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Vol. 58. Issue 1.
Pages 16-25 (January - February 2016)
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Vol. 58. Issue 1.
Pages 16-25 (January - February 2016)
Update in Radiology
Magnetic resonance imaging for planning intracavitary brachytherapy for the treatment of locally advanced cervical cancer
Resonancia magnética en la planificación de la braquiterapia intracavitaria para el tratamiento del cáncer de cérvix localmente avanzado
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M. Oñate Mirandaa, D.F. Pinhob, Z. Wardakc, K. Albuquerquec, I. Pedrosab,d,
Corresponding author
a Departamento de Radiología, Hospital Universitario La Paz, Madrid, Spain
b Department of Radiology, University of Texas, Southwestern Medical Center, Dallas, TX, United States
c Department of Radiation Oncology, University of Texas, Southwestern Medical Center, Dallas, TX, United States
d Advanced Imaging Research Center, University of Texas, Southwestern Medical Center, Dallas, TX, United States
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Table 1. Cervical cancer staging (International Federation of Gynecology and Obstetrics [FIGO], 2009).
Table 2. Magnetic resonance protocol for the planning of intracavitary brachytherapy in the management of cervical cancer used by the Texas Southwestern University.
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Abstract

Cervical cancer is the third most common gynecological cancer. Its treatment depends on tumor staging at the time of diagnosis, and a combination of chemotherapy and radiotherapy is the treatment of choice in locally advanced cervical cancers. The combined use of external beam radiotherapy and brachytherapy increases survival in these patients. Brachytherapy enables a larger dose of radiation to be delivered to the tumor with less toxicity for neighboring tissues with less toxicity for neighboring tissues compared to the use of external beam radiotherapy alone. For years, brachytherapy was planned exclusively using computed tomography (CT). The recent incorporation of magnetic resonance imaging (MRI) provides essential information about the tumor and neighboring structures making possible to better define the target volumes. Nevertheless, MRI has limitations, some of which can be compensated for by fusing CT and MRI. Fusing the images from the two techniques ensures optimal planning by combining the advantages of each technique.

Keywords:
Magnetic resonance imaging
Brachytherapy
Cervical cancer
Resumen

El cáncer de cérvix es el tercer cáncer ginecológico más frecuente. El tratamiento depende de la estadificación del tumor en el momento del diagnóstico, siendo la combinación de quimioterapia y radioterapia el tratamiento de elección para cánceres localmente avanzados. El uso combinado de radioterapia externa y braquiterapia aumenta la supervivencia en estas pacientes. La braquiterapia permite proporcionar mayor dosis de radiación al tumor con menor toxicidad de los tejidos vecinos en comparación con la radioterapia externa exclusiva. La planificación de la braquiterapia se ha realizado durante años exclusivamente con tomografía computarizada (TC). La reciente incorporación de la resonancia magnética (RM) ha demostrado que aporta información esencial del tumor y de las estructuras vecinas, y permite definir mejor los volúmenes blanco. No obstante, la RM presenta limitaciones, algunas de las cuales se pueden compensar con la fusión de imágenes de TC y RM, con lo que se consigue una planificación óptima al combinar las ventajas de cada técnica.

Palabras clave:
Resonancia magnética
Braquiterapia
Cáncer de cérvix

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