SU-E-T-141: Automated Dose Point Placement for Cervical Cancer Brachytherapy Using Tandem and Ovoid Applicators




To develop a standalone application, which automatically and consistently calculates the coordinates of points A and H based solely on the implanted applicator geometry for cervical cancer HDR brachytherapy.


Manchester point A and ABS point H are both located 2cm lateral from the central tandem plane. While both points are located 2cm above the cervical os, surrogates for the os differ. Point A is defined relative to the anatomical cervical os. Point H is defined relative to the intersection of the tandem with the superior aspects of the ovoids. The application takes an input text file generated by the treatment planning system (TPS, BrachyVision, Varian) that specifies the source geometries. It then outputs the 3D coordinates of points A and H in both the left and right directions. The algorithm was implemented and tested on 34 CT scans of 7 patients treated with HDR brachytherapy delivered using tandem and ovoids. A single experienced user retrospectively and manually placed points A and H on the CT scans, whose coordinates were used as the gold standard for the comparison to the automatically calculated points.


The automatically calculated coordinates of points A and H agree within 0.7mm with the gold standard. The averages and standard deviations of the 3D coordinate difference between points placed by the two methods are 0.3±0.1 and 0.4±0.1mm for points A and H, respectively. The maximum difference in 3D magnitude is 0.7mm.


The algorithm consistently calculates dose point coordinates independently of the planner for cervical cancer brachytherapy treated with tandem and ovoids. Automated point placement based on the geometry of the implanted applicators agrees in sub-millimeter with careful manual placements by an experienced user. This algorithm expedites the planning process and eliminates dependencies on either user input or TPS visualization tools.