Rectum and bladder spacing in cervical cancer brachytherapy using a novel injectable hydrogel compound Journal Article


Authors: Damato, A. L.; Kassick, M.; Viswanathan, A. N.
Article Title: Rectum and bladder spacing in cervical cancer brachytherapy using a novel injectable hydrogel compound
Abstract: Purpose The aim of this study was to evaluate injection of a novel hydrogel (TraceIT; Augmenix, Waltham, MA) between the cervix, rectum, and bladder in female cadavers compared with, and in addition to, the current standard of gauze packing, for organ-at-risk sparing in cervical cancer brachytherapy planning. Methods and Materials This brachytherapy cadaver study used T2-weighted MRI and CT imaging to compare three scenarios: (1) gauze packing alone, (2) hydrogel injection placed in the cervical fornices and rectovaginal septum, and (3) gauze packing in conjunction with hydrogel injection. Hydrogel distribution was evaluated. Doses to 2 cm3 volumes (D2cc) for the rectum, bladder, and sigmoid were collected. Statistical significance (p < 0.05) was evaluated using a two-tailed paired t test. Results Hydrogel was successfully injected to space the bladder and rectum from the cervix in all five cadavers. The spacer was easily identifiable on both CT and MRI. The use of hydrogel in addition to packing resulted in a 22% decrease in rectum D2cc dose (p = 0.02), a 10% decrease in bladder D2cc (p = 0.27), and no change in sigmoid D2cc dose. No difference was observed between hydrogel only vs. gauze packing only. Conclusions Our results revealed a significant clinically meaningful decrease in rectal D2cc associated with the use of hydrogel in addition to gauze packing—TraceIT hydrogel holds promise as a spacer in cervical cancer therapy. © 2017 American Brachytherapy Society
Keywords: radiation dose; nuclear magnetic resonance imaging; computer assisted tomography; statistical significance; uterine cervix cancer; brachytherapy; chemoradiotherapy; student t test; cervical cancer; rectum; bladder; anatomical variation; radiotherapy planning; hydrogel; organs at risk; sigmoid; gynecologic cancers; brachytherapy device; human; priority journal; article; bladder sparing; rectum sparing; gauze dressing; hydrogel organ spacer
Journal Title: Brachytherapy
Volume: 16
Issue: 5
ISSN: 1538-4721
Publisher: Elsevier Science, Inc.  
Date Published: 2017-09-01
Start Page: 949
End Page: 955
Language: English
DOI: 10.1016/j.brachy.2017.04.236
PROVIDER: scopus
PUBMED: 28619385
DOI/URL:
Notes: Article -- Export Date: 4 October 2017 -- Source: Scopus
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  1. Antonio Leonardo Damato
    79 Damato