Feasibility study and optimum loading pattern of a multi-ring inflatable intravaginal applicator

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: A cylinder applicator is the standard treatment device for intravaginal brachytherapy. However, they are limited in their ability to simultaneously spare the organs at risk (OAR), and reduce the hot spot in the vaginal mucosa, while achieving adequate dose conformality. This study aims to compare the dosimetric characteristics of single and multichannel cylinders, and utilizes volume point dose optimizations to investigate the feasibility and optimum loading method for a multi-ring inflatable intravaginal applicator. Material and methods: Studies were designed to: (1) test the feasibility of multi-ring applicators, (2) compare dose distributions between different multi-channel applicators and loading patterns, (3) test non-uniform prescription depths around the multi-ring cylinder. Results: Compared to a cylinder with a single central channel, a cylinder with 6 lumina arranged around the periphery, providing the lumina had adequate distance to the cylinder surface, could reduce dose beyond the prescription depth. However, when the number of outer lumina increased from 6 to 12, no further dose reduction could be achieved and the high dose volume close to the surface of the cylinder increased. Moreover, an additional ring, with lumina further away from the surface, provided increased dose shaping capabilities, allowing for individualized dose distributions. Conclusions: Dose could be reduced to normal tissue and the inner mucosa, and better conformity was seen to unique anatomical shapes. A modified peripheral loading pattern provided the optimum dose distribution, yielding good conformity, dose sparing at adjacent organs, and dose reduction in the high dose region of the vaginal mucosa.

Original languageEnglish (US)
Pages (from-to)93-100
Number of pages8
JournalJournal of Contemporary Brachytherapy
Volume5
Issue number2
DOIs
StatePublished - 2013

Fingerprint

Feasibility Studies
Mucous Membrane
Prescriptions
Organs at Risk
Brachytherapy
Equipment and Supplies
Therapeutics

Keywords

  • Brachytherapy
  • Endometrial cancer
  • Intravaginal
  • Multi-channel
  • Multi-ring applicator

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{189ee7a616ec412d9761211fb0ff3924,
title = "Feasibility study and optimum loading pattern of a multi-ring inflatable intravaginal applicator",
abstract = "Purpose: A cylinder applicator is the standard treatment device for intravaginal brachytherapy. However, they are limited in their ability to simultaneously spare the organs at risk (OAR), and reduce the hot spot in the vaginal mucosa, while achieving adequate dose conformality. This study aims to compare the dosimetric characteristics of single and multichannel cylinders, and utilizes volume point dose optimizations to investigate the feasibility and optimum loading method for a multi-ring inflatable intravaginal applicator. Material and methods: Studies were designed to: (1) test the feasibility of multi-ring applicators, (2) compare dose distributions between different multi-channel applicators and loading patterns, (3) test non-uniform prescription depths around the multi-ring cylinder. Results: Compared to a cylinder with a single central channel, a cylinder with 6 lumina arranged around the periphery, providing the lumina had adequate distance to the cylinder surface, could reduce dose beyond the prescription depth. However, when the number of outer lumina increased from 6 to 12, no further dose reduction could be achieved and the high dose volume close to the surface of the cylinder increased. Moreover, an additional ring, with lumina further away from the surface, provided increased dose shaping capabilities, allowing for individualized dose distributions. Conclusions: Dose could be reduced to normal tissue and the inner mucosa, and better conformity was seen to unique anatomical shapes. A modified peripheral loading pattern provided the optimum dose distribution, yielding good conformity, dose sparing at adjacent organs, and dose reduction in the high dose region of the vaginal mucosa.",
keywords = "Brachytherapy, Endometrial cancer, Intravaginal, Multi-channel, Multi-ring applicator",
author = "Hsiang-Chi Kuo and Mehta, {Keyur J.} and Ravindra Yaparpalvi and Linda Hong and Dinesh Mynampati and Tome, {Wolfgang A.} and Shalom Kalnicki",
year = "2013",
doi = "10.5114/jcb.2013.35580",
language = "English (US)",
volume = "5",
pages = "93--100",
journal = "Journal of Contemporary Brachytherapy",
issn = "1689-832X",
publisher = "Termedia Publishing House Ltd.",
number = "2",

}

TY - JOUR

T1 - Feasibility study and optimum loading pattern of a multi-ring inflatable intravaginal applicator

AU - Kuo, Hsiang-Chi

AU - Mehta, Keyur J.

AU - Yaparpalvi, Ravindra

AU - Hong, Linda

AU - Mynampati, Dinesh

AU - Tome, Wolfgang A.

AU - Kalnicki, Shalom

PY - 2013

Y1 - 2013

N2 - Purpose: A cylinder applicator is the standard treatment device for intravaginal brachytherapy. However, they are limited in their ability to simultaneously spare the organs at risk (OAR), and reduce the hot spot in the vaginal mucosa, while achieving adequate dose conformality. This study aims to compare the dosimetric characteristics of single and multichannel cylinders, and utilizes volume point dose optimizations to investigate the feasibility and optimum loading method for a multi-ring inflatable intravaginal applicator. Material and methods: Studies were designed to: (1) test the feasibility of multi-ring applicators, (2) compare dose distributions between different multi-channel applicators and loading patterns, (3) test non-uniform prescription depths around the multi-ring cylinder. Results: Compared to a cylinder with a single central channel, a cylinder with 6 lumina arranged around the periphery, providing the lumina had adequate distance to the cylinder surface, could reduce dose beyond the prescription depth. However, when the number of outer lumina increased from 6 to 12, no further dose reduction could be achieved and the high dose volume close to the surface of the cylinder increased. Moreover, an additional ring, with lumina further away from the surface, provided increased dose shaping capabilities, allowing for individualized dose distributions. Conclusions: Dose could be reduced to normal tissue and the inner mucosa, and better conformity was seen to unique anatomical shapes. A modified peripheral loading pattern provided the optimum dose distribution, yielding good conformity, dose sparing at adjacent organs, and dose reduction in the high dose region of the vaginal mucosa.

AB - Purpose: A cylinder applicator is the standard treatment device for intravaginal brachytherapy. However, they are limited in their ability to simultaneously spare the organs at risk (OAR), and reduce the hot spot in the vaginal mucosa, while achieving adequate dose conformality. This study aims to compare the dosimetric characteristics of single and multichannel cylinders, and utilizes volume point dose optimizations to investigate the feasibility and optimum loading method for a multi-ring inflatable intravaginal applicator. Material and methods: Studies were designed to: (1) test the feasibility of multi-ring applicators, (2) compare dose distributions between different multi-channel applicators and loading patterns, (3) test non-uniform prescription depths around the multi-ring cylinder. Results: Compared to a cylinder with a single central channel, a cylinder with 6 lumina arranged around the periphery, providing the lumina had adequate distance to the cylinder surface, could reduce dose beyond the prescription depth. However, when the number of outer lumina increased from 6 to 12, no further dose reduction could be achieved and the high dose volume close to the surface of the cylinder increased. Moreover, an additional ring, with lumina further away from the surface, provided increased dose shaping capabilities, allowing for individualized dose distributions. Conclusions: Dose could be reduced to normal tissue and the inner mucosa, and better conformity was seen to unique anatomical shapes. A modified peripheral loading pattern provided the optimum dose distribution, yielding good conformity, dose sparing at adjacent organs, and dose reduction in the high dose region of the vaginal mucosa.

KW - Brachytherapy

KW - Endometrial cancer

KW - Intravaginal

KW - Multi-channel

KW - Multi-ring applicator

UR - http://www.scopus.com/inward/record.url?scp=84882361199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84882361199&partnerID=8YFLogxK

U2 - 10.5114/jcb.2013.35580

DO - 10.5114/jcb.2013.35580

M3 - Article

C2 - 23878554

AN - SCOPUS:84882361199

VL - 5

SP - 93

EP - 100

JO - Journal of Contemporary Brachytherapy

JF - Journal of Contemporary Brachytherapy

SN - 1689-832X

IS - 2

ER -