MR Image Guided Gynecologic Brachytherapy

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DESCRIPTION (provided by applicant): Patients with gynecologic cancers localized to the pelvis may be curatively treated with radiation. The use of brachytherapy, the placement of radioactive seeds directly into the center of the tumor, after external beam radiation, permits dose escalation to the tumor, resulting in successful regression and eradication of the tumor. However, adjacent to the tumor, critical normal tissue structures including the small bowel, sigmoid, rectum, and bladder may rest in regions that can receive high doses of radiation. In most centers in the U.S., simple imaging (X-ray or CT) with doses prescribed to a single point are the standard of care. Normal tissues are not defined by their actual dimensions, rather by points that approximate their location. In order to successfully determine the location of the tumor and its relationship to the normal tissues structures in order to minimize the dose to them, it is necessary to image the pelvis during brachytherapy applicator placement. MRI delineate tumor and OAR in the pelvis with much more precision than other imaging modalities. In this clinical trial, the utility of 3T T2- weighted MRI imaging, in addition to DWI MRI, and how the images correlate with biopsy-confirmed presence of cancer will be studied.