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Title: Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo

Abstract

Purpose: Vaginal balloon packing is a means to displace organs at risk during high dose rate brachytherapy of the uterine cervix. We tested the hypothesis that contrast-filled vaginal balloon packing reduces radiation dose to organs at risk, such as the bladder and rectum, in comparison to water- or air-filled balloons. Methods and Materials: In a phantom study, semispherical vaginal packing balloons were filled with air, saline solution, and contrast agents. A high dose rate iridium-192 source was placed on the anterior surface of the balloon, and the diode detector was placed on the posterior surface. Dose ratios were taken with each material in the balloon. Monte Carlo (MC) simulations, by use of the MC computer program DOSXYZnrc, were performed to study dose reduction vs. balloon size and contrast material, including commercially available iodine- and gadolinium-based contrast agents. Results: Measured dose ratios on the phantom with the balloon radius of 3.4 cm were 0.922 {+-} 0.002 for contrast/saline solution and 0.808 {+-} 0.001 for contrast/air. The corresponding ratios by MC simulations were 0.895 {+-} 0.010 and 0.781 {+-} 0.010. The iodine concentration in the contrast was 23.3% by weight. The dose reduction of contrast-filled balloon ranges from 6% to 15% comparedmore » with water-filled balloon and 11% to 26% compared with air-filled balloon, with a balloon size range between 1.4 and 3.8 cm, and iodine concentration in contrast of 24.9%. The dose reduction was proportional to the contrast agent concentration. The gadolinium-based contrast agents showed less dose reduction because of much lower concentrations in their solutions. Conclusions: The dose to the posterior wall of the bladder and the anterior wall of the rectum can be reduced if the vaginal balloon is filled with contrast agent in comparison to vaginal balloons filled with saline solution or air.« less

Authors:
 [1];  [1]; ;  [1]
  1. Radiation Oncology, Moffitt Cancer Center, Tampa, FL (United States)
Publication Date:
OSTI Identifier:
21587621
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2010.08.033; PII: S0360-3016(10)03113-5; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BALLOONS; BLADDER; BRACHYTHERAPY; CONTRAST MEDIA; DOSE RATES; FEMALE GENITALS; GADOLINIUM; HAZARDS; IODINE; IRIDIUM 192; MONTE CARLO METHOD; NEOPLASMS; RADIATION DOSES; RECTUM; SIMULATION; AIRCRAFT; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CALCULATION METHODS; DAYS LIVING RADIOISOTOPES; DIGESTIVE SYSTEM; DISEASES; DOSES; ELECTRON CAPTURE RADIOISOTOPES; ELEMENTS; GASTROINTESTINAL TRACT; HALOGENS; HEAVY NUCLEI; INTERNAL CONVERSION RADIOISOTOPES; INTESTINES; IRIDIUM ISOTOPES; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LARGE INTESTINE; MEDICINE; METALS; MINUTES LIVING RADIOISOTOPES; NONMETALS; NUCLEAR MEDICINE; NUCLEI; ODD-ODD NUCLEI; ORGANS; RADIOISOTOPES; RADIOLOGY; RADIOTHERAPY; RARE EARTHS; THERAPY; URINARY TRACT; YEARS LIVING RADIOISOTOPES

Citation Formats

Saini, Amarjit S., Zhang, Geoffrey G., E-mail: geoffrey.zhang@moffitt.org, Finkelstein, Steven E., and Biagioli, Matthew C. Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.08.033.
Saini, Amarjit S., Zhang, Geoffrey G., E-mail: geoffrey.zhang@moffitt.org, Finkelstein, Steven E., & Biagioli, Matthew C. Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo. United States. doi:10.1016/j.ijrobp.2010.08.033.
Saini, Amarjit S., Zhang, Geoffrey G., E-mail: geoffrey.zhang@moffitt.org, Finkelstein, Steven E., and Biagioli, Matthew C. Fri . "Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo". United States. doi:10.1016/j.ijrobp.2010.08.033.
@article{osti_21587621,
title = {Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo},
author = {Saini, Amarjit S. and Zhang, Geoffrey G., E-mail: geoffrey.zhang@moffitt.org and Finkelstein, Steven E. and Biagioli, Matthew C.},
abstractNote = {Purpose: Vaginal balloon packing is a means to displace organs at risk during high dose rate brachytherapy of the uterine cervix. We tested the hypothesis that contrast-filled vaginal balloon packing reduces radiation dose to organs at risk, such as the bladder and rectum, in comparison to water- or air-filled balloons. Methods and Materials: In a phantom study, semispherical vaginal packing balloons were filled with air, saline solution, and contrast agents. A high dose rate iridium-192 source was placed on the anterior surface of the balloon, and the diode detector was placed on the posterior surface. Dose ratios were taken with each material in the balloon. Monte Carlo (MC) simulations, by use of the MC computer program DOSXYZnrc, were performed to study dose reduction vs. balloon size and contrast material, including commercially available iodine- and gadolinium-based contrast agents. Results: Measured dose ratios on the phantom with the balloon radius of 3.4 cm were 0.922 {+-} 0.002 for contrast/saline solution and 0.808 {+-} 0.001 for contrast/air. The corresponding ratios by MC simulations were 0.895 {+-} 0.010 and 0.781 {+-} 0.010. The iodine concentration in the contrast was 23.3% by weight. The dose reduction of contrast-filled balloon ranges from 6% to 15% compared with water-filled balloon and 11% to 26% compared with air-filled balloon, with a balloon size range between 1.4 and 3.8 cm, and iodine concentration in contrast of 24.9%. The dose reduction was proportional to the contrast agent concentration. The gadolinium-based contrast agents showed less dose reduction because of much lower concentrations in their solutions. Conclusions: The dose to the posterior wall of the bladder and the anterior wall of the rectum can be reduced if the vaginal balloon is filled with contrast agent in comparison to vaginal balloons filled with saline solution or air.},
doi = {10.1016/j.ijrobp.2010.08.033},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 80,
place = {United States},
year = {2011},
month = {7}
}