Magnetic resonance imaging in cervical cancer interventional radiotherapy (brachytherapy): a pictorial essay focused on radiologist management

Luca Russo; Valentina Lancellotta; Maura Miccò; Bruno Fionda; Giacomo Avesani; Angeles Rovirosa; Piotr Wojcieszek; Giovanni Scambia; Riccardo Manfredi; Luca Tagliaferri; Benedetta Gui

doi:10.5114/jcb.2022.117727

Magnetic resonance imaging in cervical cancer interventional radiotherapy (brachytherapy): a pictorial essay focused on radiologist management

J Contemp Brachytherapy. 2022 Jun;14(3):287-298. doi: 10.5114/jcb.2022.117727. Epub 2022 Jun 30.

Authors

Luca Russo¹, Valentina Lancellotta², Maura Miccò¹, Bruno Fionda², Giacomo Avesani¹, Angeles Rovirosa^{3

4}, Piotr Wojcieszek⁵, Giovanni Scambia^{6

7}, Riccardo Manfredi^{1

8}, Luca Tagliaferri^#², Benedetta Gui^#¹

Affiliations

¹ Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
² Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
³ Fonaments Clinics Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
⁴ Department of Radiation Oncology, Hospital Clinic i Universitari, Barcelona, Spain.
⁵ Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
⁶ UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
⁷ Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy.
⁸ Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.

^# Contributed equally.

Abstract

The standard treatment for locally advanced cervical cancer (LACC) is platinum-based chemotherapy in association with external beam radiotherapy (EBRT) and brachytherapy (BT), often also called 'interventional radiotherapy' (IRT). Magnetic resonance imaging (MRI) is the most accurate imaging modality for both staging and response evaluation; therefore MRI-guided IRT has become the method of choice for planning a radiation boost after EBRT. The aim of this paper was to describe the MRI radiological workflow currently ongoing at our Institution. In addition, we provided a detailed pictorial essay of our experience, especially for radiologists, to implement MRI-based IRT spread in clinical practice.

Keywords: brachytherapy; cervical cancer; magnetic resonance imaging.