How is your institution incorporating MRI planning into cervical EBRT/brachy?

Our department began utilizing MRI-based cervical brachytherapy in 2014. An MRI-based brachytherapy program is multi-disciplinary effort that required support from all departments, and it took about 6 months for us to implement. We have since progressed from MRI-based intracavitary only implants to MRI-based interstitial and hybrid intracavitary/interstitial implants. For our workflow and optimal treatment of the patient, we decided to perform 2 implants about 1-2 weeks apart with 2 fractions delivered per implant which includes an overnight stay in the hospital. We get an MRI with the applicator in situ for each implant. We began using both MRI and CT as we transitioned, and this was helpful as we all began gaining experience but since tra...

I agree with everything @Dr. First Last and @Dr. First Last have outlined. Although challenging, it is certainly worth the effort to establish an MRI-based brachytherapy program. The system and workflow will naturally evolve from your available resources and staff.

We transitioned to MRI based brachy at the University of Cincinnati in 2014. The techniques we use are entirely different than what I used during my training. I am currently doing an MRI sim at fraction 1 with the applicator in place using a 1.5 T magnet and titanium applicators. We are doing 4-5 total fractions. For fractions 2-5, I acquire a CT only with rigid fusion to the MRI dataset assuming the HR-CTV will only get smaller (there is data that the HR CTV decreases some over ...