Hostname: page-component-686fd747b7-8z4zl Total loading time: 0 Render date: 2025-02-13T13:44:51.082Z Has data issue: false hasContentIssue false
  • English
  • Français

Implementation of ultrasound bladder volume scanning for patients receiving intensity-modulated radiotherapy to the cervix or endometrium: clinical experiences from a United Kingdom radiotherapy department

Published online by Cambridge University Press:  08 May 2017

K. Claxton  and
R. Appleyard
K. Claxton*
Affiliation:
Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham, UK
R. Appleyard
Affiliation:
Sheffield Hallam University, Sheffield, UK
*
Correspondence to: Kate Claxton, Advanced Practitioner, Gloucestershire Oncology Centre, Cheltenham General Hospital, Sandford Road, Cheltenham, Gloucestershire GL53 7AN, UK. Tel: +443004224147. E-mail: kate.claxton1@glos.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background and purpose

Achieving daily consistent bladder volume is acknowledged as challenging for patients undergoing radiotherapy to the cervix or endometrium. We investigated if use of an ultrasound bladder volume scanner (BioCon-700) improves bladder reproducibility when used during an active volume correction protocol.

Materials and methods

During our method-comparison study, prospectively recruited patients (n=20) followed a fluid-loading protocol to achieve acceptable bladder volume. Bladder ultrasound was performed daily to verify planned volume, with patients actively correcting volumes outside a planned range up to a maximum of three times. Using the Bland–Altman method, we compared mean ultrasound readings (USMean) with mean cone-beam computed tomography (CBCT) volumes (CBCTMean). We also conducted staff focus groups exploring issues encountered during implementation of bladder scanning.

Results

Comparing USMean with CBCTMean produced a mean of the differences −10±49·92 mL (1 SD), demonstrating that bladder volume scanning is equivalent to our standard measure for the stated confidence levels. The cohort mean bladder volume decrease from week 1 to 5 was only 8·4%. Mean USMean was 323 mL, mean CBCTMean was 313 mL. Staff experience with the scanner overall was positive.

Conclusions

The BioCon-700 is suitable for the purpose of daily pre-treatment volume verification, facilitating daily assessment and modification of bladder volume, resulting in reproducible treatment volumes.

Keywords

bladder volume scannergynaecologicalultrasound
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 3 , September 2017 , pp. 232 - 244
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Ahmad, R, Hoogeman, M S, Quint, S, Mens, J W, de Pree, I, Heijmen, B J M. Inter-fraction bladder filling variations and time trends for cervical cancer patients assessed with a portable 3-dimensional ultrasound bladder scanner. Radiother Oncol 2008; 89 (2): 172–179.Google Scholar
2. Taylor, A, Powell, M E B. An assessment of interfractional uterine and cervical motion: implications for radiotherapy target volume definition in gynaecological cancer. Radiother Oncol 2008; 88 (2): 250–257.Google Scholar
3. Lim, K, Kelly, V, Stewart, J et al. Pelvic radiotherapy for cancer of the cervix: is what you plan actually what you deliver? Int J Radiat Oncol Biol Phys 2009; 74 (1): 304–312.Google Scholar
4. Bondar, M L, Hoogeman, M S, Mens, J W et al. Individualized nonadaptive and online-adaptive intensity-modulated radiotherapy treatment strategies for cervical cancer patients based on pretreatment acquired variable bladder filling computed tomography scans. Int J Radiat Oncol Biol Phys 2012; 83 (5): 1617–1623.CrossRefGoogle ScholarPubMed
5. Haripotepornkul, N H, Nath, S K, Scanderbeg, D, Saenz, C, Yashar, C M. Evaluation of intra- and inter-fraction movement of the cervix during intensity modulated radiation therapy. Radiother Oncol 2011; 98 (3): 347–351.CrossRefGoogle ScholarPubMed
6. Ung, K A, White, R, Mathlum, M, Lynch, R. Comparison study of portable bladder scanner versus cone-beam CT scan for measuring bladder volumes in post-prostatectomy patients undergoing radiotherapy. J Med Imaging Radiat Oncol 2014; 58 (3): 377–383.Google Scholar
7. Bland, J M, Altman, D G. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8 (2): 135–160.Google Scholar
8. Giavarina, D. Understanding Bland-Altman analysis. Biochem Med (Zagreb) 2015; 25 (2): 141–151.Google Scholar
9. Myles, P S. Using the Bland–Altman method to measure agreement with repeated measures. Br J Anaesthesia 2007; 99 (3): 309–311.Google Scholar
10. Wallice, S, Hickman, M, Zarkar, A, Webster, G. EP-1773: evaluating the use of bladder volume measurement ultrasound device in radiotherapy. Radiother Oncol 2014; 111: S277–S278.CrossRefGoogle Scholar
11. Mortensen, H, Jakobsen, K L, Edmund, J, Juhler-Nøttrup, T, Nordentoft, I. EP-1625: validation of an ultrasound bladder scanner in the workflow of treatment planning. Radiother Oncol 2015; 115: S890–S891.Google Scholar
12. Small, D R, Watson, A, McConnachie, A. A quantitative comparison of four current portable ultrasound bladder scanners. Br J Med Surg Urol 2008; 1: 35–40.Google Scholar
13. Hynds, S, McGarry, C, Mitchell, D et al. Assessing the daily consistency of bladder filling prior to conformal prostate radiotherapy using an ultrasonic Bladderscan device. Radiother Oncol 2011; 84: 813–818.Google Scholar
14. Haworth, A, Paneghel, A, Bressel, M et al. Prostate bed radiation therapy: the utility of ultrasound volumetric imaging of the bladder. Clin Oncol (R Coll Radiol) 2014; 26 (12): 789–796.Google Scholar
15. O’Doherty, U M, McNair, H A, Norman, A R et al. Variability of bladder filling in patients receiving radical radiotherapy to the prostate. Radiother Oncol 2006; 79 (3): 335–340.CrossRefGoogle ScholarPubMed
16. Stam, M R, van Lin, E N, van der Vight, L P, Kaanders, J H A M, Visser, A G. Bladder filling variation during radiation treatment of prostate cancer: Can the use of a bladder ultrasound scanner and biofeedback optimize bladder filling? Int J Radiat Oncol Biol Phys 2006; 65 (2): 371–377.Google Scholar
17. Alagiakrishnan, K, Valpreda, M. Ultrasound bladder scanner presents falsely elevated postvoid residual volumes. Can Fam Physician 2009; 55 (2): 163–164.Google Scholar
18. Chang, J S, Yoon, H I, Cha, H J et al. Bladder filling variations during concurrent chemotherapy and pelvic radiotherapy in rectal cancer patients: early experience of bladder volume assessment using ultrasound scanner. Radiat Oncol J 2013; 31 (1): 41–47.Google Scholar
19. Nakamura, N, Shikama, N, Takahashi, O et al. Variability in bladder volumes of full bladders in definitive radiotherapy for cases of localized prostate cancer. Strahlenther Onkol 2010; 186 (11): 637–642.Google Scholar
20. O’Shea, E, Armstrong, J, O’Hara, T, O’Neill, L, Thirion, P. Validation of an external ultrasound device for bladder volume measurements in prostate conformal radiotherapy. Radiography 2008; 14 (3): 178–183.CrossRefGoogle Scholar