Australia: Peter Maccullum Cancer Center, Melbourne

Abstract

Transabdominal ultrasound (US) has been used to assist applicator placement at the Peter MacCallum Cancer Centre since 1985. Magnetic resonance imaging (MRI) was introduced in 2001 to assess tumor response to external beam treatment. The next logical step was to assess brachytherapy dosimetry on the MRI scan and develop an image-based planning and treatment protocol. Over time a strong correlation between the size and shape of the uterus and cervix, containing residual tumor, as seen on the US and MRI images, was observed. It became apparent that US could give an accurate depiction of the applicator within the cervix and uterus, and the cervix and uterus within the pelvis. Ultrasound was progressively incorporated into the protocol to avoid uterine perforation and to assist with the dosimetric coverage of the cervix, residual tumor, and uterus [1]. All patients receive external beam radiotherapy prior to intracavitary brachytherapy (ICBT).