Review,
Magnetic Resonance Image Guided Brachytherapy
Affiliations
- [1] Aarhus University Hospital [NORA names: Central Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD];
- [2] Washington University School of Medicine [NORA names: United States; America, North; OECD];
- [3] Brigham and Women's Hospital [NORA names: United States; America, North; OECD];
- [4] Medical University of Vienna [NORA names: Austria; Europe, EU; OECD];
- [5] University of Texas MD Anderson Cancer Center [NORA names: United States; America, North; OECD]
Abstract
The application of magnetic resonance image (MRI)-guided brachytherapy has demonstrated significant growth during the past 2 decades. Clinical improvements in cervix cancer outcomes have been linked to the application of repeated MRI for identification of residual tumor volumes during radiotherapy. This has changed clinical practice in the direction of individualized dose administration, and resulted in mounting evidence of improved clinical outcome regarding local control, overall survival as well as morbidity. MRI-guided prostate high-dose-rate and low-dose-rate brachytherapies have improved the accuracy of target and organs-at-risk delineation, and the potential exists for improved dose prescription and reporting for the prostate gland and organs at risk. Furthermore, MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence. MRI-guided brachytherapy involves advanced imaging, target concepts, and dose planning. The key issue for safe dissemination and implementation of high-quality MRI-guided brachytherapy is establishment of qualified multidisciplinary teams and strategies for training and education. © 2014 Elsevier Inc.