Abstract
ObjectiveTo identify a contrast material that could be used as a dummy marker for magnetic resonance imaging.Materials and MethodsMagnetic resonance images were acquired with six different catheter-filling materials-water, glucose 50%, saline, olive oil, glycerin, and copper sulfate (CuSO4) water solution (2.08 g/L)-inserted into compatible computed tomography/magnetic resonance imaging ring applicators placed in a phantom made of gelatin and CuSO4. The best contrast media were tested in four patients with the applicators in place.ResultsIn T2-weighted sequences, the best contrast was achieved with the CuSO4-filled catheters, followed by saline- and glycerin-filled catheters, which presented poor visualization. In addition (also in T2-weighted sequences), CuSO4 presented better contrast when tested in the phantom than when tested in the patients, in which it provided some contrast but with poor identification of the first dwell position, mainly in the ring.ConclusionWe found CuSO4 to be the best solution for visualization of the applicator channels, mainly in T2-weighted images in vitro, although the materials tested presented low signal intensity in the images obtained in vivo, as well as poor precision in determining the first dwell position.
Highlights
The major challenge in radiation therapy is to treat lesions with a high effective dose, while minimizing the dose to adjacent normal tissue and organs at risk[1], diminishing side effects and treatment complications
The images were compared in order to determine which solution and magnetic resonance imaging (MRI) sequence promoted the best visualization for applicator reconstruction (Figures 2 and 3)
Image-guided brachytherapy for gynecologic malignancies can be performed with computed tomography (CT) or MRI scans
Summary
The major challenge in radiation therapy is to treat lesions with a high effective dose, while minimizing the dose to adjacent normal tissue and organs at risk[1], diminishing side effects and treatment complications. Because of its high dose-gradient characteristic, brachytherapy has the potential to help radiation oncologists achieve a good therapeutic ratio (a high dose to the tumor with good preservation of the surrounding normal tissue). Image-guided or 3D brachytherapy for gynecologic malignancies has the potential to improve local control and survival even further among cervical cancer patients[6,7]. Such techniques are still not in routine use, even in developed countries[8,9]
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