Login
Communauté Vinci
Extérieur
Si votre nom d'utilisateur ne se termine pas par @vinci.be ou @student.vinci.be, utilisez le formulaire ci-dessous pour accéder à votre compte de lecteur.
Titre : | Validité dun protocole de contrôle du volume vésical dans le cadre du traitement par radiothérapie des cancers de la vessie |
Auteurs : | Yassine Raji, Auteur ; David Dechambre, Promoteur |
Type de document : | Travail de fin d'études |
Editeur : | Bruxelles : Institut Paul Lambin, 2020 |
Langues: | Français |
Index. décimale : | TFE - Imagerie médicale |
Résumé : | Introduction: In this study, we determined the validity of a bladders volume control protocol in the context of radiotherapy treatment of bladder cancer and discussed the implication on a Plan of the day treatment strategy: selecting between two plans differing by an isotropic 5mm margin the most appropriated to the actual bladder volume. Material and method: For 9 patients, bladder was delineated on daily MVCT acquired during the course of treatment. Over those 239 MVCT bladder volume and shape (using the Dice Similarity coefficient, DSC) were evaluated and compared to the reference scanner (CT) used for the treatment planning. Simulation protocol was evaluated by comparing the reference bladder volume (Vsim) to the MVCT bladder volume (VMVCT). To verify the validity of the pre-treatment bladder emptying protocol, we compared the VMVCT to their median value for each patient individually. DSC was computed to verify that identical bladder volume were associated to similar shapes. Results: The average VMVCT was systematically inferior to Vsim (36±23%). Slightly less than 75% of MVCT showed a bladder volume varying less than 20% of their per-patient median. Moreover, 8 over 9 patients showed a linear relationship between the variation of VMVCT to Vsim and the DSC. The patient for which we did not found that relationship was investigated in detail. Variation in the intestinal and rectal volume were the main factor for bladder variation in shape and position. The efficiency of the plan of the day strategy is reduced by the delineation protocols where the bladder is defined on the injected CT. Hence the resulting bladder volume is no more the vesical residue, but a bladder partially filled with contrast agent. Conclusion: We suggest a modification of the bladders volume control protocol for both the acquisition of the reference scanner and during the treatment. It includes a vesical, intestinal and rectal preparation. We made recommendation for an update in the delineation protocol in order to contour the vesical residue on a scanner without contrast. We believe it could improve the efficiency of the plan of the day treatment strategy. |
Accès : | Identifiez-vous avant d'accéder au document électronique |
Disponible en ligne : | Oui |
Lieu du stage : | Cliniques Universitaires Saint - Luc |
Département : | Imagerie médicale |
Documents numériques (1)
Ce document n'est visible qu'après identification
TFE IM Adobe Acrobat PDF |