Abstract
BackgroundThe accuracy of any radiation therapy delivery is limited by target organ translocation and distortion. Bladder filling is one of the recognised factors affecting prostate translocation and distortion. The purpose of our study was to evaluate the effect of bladder volume on prostate translocation and distortion by using detailed three-dimensional prostate delineation on MRI.Patients and methodsFifteen healthy male volunteers were recruited in this prospective, institutional review board-approved study. Each volunteer underwent 4 different drinking preparations prior to imaging, with MR images acquired pre- and post-void. MR images were co-registered by using bony landmarks and three-dimensional contouring was performed in order to assess the degree of prostate translocation and distortion. According to changes in bladder or rectum distention, subdivisions were made into bladder and rectal groups. Studies with concomitant change in both bladder and rectal volume were excluded.ResultsForty studies were included in the bladder volume study group and 8 in the rectal volume study group. The differences in rectal volumes yielded higher levels of translocation (p < 0.01) and distortion (p = 0.02) than differences in bladder volume. Moderate correlation of prostate translocation with bladder filling was shown (r = 0.64, p < 0.01). There was no important prostate translocation when bladder volume change was < 2-fold (p < 0.01). Moderate correlation of prostate distortion with bladder filling was shown (r = 0.61, p < 0.01).ConclusionsBladder volume has a minimal effect on prostate translocation and effect on prostate distortion is negligible. Prostate translocation may be minimalised if there is < 2-fold increase in the bladder volume.
Highlights
Some studies have shown that radiation therapy with a full bladder protocol has distinct advantages in relation to dose load to both rectum and bladder.[14,15]
The results of our study suggest that bladder volume has only a minimal effect on prostate translocation and its effect on prostate distortion is negligible
In our study, detailed magnetic resonance imaging (MRI) prostate delineation on axial slices with sub-millimetre in-plane resolution was performed to more accurately quantify the degree of prostate translocation and distortion secondary to changes in bladder or rectal volumes, using a previously devised computational framework.[25]
Summary
Snoj Z et al / Bladder volume on prostate translocation and distortion therapy, with options being modulated according to baseline patient risk group.[2,3] Radiation therapy, either alone or in conjunction with hormonal therapy, is an effective and accepted care option across all risk groups.[3].
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