Inter-fraction bladder filling variations and time trends for cervical cancer patients assessed with a portable 3-dimensional ultrasound bladder scanner

Rozilawati Ahmad, Mischa S. Hoogeman, Sandra Quint, Jan Willem Mens, Ilse de Pree, Ben J M Heijmen

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background and Purpose: For cervical cancer patients, bladder filling variations may result in inadequate EBRT target coverage, unless large safety margins are used. For a group of patients who received full bladder instructions, inter-fraction variations and time trends in bladder volume were quantified, and a 3D ultrasound (US) scanner was tested for on-line bladder volume measurements. Methods and materials: For 24 patients, the bladder volume was measured with US at the time of the planning CT scan, and twice weekly during the course of RT. Comparisons of US with planning CT were used to assess the bladder scanner accuracy. Patients were treated in prone on a belly board, EPID images were acquired to correlate set-up errors with bladder filling variations. Results: Measured US and CT bladder volumes were strongly correlated (R = 0.97, slope 1.1 ± 0.1). The population mean bladder volume at planning of 378 ± 209 ml (1 SD) reduced to 109 ± 88 ml (1 SD) in week 6, a reduction by 71% (average reduction 46 ml/week), revealing a large inter-fraction time trend. Intra-patient variation in bladder volume during RT was 168 ml (1 SD) (range 70-266 ml). Rotation around the LR axis was significantly correlated with bladder volume changes. Conclusions: Despite a full bladder instruction, bladder volumes reduced dramatically during treatment, implying large time trends in target position of these patients. The portable US scanner provides a quick and reliable measurement of the bladder volume, which might assist future online treatment adaptation.

Original languageEnglish
Pages (from-to)172-179
Number of pages8
JournalRadiotherapy and Oncology
Volume89
Issue number2
DOIs
Publication statusPublished - Nov 2008
Externally publishedYes

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Uterine Cervical Neoplasms
Urinary Bladder
Cone-Beam Computed Tomography
Urinary Bladder Neoplasms
Safety

Keywords

  • 3D portable Ultrasound
  • Bladder volume
  • Cervix cancer
  • IGRT
  • Patient positioning
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Inter-fraction bladder filling variations and time trends for cervical cancer patients assessed with a portable 3-dimensional ultrasound bladder scanner. / Ahmad, Rozilawati; Hoogeman, Mischa S.; Quint, Sandra; Mens, Jan Willem; de Pree, Ilse; Heijmen, Ben J M.

In: Radiotherapy and Oncology, Vol. 89, No. 2, 11.2008, p. 172-179.

Research output: Contribution to journalArticle

Ahmad, Rozilawati ; Hoogeman, Mischa S. ; Quint, Sandra ; Mens, Jan Willem ; de Pree, Ilse ; Heijmen, Ben J M. / Inter-fraction bladder filling variations and time trends for cervical cancer patients assessed with a portable 3-dimensional ultrasound bladder scanner. In: Radiotherapy and Oncology. 2008 ; Vol. 89, No. 2. pp. 172-179.
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