Assessment of ovarian movement on consecutive pelvic MRI examinations in patients with gynaecological malignancies: what is the planning organ-at-risk volume for radiotherapy?
Assessment of ovarian movement on consecutive pelvic MRI examinations in patients with gynaecological malignancies: what is the planning organ-at-risk volume for radiotherapy?
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DOI：
10.1259/bjr/22205448
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发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Sala, E.
中科院分区：
文献类型：
--
作者：
Peters, N. H. G. M.;Patterson, A. J.;Sala, E.
目的：评价妇科恶性肿瘤患者连续行MRI检查时卵巢运动的程度，以确定在盆腔放疗中避免卵巢切除的潜在安全体积。方法：对宫颈癌、阴道癌和子宫内膜癌患者在放疗前和放疗中进行盆腔MRI检查。卵巢的位置是通过连续两次盆腔轴位和矢状位的MRI检查来回顾确定的。测定卵巢在头尾、前后和内侧方向的运动。根据95%和99%的参考区间，通过计算椭圆体积计算安全体积。结果：纳入30例妇科恶性肿瘤患者。所有病例的MRI检查均可显示双侧卵巢。包括95%和99%卵巢运动的卵巢周围的安全体积，左侧和右侧分别为11和25 cm(3)(95%)，24和54 cm(3)(99%)。结论：在卵巢周围增加安全体积可以减少卵巢的高剂量辐射。这可能会避免卵巢切除，降低显著的生育发病率。
Objectives: The aims of this study are to assess the extent of ovarian movement on consecutive MRI examinations in patients with gynaecological malignancies and to define potential safety volumes around the ovaries that may avoid ovarian ablation during pelvic irradiation.Methods: Patients with cervical, vaginal and endometrial cancer who underwent MRI examinations of the pelvis before and during radiotherapy were included in the study. The position of the ovaries was retrospectively determined on two consecutive axial and sagittal T-2 weighted MRI examinations of the pelvis. Ovarian movement was determined in craniocaudal, anteroposterior and mediolateral directions. Safety volumes were calculated by computing elliptical volumes based on the derived 95% and 99% reference intervals.Results: 30 patients with a gynaecological malignancy were included. Both ovaries could be identified on the MRI examinations in all cases. The safety volumes around the ovaries encompassing 95% and 99% of ovarian movement were 11 and 25cm(3) (95%), and 24 and 54cm(3) (99%), for the left and right ovary, respectively.Conclusion: Adding a safety volume around the ovaries may reduce the high radiation dose to the ovaries. This could potentially avoid ovarian ablation, reducing significant fertility morbidity.