Hyper-dense foreign bodies found in the bowel during IGRT following brachytherapy

Irena Dragojević; Kelly Kisling; Daniel Scanderbeg; Gina Mansy

doi:10.1016/j.meddos.2020.07.001

Hyper-dense foreign bodies found in the bowel during IGRT following brachytherapy

Med Dosim. 2021;46(1):45-50. doi: 10.1016/j.meddos.2020.07.001. Epub 2020 Aug 7.

Authors

Irena Dragojević¹, Kelly Kisling², Daniel Scanderbeg², Gina Mansy²

Affiliations

¹ Department of Radiation Medicine and Applied Sciences, University of California San Diego, Chula Vista, CA 91914, USA. Electronic address: idragojevic@ucsd.edu.
² Department of Radiation Medicine and Applied Sciences, University of California San Diego, Chula Vista, CA 91914, USA.

PMID: 32778519
DOI: 10.1016/j.meddos.2020.07.001

Abstract

A 28-year-old female with locally advanced adenocarcinoma of the cervix was undergoing treatment with external beam radiation therapy (EBRT), concurrent chemotherapy and high dose rate brachytherapy (BT). On-board imaging obtained prior to one of her external beam treatments revealed four radiopaque foreign bodies in her abdomen. The patient's treatment was delayed for further work-up of this new finding. Upon further investigation, it was discovered that the patient had recently started taking bismuth subsalicylate tablets (brand name: Pepto-Bismol, Procter & Gamble Co., Cincinnati, OH). A computed tomography (CT) scan of the tablets confirmed the size and Hounsfield Unit (HU) values coincided with the foreign object properties seen on the patient's scan. This unexpected finding is important to recognize as it consequently lead to a delay in treatment, additional imaging, and patient anxiety.

Keywords: Brachytherapy; Foreign body; IGRT; Treatment planning.

Publication types

Case Reports

MeSH terms

Adenocarcinoma*
Adult
Brachytherapy*
Female
Foreign Bodies*
Humans
Radiotherapy Planning, Computer-Assisted
Tomography, X-Ray Computed
Uterine Cervical Neoplasms*