Abstract：
The aim of this study was to evaluate injection of a novel hydrogel (TraceIT; Augmenix, Waltham, MA) between the cervix, rectum, and bladder in female cadavers compared with, and in addition to, the current standard of gauze packing, for organ-at-risk sparing in cervical cancer brachytherapy planning.
This brachytherapy cadaver study used T2-weighted MRI and CT imaging to compare three scenarios: (1) gauze packing alone, (2) hydrogel injection placed in the cervical fornices and rectovaginal septum, and (3) gauze packing in conjunction with hydrogel injection. Hydrogel distribution was evaluated. Doses to 2 cm3 volumes (D2cc) for the rectum, bladder, and sigmoid were collected. Statistical significance (p < 0.05) was evaluated using a two-tailed paired t test.
Hydrogel was successfully injected to space the bladder and rectum from the cervix in all five cadavers. The spacer was easily identifiable on both CT and MRI. The use of hydrogel in addition to packing resulted in a 22% decrease in rectum D2cc dose (p = 0.02), a 10% decrease in bladder D2cc (p = 0.27), and no change in sigmoid D2cc dose. No difference was observed between hydrogel only vs. gauze packing only.
Our results revealed a significant clinically meaningful decrease in rectal D2cc associated with the use of hydrogel in addition to gauze packing-TraceIT hydrogel holds promise as a spacer in cervical cancer therapy.
This brachytherapy cadaver study used T2-weighted MRI and CT imaging to compare three scenarios: (1) gauze packing alone, (2) hydrogel injection placed in the cervical fornices and rectovaginal septum, and (3) gauze packing in conjunction with hydrogel injection. Hydrogel distribution was evaluated. Doses to 2 cm3 volumes (D2cc) for the rectum, bladder, and sigmoid were collected. Statistical significance (p < 0.05) was evaluated using a two-tailed paired t test.
Hydrogel was successfully injected to space the bladder and rectum from the cervix in all five cadavers. The spacer was easily identifiable on both CT and MRI. The use of hydrogel in addition to packing resulted in a 22% decrease in rectum D2cc dose (p = 0.02), a 10% decrease in bladder D2cc (p = 0.27), and no change in sigmoid D2cc dose. No difference was observed between hydrogel only vs. gauze packing only.
Our results revealed a significant clinically meaningful decrease in rectal D2cc associated with the use of hydrogel in addition to gauze packing-TraceIT hydrogel holds promise as a spacer in cervical cancer therapy.
摘要：
这项研究的目的是评估一种新型水凝胶(TraceIT;Augmenix，沃尔瑟姆,MA）在子宫颈之间，直肠,和女性尸体的膀胱相比，此外，目前的纱布包装标准，在宫颈癌近距离放射治疗计划中保留危险器官。
这项近距离放射治疗尸体研究使用T2加权MRI和CT成像来比较三种情况：（1）仅纱布包装，（2）水凝胶打针放置于宫颈穹窿和直肠阴道隔，和(3)与水凝胶注射结合的纱布包装。评价水凝胶分布。直肠剂量为2cm3体积(D2cc)，膀胱,收集乙状结肠。使用双尾配对t检验评估统计学显著性(p<0.05)。
成功地注射了水凝胶，将所有五具尸体的膀胱和直肠与子宫颈隔开。间隔物在CT和MRI上都很容易识别。除了包装外，使用水凝胶导致直肠D2cc剂量减少22％（p=0.02），膀胱D2cc减少10%(p=0.27)，乙状结肠D2cc剂量无变化。在仅水凝胶与水凝胶之间没有观察到差异仅纱布包装。
我们的结果表明，除纱布包装外，与使用水凝胶相关的直肠D2cc在临床上显着有意义的降低-TraceIT水凝胶有望作为宫颈癌治疗中的间隔物。
这项近距离放射治疗尸体研究使用T2加权MRI和CT成像来比较三种情况：（1）仅纱布包装，
成功地注射了水凝胶，将所有五具尸体的膀胱和直肠与子宫颈隔开。
我们的结果表明，除纱布包装外，与使用水凝胶相关的直肠D2cc在临床上显着有意义的降低-TraceIT水凝胶有望作为宫颈癌治疗中的间隔物。
