# Multiparametric Magnetic Resonance Imaging as a Novel Approach to Brachytherapy for Cervical Cancer

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $139,130

## Abstract

Project Summary/Abstract
Cervical cancer causes significant impact on society, as it is a high cause of female mortality, with over 600,000 women
diagnosed each year. Locally advanced disease is best treated with a combination of external beam radiation (EBRT)
followed by brachytherapy. Brachytherapy delivers a focused, high dose into the tumor that is best directed by the use
of MR imaging at the time of brachytherapy to ensure that the entire tumor can be treated with radiation. The
placement of brachytherapy catheters, is typically done without any guidance, and complications due to inadvertent
insertion into normal tissues (blood vessels, rectum, bladder), rather than into residual tumor, may result. Magnetic
resonance-guided brachytherapy (MRBT) has significantly improved survival and reduced complications caused by
inadvertently radiating neighboring tissues. Identifying normal tissues as residual tumor before MRBT may result in
inadvertent treatment with radiation of healthy tissues, which increases complications. MRI multi-parametric
identification of post-EBRT residual tumor, combined with actively-tracked catheter placement into the disease as seen
on MR scanning, can result in a more precise treatment volume, and faster and more accurate MRBT catheter
placement, leading to better outcomes and reduced complications. This should increase the use of MRBT in treating
cervical cancer, as well as recurrent endometrial, vaginal, prostate, and other cancers.
The proposed procedure utilizes several novel tools: (a) MRI sequences that map the tissue parameters perfusion,
diffusion, fibrosis and oxygenation in the post-EBRT pelvis, which are analyzed by expert clinicians, and used to develop
a method for providing refined remnant tumor maps; and, (b) instantaneous intraoperative dose mapping, where
catheter locations at any time during placement are used to predict and guide what the clinician’s best next move
should be, such as changing current catheter locations or adding more catheters. Together, these methods will
culminate in dose-optimized catheter placements that will lower tumor recurrence and limit radiation side effects.
This project is a collaboration between Johns Hopkins University and Elekta Inc. JHU radiation oncologists, radiologists,
medical physicists and MRI physicists, along with a panel of experts in identifying remnant tumor, will work jointly with
Elekta engineers to develop an innovative platform with broad applications in radiation oncology.

## Key facts

- **NIH application ID:** 10993754
- **Project number:** 3R01CA237005-05S1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Akila Viswanathan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $139,130
- **Award type:** 3
- **Project period:** 2020-03-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10993754

## Citation

> US National Institutes of Health, RePORTER application 10993754, Multiparametric Magnetic Resonance Imaging as a Novel Approach to Brachytherapy for Cervical Cancer (3R01CA237005-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10993754. Licensed CC0.

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