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Cancer Imaging

Open Access

MRI in intracavitary brachytherapy planning for cervical cancer malignancy, the pitfalls and complications

Cancer Imaging201515(Suppl 1):P36

Published: 2 October 2015


Cervical CancerClinical Target VolumeVaginal FornixPotential MisinterpretationIntracavitary Brachytherapy

Learning objectives

  • Discuss the role and benefits of MRI in planning for brachytherapy treatment in cervical cancer.

  • Discuss the key mechanisms of the applicator and the technical aspects of planning brachytherapy.

  • Discuss the role of MRI imaging in recognising the features of appropriate applicator placement and common complications.

  • Review key MRI features of radiation-related alterations in the pelvis post treatment and tumour response assessment.


  • Anatomy of the female pelvic organs on MRI

  • Key MRI imaging features of cervical cancer on MRI

  • Review the staging of cervical cancer amenable to brachytherapy (FIGO)

  • Advantages of brachytherapy versus external beam radiotherapy in treating cervical cancer.

  • Technical aspects of applicator selection and positioning in brachytherapy.

  • MRI features in assessment of appropriate placement of brachytherapy device, recognition of “organs at risk”.

  • Benefits of MRI versus more traditional imaging techniques CT and Radiographs, in brachytherapy planning.

  • “Red flag” features of brachytherapy device misplacement in MRI.

  • Features of tumour response and target organ assessment.

  • Complications of brachytherapy including post radiation fibrosis.


  • Analysis of MRI findings at the time of brachytherapy with the applicator is essential in the assessment of gross tumour volume, clinical target volumes and patho-anatomical structures.

  • T2-weighted MR images minimise potential misinterpretation due to partial volume effects, which improves depiction of tumour in parametria, vaginal fornices, and cervix.

Authors’ Affiliations

W Smithfield, St Bartholomew's Hospital, London, UK


© Coniglio et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.