Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center
ObjectivesTo evaluate the incidence and degree of rectal wall infiltration (RWI) of spacer gel used during prostate radiotherapy among two practitioners experienced in using rectal spacers.Materials and methodsConsecutive patients with prostate cancer who received prostate radiotherapy after hydroge...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1563015/full |
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| author | Sungmin Woo Anton S. Becker Aaron E. Katz Angela Tong Hebert A. Vargas David J. Byun Jonathan W. Lischalk Jonathan A. Haas Michael J. Zelefsky |
| author_facet | Sungmin Woo Anton S. Becker Aaron E. Katz Angela Tong Hebert A. Vargas David J. Byun Jonathan W. Lischalk Jonathan A. Haas Michael J. Zelefsky |
| author_sort | Sungmin Woo |
| collection | DOAJ |
| description | ObjectivesTo evaluate the incidence and degree of rectal wall infiltration (RWI) of spacer gel used during prostate radiotherapy among two practitioners experienced in using rectal spacers.Materials and methodsConsecutive patients with prostate cancer who received prostate radiotherapy after hydrogel rectal spacer insertion in August 2023–August 2024 by two experienced practitioners were retrospectively included. Post-implant magnetic resonance imaging examinations were evaluated by two radiologists for RWI: 0 (no abnormality), 1 (rectal wall edema), 2 (superficial RWI), and 3 (deep RWI). Scores 2–3 were considered positive for RWI and their location and degree of RWI (radial, longitudinal, and circumferential) were also categorized. Inter-reader agreement was assessed with Cohen’s Kappa.Results215 men were included. Agreement was substantial between the radiologists for RWI scores (Kappa, 0.697; 95% confidence interval, 0.594-0.800). RWI scores were 0 in 80.5% (173/215), 1 in 7.9% (17/215), 2 in 10.7% (23/215), and, 3 in 0.9% (2/215) of the men. Altogether, RWI was present (scores 2–3) in 11.6% (25/215), most commonly in the mid-gland and apex with median radial, longitudinal, and circumferential involvement of 3.2 mm, 8.6 mm, and 11.5%. None of these patients demonstrated any significant rectal toxicity.ConclusionRWI was very uncommon for experienced practitioners. The degree of RWI was focal and not associated with increased complications. |
| format | Article |
| id | doaj-art-d8a4aa398205413a8ac55f16b97db9c9 |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-d8a4aa398205413a8ac55f16b97db9c92025-08-20T03:00:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011510.3389/fonc.2025.15630151563015Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume centerSungmin Woo0Anton S. Becker1Aaron E. Katz2Angela Tong3Hebert A. Vargas4David J. Byun5Jonathan W. Lischalk6Jonathan A. Haas7Michael J. Zelefsky8Department of Radiology, NYU Grossman School of Medicine, New York, NY, United StatesDepartment of Radiology, NYU Grossman School of Medicine, New York, NY, United StatesDepartment of Urology, NYU Grossman Long Island School of Medicine, Mineola, NY, United StatesDepartment of Radiology, NYU Grossman School of Medicine, New York, NY, United StatesDepartment of Radiology, NYU Grossman School of Medicine, New York, NY, United StatesDepartment of Radiation Oncology, NYU Grossman School of Medicine, New York, NY, United StatesDepartment of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital-Long Island, New York, NY, United StatesDepartment of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital-Long Island, Mineola, NY, United StatesDepartment of Radiation Oncology, NYU Grossman School of Medicine, New York, NY, United StatesObjectivesTo evaluate the incidence and degree of rectal wall infiltration (RWI) of spacer gel used during prostate radiotherapy among two practitioners experienced in using rectal spacers.Materials and methodsConsecutive patients with prostate cancer who received prostate radiotherapy after hydrogel rectal spacer insertion in August 2023–August 2024 by two experienced practitioners were retrospectively included. Post-implant magnetic resonance imaging examinations were evaluated by two radiologists for RWI: 0 (no abnormality), 1 (rectal wall edema), 2 (superficial RWI), and 3 (deep RWI). Scores 2–3 were considered positive for RWI and their location and degree of RWI (radial, longitudinal, and circumferential) were also categorized. Inter-reader agreement was assessed with Cohen’s Kappa.Results215 men were included. Agreement was substantial between the radiologists for RWI scores (Kappa, 0.697; 95% confidence interval, 0.594-0.800). RWI scores were 0 in 80.5% (173/215), 1 in 7.9% (17/215), 2 in 10.7% (23/215), and, 3 in 0.9% (2/215) of the men. Altogether, RWI was present (scores 2–3) in 11.6% (25/215), most commonly in the mid-gland and apex with median radial, longitudinal, and circumferential involvement of 3.2 mm, 8.6 mm, and 11.5%. None of these patients demonstrated any significant rectal toxicity.ConclusionRWI was very uncommon for experienced practitioners. The degree of RWI was focal and not associated with increased complications.https://www.frontiersin.org/articles/10.3389/fonc.2025.1563015/fullhydrogelmagnetic resonance imagingradiotherapyspacerrectal wall infiltration |
| spellingShingle | Sungmin Woo Anton S. Becker Aaron E. Katz Angela Tong Hebert A. Vargas David J. Byun Jonathan W. Lischalk Jonathan A. Haas Michael J. Zelefsky Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center Frontiers in Oncology hydrogel magnetic resonance imaging radiotherapy spacer rectal wall infiltration |
| title | Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center |
| title_full | Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center |
| title_fullStr | Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center |
| title_full_unstemmed | Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center |
| title_short | Low incidence of significant hydrogel spacer rectal wall infiltration: results from an experienced high-volume center |
| title_sort | low incidence of significant hydrogel spacer rectal wall infiltration results from an experienced high volume center |
| topic | hydrogel magnetic resonance imaging radiotherapy spacer rectal wall infiltration |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1563015/full |
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