CT imaging for gynecological HDR: tools and tricks.

Computerized tomography (CT)-assisted treatment planning for high-dose-rate (HDR) gynecological cancer treatments allows for better structure visualization and dose-volume histogram analysis definition. Problems associated with CT imaging are addressed. These pitfalls include the potential for multiple patient transfers and movement between applicator insertion, simulation, and treatment. Applicator CT imaging artifacts are also discussed. A modified transport table and a machined connection for a commercially available non-CT-compatible tandem and a CT-compatible ring applicator are described. These 2 modifications provide a safe and reliable method to utilize the advantages of CT imaging for gynecological HDR treatments.