Automated implant configuration optimisation for high dose rate brachytherapy

Brachytherapy (BT) is an essential component in the curative treatment of cervical cancer. With commercial BT implant devices, called applicators, the radioactive sources can only be positioned in fixed intracavitary channels or in a fixed array of interstitial needles. Patient-tailored BT applicators containing individualised needle channels...

Designing a Smart Speculum for Low Resource Settings: The Impact of Contextual Factors on the Design of a Point of Care Cervical Cancer Screening Device

Cervical Cancer (CC) is a preventable disease and is easily treated when detected early. Yet it is the second most prevalent cancer related death in Cameroon, causing an estimated 1787 deaths each year (Woks et al, 2023). Cameroon has implemented no national strategy to prevent this disease and so screening practices that are in place are...

Multibody dynamic modeling of the behavior of flexible instruments used in cervical cancer brachytherapy

Background: The steep radiation dose gradients in cervical cancer brachytherapy (BT) necessitate a thorough understanding of the behavior of afterloader source cables or needles in the curved channels of (patient-tailored) applicators. Purpose: The purpose of this study is to develop and validate computer models to simulate: (1) BT source...

Keeping your best options open with AI-based treatment planning in prostate and cervix brachytherapy

PURPOSE: Without a clear definition of an optimal treatment plan, no optimization model can be perfect. Therefore, instead of automatically finding a single “optimal” plan, finding multiple, yet different near-optimal plans, can be an insightful approach to support radiation oncologists in finding the plan they are looking for. METHODS AND...

Motion and uncertainties management in intensity-modulated proton therapy for cervical cancer

Purpose: Proton therapy has been proposed as an alternative to conventional photon therapy for the treatment of locally advanced cervical cancer (LACC) since these patients experience toxicities. Proton therapy may allow for significant sparing of the organs at risk, reducing the incidence of treatment-related morbidities. The aim of this study...

Automatic Contour Quality Assurance on CBCT scans for Locally Advanced Cervical Cancer Patients: A comparison study using Machine Learning

<b>Background and purpose</b>: One of the main challenges in external beam radiotherapy treatment of locally advanced cervical cancer patients is dealing with bladder and rectum filling. Organ filling causes inter­fraction motion of the uterus, requiring large treatment planning volumes, or a plan library. Current assessment of tumor position is...

Clinical implementation of adaptive intensity-modulated proton therapy (aIMPT) for locally advanced cervical cancer (LACC)

Each year, more than 800 women in the Netherlands are diagnosed with cervical cancer, of which approximately half have locally advanced disease. The standard treatment for locally advanced cervical cancer (LACC) is external beam radiotherapy (EBRT) with concurrent chemotherapy followed by brachytherapy. Many patients experience some degree of...

Robust needle channel planning for patient-tailored applicator design in cervical cancer brachytherapy

Brachytherapy (BT) is an essential component in the treatment of cervical cancer as it allows for locally delivering a high dose to the tumour with minimal trauma to surrounding tissues and organs at risk (OARs). However, in advanced cervical cancer patients commercially available BT applicators are particularly ill-adapted and therefore result...

Creating a Phantom of the Vaginal Cavity for Gynaecological Brachytherapy

The goal of this study is to create a phantom which can be used to test strategies for sealing the vaginal cavity, so that ultrasound gel can be used to fill the vaginal cavity improve the visibility of the vaginal cavity in MR-images.<br/>Silicone rubber and PolyVinyl Alcohol (PVA) were tested, to check whether their mechanical properties can...

Mr thermometry accuracy and prospective imaging-based patient selection in mr-guided hyperthermia treatment for locally advanced cervical cancer

The efficacy of a hyperthermia treatment depends on the delivery of well-controlled heating; hence, accurate temperature monitoring is essential for ensuring effective treatment. For deep pelvic hyperthermia, there are no comprehensive and systematic reports on MR thermometry. Moreover, data inclusion generally lacks objective selection...

Fast and fully-automated multi-criterial treatment planning for adaptive HDR brachytherapy for locally advanced cervical cancer

Purpose: To develop and evaluate a fast, automated multi-criterial treatment planning approach for adaptive high-dose-rate (HDR) intracavitary + interstitial brachytherapy (BT) for locally advanced cervical cancer. Methods and materials: Twenty-two previously delivered single fraction MRI-based HDR treatment plans (SF_clin) were...

A systematic review and meta-analysis of thermal coagulation compared with cryotherapy to treat precancerous cervical lesions in low- and middle-income countries

Background: Thermal coagulation is gaining popularity for treating cervical intraepithelial neoplasia (CIN) in screening programs in low- and middle-income countries (LMICs) due to unavailability of cryotherapy. Objectives: Assess the effectiveness of thermal coagulation for treatment of CIN lesions compared with cryotherapy, with a focus on...

Development of a brachytherapy device for cervical cancer: in case of lower vaginal involvement or distal parametrial extension

Brachytherapy is recommended in the treatment of cervical cancer. In case of a tumour extending lateral to the pelvic wall or more than 0.5 cm from the vaginal surface, current applicators are not sufficient to irradiate the target area. Therefore, the use of extra free-hand needles is required. Free-hand placement of interstitial needles is...