AROI-ESTRO GYN Teaching Course

Organ filing: Bladder

Jhingran A, et al. IJROBP 2012

• 24 patients

• Post-histerectomy pelvic IMRT

• Simulation with full and empty bladder

• Bladder filling instructions (full bladder on treatment)

• Rescanning twice weekly during IMRT

• Bladder volumes varied: Median difference (max-min V): 247 cm3 (95-585)

• Rectal V variation less pronounced

• Vaginal fiducial markers movement:

- 0.6 cm in lateral direction (0-0.9 cm)

- 1.5 cm in AP direction (0.8-2.8 cm)

- 1.2 cm in sup.-inf. direction (0.6-2.1)

• Large rectal/bladder V correlated with significant vaginal apex displacement

• Conclusion: even with detailed instructions, patients are unable to maintain consistent bladder filling.

Jhingran A, et al. IJROBP 2012