Determining inter-fractional motion of the uterus using 3D ultrasound imaging during radiotherapy for cervical cancer

Mariwan Baker, Jørgen Arendt Jensen, Claus F. Behrens

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    Abstract

    Uterine positional changes can reduce the accuracy of radiotherapy for cervical cancer patients. The purpose of this study was to; 1) Quantify the inter-fractional uterine displacement using a novel 3D ultrasound (US) imaging system, and 2) Compare the result with the bone match shift determined by Cone-Beam CT (CBCT) imaging.Five cervical cancer patients were enrolled in the study. Three of them underwent weekly CBCT imaging prior to treatment and bone match shift was applied. After treatment delivery they underwent a weekly US scan. The transabdominal scans were conducted using a Clarity US system (Clarity® Model 310C00). Uterine positional shifts based on soft-tissue match using US was performed and compared to bone match shifts for the three directions. Mean value (±1 SD) of the US shifts were (mm); anterior-posterior (A/P): (3.8±5.5), superior-inferior (S/I) (-3.5±5.2), and left-right (L/R): (0.4±4.9). The variations were larger than the CBCT shifts. The largest inter-fractional displacement was from -2 mm to +14 mm in the AP-direction for patient 3. Thus, CBCT bone matching underestimates the uterine positional displacement due to neglecting internal uterine positional change to the bone structures. Since the US images were significantly better than the CBCT images in terms of soft-tissue visualization, the US system can provide an optional image-guided radiation therapy (IGRT) system. US imaging might be a better IGRT system than CBCT, despite difficulty in capturing the entire uterus. Uterine shifts based on US imaging contains relative uterus-bone displacement, which is not taken into consideration using CBCT bone match.
    Original languageEnglish
    Title of host publicationProceedings of SPIE
    Number of pages10
    Volume9040
    PublisherSPIE - International Society for Optical Engineering
    Publication date2014
    Article number90400Y
    DOIs
    Publication statusPublished - 2014
    EventSPIE Medical Imaging 2014 - Town & Country Resort and Convention Center, San Diego, United States
    Duration: 15 Feb 201420 Feb 2014
    https://spie.org/conferences-and-exhibitions/past-conferences-and-exhibitions/medical-imaging-2014

    Conference

    ConferenceSPIE Medical Imaging 2014
    LocationTown & Country Resort and Convention Center
    Country/TerritoryUnited States
    CitySan Diego
    Period15/02/201420/02/2014
    Internet address

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