Clinical trial NCT04336683: Feasibility Study for Ultrasound-Guided Interstitial Brachytherapy for Gynecological CancersV2
Official title: Feasibility Study for Ultrasound-Guided Interstitial Brachytherapy for Gynecological CancersV2
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Gynecologic Cancer
Keywords: 3D Ultrasound
Intervention
Lead sponsor: Western University, Canada
Sponsor class: OTHER
First posted: 2020-04-07
Enrollment: 35
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Patients who are assigned to gynecological brachytherapy.
Primary purpose: OTHER

Brief summary: Brachytherapy treatment in gynecological cancers is an essential component to delivering adequate doses of radiation to a tumour while sparing normal tissue. Interstitial and intracavitary brachytherapy is often needed in advanced or recurrent disease, in cases where intrauterine brachytherapy may not deliver the optimal outcome. Interstitial brachytherapy is based on a defined template-and-needle system, and the procedure relies on clinical examination and pre-treatment imaging to guide needle insertion. There is currently no standard image-guided process to help direct needles in the pelvis. The investigators propose a 3D ultrasound device that will provide real-time imaging for the brachytherapy procedure which will aid in avoiding needle insertion into pelvic organs and result in optimal dose coverage to the tumour.

Detailed description: This is an efficacy study to optimize the use of three-dimensional ultrasound imaging for interstitial and intracavitary brachytherapy. In this study, 3DUS images will be acquired during the regular clinical procedure to assess the quality of the images, anatomical detail and location of needles. The acquired images will be analyzed post-treatment and fused with pre-treatment MRI, and post-treatment CT scans to develop a virtual simulated radiation treatment plan, and to verify the applicator positions.

Eligibility criteria: Inclusion Criteria:

* Patients with locally advanced or recurrent gynecological malignancies who are offered interstitial or intracavitary brachytherapy treatment. These typically would include patients with primary or recurrent vaginal cancers, endometrial cancers or cervical cancers. Histologies of these cancers are typically adenocarcinomas or squamous cell carcinomas

Exclusion Criteria:

* Above patients who are not offered interstitial or intracavitary brachytherapy as a treatment modality

Primary outcomes:
measure: Efficacy of the 3DUS device to visualize applicators
timeFrame: 16 Weeks
Secondary outcomes:
measure: 3DUS to CT Fusion
timeFrame: 16 Weeks
Other outcomes:
Locations:
city: London
country: Canada
facility: London Regional Cancer Program, Victoria Hospital
state: Ontario
Study officials:
affiliation: Schulich School of Medicine and Dentistry
name: David D'Souza, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Rodgers JR, Hrinivich WT, Surry K, Velker V, D'Souza D, Fenster A. A semiautomatic segmentation method for interstitial needles in intraoperative 3D transvaginal ultrasound images for high-dose-rate gynecologic brachytherapy of vaginal tumors. Brachytherapy. 2020 Sep-Oct;19(5):659-668. doi: 10.1016/j.brachy.2020.05.006. Epub 2020 Jul 3.
citation: Rodgers JR, Bax J, Surry K, Velker V, Leung E, D'Souza D, Fenster A. Intraoperative 360-deg three-dimensional transvaginal ultrasound during needle insertions for high-dose-rate transperineal interstitial gynecologic brachytherapy of vaginal tumors. J Med Imaging (Bellingham). 2019 Apr;6(2):025001. doi: 10.1117/1.JMI.6.2.025001. Epub 2019 Apr 8.
citation: Rodgers JR, Mendez LC, Hoover DA, Bax J, D'Souza D, Fenster A. Feasibility of fusing three-dimensional transabdominal and transrectal ultrasound images for comprehensive intraoperative visualization of gynecologic brachytherapy applicators. Med Phys. 2021 Oct;48(10):5611-5623. doi: 10.1002/mp.15175. Epub 2021 Sep 2.