式，可在近距离治疗过程中使用。超声主要用于确保施源器的安全插入，但也可用于指导计划。本文描述了用于计划的超声图像的使用方法。超声在患者在放射治疗部门内移动和转移后，作为确认施源器位置的验证辅助手段特别有用。它还可用于验证在近距离治疗过程中治疗体积的尺寸。在宫颈癌近距离治疗中，需要一种经济实用的软组织成像方式，但这一需求尚未得到满足。超声有可能满足这一需求。
