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首页> 外文期刊>Urology >Intravesical lipiodol injection technique for image-guided radiation therapy for bladder cancer
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Intravesical lipiodol injection technique for image-guided radiation therapy for bladder cancer

机译：膀胱内碘油注射技术用于膀胱癌的图像引导放射治疗

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Introduction To describe the technique of injecting Lipiodol in the submucosa of the urinary bladder wall as a novel modality to improve localization of muscle-invasive bladder tumors before image-guided radiation therapy. Technical Considerations Eight patients underwent submucosal Lipiodol injections at transurethral bladder tumor reresection. A rigid cystoscope with a working port was used to inject Lipiodol into bladder submucosa circumferentially around the tumor bed (2-3 mm from margin of resection). Approximately 20-30 injections were used to demarcate the tumor bed for external beam radiation therapy, which was used as part of a bladder-sparing approach. All patients were diagnosed with clinically localized, high-grade, muscle-invasive carcinoma and were deemed nonsurgical candidates or were unwilling to undergo radical cystectomy. Five of the 8 patients received radiation at our institution. Lipiodol injections (95%) were visible on treatment planning computed tomographic scans and kilovoltage portal images throughout the 7-week course of image-guided radiation therapy. In 2 of 5 patients, the tumor bed based on Lipiodol extended outside a planning target volume that would have been treated with radiation therapy based on cystoscopy reports and computed tomographic scans without Lipiodol. There were no adverse events or treatment-related toxicities secondary to Lipiodol injection. Conclusion Intravesical Lipiodol injection is an easy-to-perform technique that is safe and effective. Lipiodol serves as a fiducial marker that improves tumor bed localization for radiation therapy, thereby reducing the likelihood of missing the tumor.
机译：引言描述在影像引导的放射治疗之前，在膀胱壁粘膜下层注射脂质碘的技术，以改善肌肉浸润性膀胱肿瘤的定位。技术上的考虑8例患者在经尿道膀胱肿瘤切除术时接受了粘膜下脂质碘油注射。使用具有工作端口的硬性膀胱镜将脂质碘在肿瘤床周围（距切除术边缘2-3 mm）沿周向注入膀胱粘膜下层。大约20到30次注射用于划定肿瘤床以进行外部束放射治疗，这是保留膀胱的方法的一部分。所有患者均被诊断出具有临床局限性，高度，肌肉浸润性癌，被认为是非手术候选人或不愿接受根治性膀胱切除术。 8位患者中有5位在我们机构接受了放射治疗。在为期7周的图像引导放射治疗过程中，在治疗计划，计算机断层扫描和千伏门户图像上可以看到碘化碘注射液（95％）。在5名患者中，有2名患者的基于Lipiodol的肿瘤床超出了计划的目标体积，而根据膀胱镜检查报告和不具有Lipiodol的计算机断层扫描技术，这些患者已经可以接受放射治疗。 Lipiodol注射后无不良事件或与治疗相关的毒性反应。结论膀胱内注射碘化油是一种安全，有效的易行技术。碘油可作为基准标记物，改善放射治疗的肿瘤床定位，从而减少遗漏肿瘤的可能性。

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