Applicators

The development of novel brachytherapy applicators is one of the cornerstones of the rapid evolution of image-guided adaptive brachytherapy (IGABT). In contrast to the standard system-based conventional techniques, IGABT provides a platform for anatomy-based personalized adaptation of applicator insertion and treatment planning, according to common concepts, which are in principle independent of the tumor site. Modern intracavitary (IC) applicators for cervical and endometrial cancer are derived from historical systems with long traditions. Fabrication of magnetic resonance imaging (MRI)-compatible IC applicators enabled the implementation of MRI-based IGABT, which can be considered the single most important element of IC applicator development. The limitations of the standard IC and endoluminal applicators can be divided into topographic and dosimetric restrictions, which are intimately interrelated. The concept of image-guided development of novel brachytherapy applicators has been elaborated in the past decade particularly in the field of gynecologic tumors. Brachytherapy is a standard component of treatment for primary, recurrent, and metastatic tumors of the vagina.