Dosimetric and cost comparison of first fraction imaging versus fractional re-imaging on critical organ dose in vaginal cuff brachytherapy

There is no statistically significant difference in the mean dose to the bladder, rectum, or bowel in patients undergoing HDR vaginal cuff brachytherapy with a first fraction imaging scheme versus a fractional re-imaging scheme. These results indicate that fractional re-imaging is not necessary except in patients whose estimated dose to critical organs is near the maximum limit.