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Semin Radiat Oncol. 2014 Jul;24(3):181-91. doi: 10.1016/j.semradonc.2014.02.007.

Magnetic resonance image guided brachytherapy.

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Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. Electronic address:
Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women׳s Hospital, Boston, MA.
Department of Radiotherapy, Comprehensive Cancer Center and Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.


The application of magnetic resonance image (MRI)-guided brachytherapy has demonstrated significant growth during the past 2 decades. Clinical improvements in cervix cancer outcomes have been linked to the application of repeated MRI for identification of residual tumor volumes during radiotherapy. This has changed clinical practice in the direction of individualized dose administration, and resulted in mounting evidence of improved clinical outcome regarding local control, overall survival as well as morbidity. MRI-guided prostate high-dose-rate and low-dose-rate brachytherapies have improved the accuracy of target and organs-at-risk delineation, and the potential exists for improved dose prescription and reporting for the prostate gland and organs at risk. Furthermore, MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence. MRI-guided brachytherapy involves advanced imaging, target concepts, and dose planning. The key issue for safe dissemination and implementation of high-quality MRI-guided brachytherapy is establishment of qualified multidisciplinary teams and strategies for training and education.

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