Hydrogel spacer distribution within the perirectal space in patients undergoing radiotherapy for prostate cancer: Impact of spacer symmetry on rectal.

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Hydrogel spacer distribution within the perirectal space in patients undergoing radiotherapy for prostate cancer: Impact of spacer symmetry on rectal dose reduction and the clinical consequences of hydrogel infiltration into the rectal wall Benjamin W. Fischer-Valuck, MD, Anupama Chundury, MD, Hiram Gay, MD, Walter Bosch, DSc, Jeff Michalski, MD, MBA Practical Radiation Oncology Volume 7, Issue 3, Pages 195-202 (May 2017) DOI: 10.1016/j.prro.2016.10.004 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Coronal view of the prostate with location of the midgland, superior (Sup), and inferior (Inf) axial slices evaluated. Also shown are symmetry locations, with 1 representing midline, 2L/2R representing 1 cm left and right, and 3L/3R 2 cm left and right, respectively. Practical Radiation Oncology 2017 7, 195-202DOI: (10.1016/j.prro.2016.10.004) Copyright © 2016 The Authors Terms and Conditions

Figure 2 T2-weighted magnetic resonance images of symmetrical hydrogel distribution (A, score = 1), 1 cm lateral distribution (B, score = 2), and >2 cm lateral distribution (C, score = 3). Practical Radiation Oncology 2017 7, 195-202DOI: (10.1016/j.prro.2016.10.004) Copyright © 2016 The Authors Terms and Conditions

Figure 3 (A) Axial slice symmetry scores, per Table 1: Hydrogel symmetry was observed in 61.7% of midgland and superior axial slices and in 71.8% of inferior slices. (B) Absolute rectal dose-volume histogram (DVH) for each Sym score group following spacer application. Practical Radiation Oncology 2017 7, 195-202DOI: (10.1016/j.prro.2016.10.004) Copyright © 2016 The Authors Terms and Conditions

Figure 4 T2-weighted magnetic resonance imaging scans of patients with varying amounts of hydrogel rectal wall infiltration. Practical Radiation Oncology 2017 7, 195-202DOI: (10.1016/j.prro.2016.10.004) Copyright © 2016 The Authors Terms and Conditions