Image-Guided Brachytherapy Techniques in Cervical Cancer Management
Summary
Image-guided brachytherapy has revolutionised the management of cervical cancer by enabling precise administration of radiation to tumour volumes while sparing normal tissues. Central to this approach is the integration of three-dimensional imaging—most commonly computed tomography (CT) and magnetic resonance imaging (MRI)—into applicator placement, target delineation and dose optimisation. The advent of image-guided adaptive brachytherapy (IGABT) allows clinicians to account for tumour shrinkage and organ motion over a multi-fraction treatment course. Intracavitary applicators, often augmented by interstitial needles in cases of bulky or irregular disease, facilitate customised dose shaping to high-risk clinical target volumes (HR-CTVs). This technique improves local control rates and reduces toxicity to bladder, rectum and vaginal wall. Recent advances include volumetric dose–volume evaluation, hybrid intracavitary–interstitial strategies and the use of real-time imaging for applicator verification. Collectively, these innovations support personalised treatment protocols and underscore the global significance of image-guided brachytherapy in achieving optimal therapeutic outcomes for women with cervical cancer.
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Image-Guided Brachytherapy Techniques in Cervical Cancer Management publication trend
The graph below shows the total number of articles in image-guided brachytherapy techniques in cervical cancer management across all publications each year (not limited to Nature Index journals).
Technical terms
High-risk clinical target volume (HR-CTV): region encompassing gross tumour and adjacent tissues at highest risk of microscopic disease, contoured for dose prescription in brachytherapy.
D90: dose delivered to 90% of the HR-CTV, used to assess adequacy of tumour coverage.
D2cc: minimum dose received by the most exposed 2 cubic centimetres of an organ at risk, guiding limits for late toxicity.
Image-guided adaptive brachytherapy (IGABT): workflow incorporating serial imaging to adapt applicator placement and dose distribution in response to anatomical changes during treatment.
Intracavitary–interstitial technique: combined use of intra-cavity applicators and interstitial needles to conform dose to complex tumour shapes and extensions.
References
- CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer. BMC Cancer (2014).
- In-room computed tomography–based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study. Journal of Radiation Research (2016).
- A hybrid technique of intracavitary and interstitial brachytherapy for locally advanced cervical cancer: initial outcomes of a single-institute experience. BMC Cancer (2019).
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