PURPOSE: Magnetic resonance imaging (MRI)-based intracavitary brachytherapy offers several advantages over computed tomography (CT)-based brachytherapy, but many centers are unable to offer it at the time of brachytherapy because of logistic and/or financial considerations. We have implemented a method of integrating MRI into a CT-guided, high-dose-rate intracavitary brachytherapy workflow in clinics that do not have immediately available MRI capability. METHODS: At our institution, @entity1 receiving high-dose-rate intracavitary brachytherapy as a component of the definitive treatment of @entity5 have a @entity10300 sleeve placed during the first brachytherapy fraction in a dedicated suite with in-room CT-on-rails. After the first fraction of brachytherapy, an MRI is obtained with the @entity10300 sleeve, but no applicator, in place. For each subsequent fraction, CT scans are coregistered to the MRI scan by the @entity10300 sleeve. The gross target volume is defined by MRI and overlaid on the CT images for each brachytherapy treatment for dose optimization. RESULTS: This MRI-integrated workflow adds <5  minutes to the brachytherapy session for image fusion. Our initial clinical experience suggests that this approach is feasible and results in target volume reductions compared with CT-alone brachytherapy. CONCLUSIONS: Our proposed combination MRI and/or CT workflow is a feasible compromise to preserve an efficient workflow while integrating MRI target delineation, and it provides many of the advantages of both MRI- and CT-based brachytherapy. The future collection and analysis of clinical data will serve to compare the proposed approach to non-MRI containing techniques.

Implementing MRI-based target delineation for XXXX treatment within a rapid workflow environment for image-guided brachytherapy: A practical approach for centers without in-room MRI.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cervical cancer'] @entity10300 :: ('6526', 'Gene') :: ['Smit']
@entity5 :: (MESH:D009369,Disease) :: ['cervical cancer']
