Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy

María del Carmen Salas Buzón; Lucía Gutiérrez Bayard; Raquel Rodríguez Sanchez; Luis Ángel Quiñones Rodríguez; Sarah Sayago Gil; Cristina Muñoz Higueras

doi:10.5114/jcb.2021.112117

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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6/2021
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abstract:

Original paper

Dosimetric impact of bladder filling on organs at risk with barium contrast in the small bowel for adjuvant vaginal cuff brachytherapy

María del Carmen Salas Buzón

¹

,

Lucía Gutiérrez Bayard

¹

,

Raquel Rodríguez Sanchez

¹

,

Luis Ángel Quiñones Rodríguez

²

,

Sarah Sayago Gil

¹

,

Cristina Muñoz Higueras

¹

Radiation Oncology Department, Puerta del Mar University Hospital, Cádiz, Spain
Radiophysics Department, Puerta del Mar University Hospital, Cádiz, Spain

J Contemp Brachytherapy 2021; 13, 6: 655–662

DOI: https://doi.org/10.5114/jcb.2021.112117

Online publish date: 2021/12/30

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AMA

del Carmen Salas Buzón M, Gutiérrez Bayard L, Rodríguez Sanchez R, Quiñones Rodríguez L, Sayago Gil S, Muñoz Higueras C. Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy. Journal of Contemporary Brachytherapy. 2021;13(6):655-662. doi:10.5114/jcb.2021.112117.

APA

del Carmen Salas Buzón, M., Gutiérrez Bayard, L., Rodríguez Sanchez, R., Quiñones Rodríguez, L., Sayago Gil, S.,  & Muñoz Higueras, C. (2021). Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy. Journal of Contemporary Brachytherapy, 13(6), 655-662. https://doi.org/10.5114/jcb.2021.112117

Chicago

del Carmen Salas Buzón, María, Lucía Gutiérrez Bayard, Raquel Rodríguez Sanchez, Luis Ángel Quiñones Rodríguez, Sarah Sayago Gil,  and Cristina Muñoz Higueras. 2021. "Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy". Journal of Contemporary Brachytherapy 13 (6): 655-662. doi:10.5114/jcb.2021.112117.

Harvard

del Carmen Salas Buzón, M., Gutiérrez Bayard, L., Rodríguez Sanchez, R., Quiñones Rodríguez, L., Sayago Gil, S.,  and Muñoz Higueras, C. (2021). Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy. Journal of Contemporary Brachytherapy, 13(6), pp.655-662. https://doi.org/10.5114/jcb.2021.112117

MLA

del Carmen Salas Buzón, María et al. "Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy." Journal of Contemporary Brachytherapy, vol. 13, no. 6, 2021, pp. 655-662. doi:10.5114/jcb.2021.112117.

Vancouver

del Carmen Salas Buzón M, Gutiérrez Bayard L, Rodríguez Sanchez R, Quiñones Rodríguez L, Sayago Gil S, Muñoz Higueras C. Dosimetric impact of bladder filling on organs 
at risk with barium contrast in the small bowel 
for adjuvant vaginal cuff brachytherapy. Journal of Contemporary Brachytherapy. 2021;13(6):655-662. doi:10.5114/jcb.2021.112117.

Introduction
The aim of this prospective study was to analyze dosimetric impact of modifying bladder filling on dose distribution in organs at risk (OARs) when using contrast in the small bowel of patients under adjuvant therapy with high-dose-rate vaginal cuff brachytherapy (HDR-VCB) for endometrial cancer.

Material and methods
This research included 19 patients who underwent laparoscopic surgery. They were treated with HDR-VCB and 2.5-3.5 cm diameter cylinders. Two successive computerized tomography (CT) scans were performed, with empty bladder and with bladder filled with 180 cc of saline solution. Bladder, rectum, sigmoid, and small bowel were delineated as OARs. Oral barium contrast was used to clearly visualize small bowel loops. Prescription dose was 7 Gy. Dose-volume histograms were generated for each OAR, with full and empty bladder to compare doses received.

Results
Bladder distension had no dosimetric impact on the bladder, rectum, or sigmoid, unlike the small bowel. With full bladder, mean minimum dose at 2 cc (D2cc) was not significantly higher for full vs. empty bladder (5.56 vs. 5.06 Gy, p = 0.07), whereas there was a significant reduction in the small bowel (1.68 vs. 2.70 Gy, p < 0.001). With full bladder, the dose increased to 50% of the volume (D50%) of the bladder (2.11 vs. 1.28 Gy, p < 0.001), and decreased in the small bowel (0.70 vs. 1.09 Gy, p < 0.001).

Conclusions
The present study describes the dose received by organs at risk during HDR-VCB, making it possible to define the dose received by small bowel loops, when visualized with oral barium contrast. In patients undergoing laparoscopic surgery, a full bladder during HDR-VCB reduces the dose to the small bowel without a clinically relevant dose increase in the bladder, and no dose increase in other OARs.

keywords:

Dosimetric impact of bladder filling on organs at risk with barium contrast in the small bowel for adjuvant vaginal cuff brachytherapy

María del Carmen Salas Buzón 1 , Lucía Gutiérrez Bayard 1 , Raquel Rodríguez Sanchez 1 , Luis Ángel Quiñones Rodríguez 2 , Sarah Sayago Gil 1 , Cristina Muñoz Higueras 1

endometrial cancer, vaginal cuff brachytherapy, small bowel, bladder distention, barium

María del Carmen Salas Buzón

¹

,

Lucía Gutiérrez Bayard

¹

,

Raquel Rodríguez Sanchez

¹

,

Luis Ángel Quiñones Rodríguez

²

,

Sarah Sayago Gil

¹

,

Cristina Muñoz Higueras

¹