Placement of a radiation implant in patients with cervical cancer may
be difficult because of distortion of the canal by tumor or fibrosis f
rom previous radiation. The objective of this study was to determine w
hether ultrasound may be useful in recognizing or preventing complicat
ions associated with placement of an intracavitary implant. Transabdom
inal ultrasound was used during and after 20 intracavitary implants in
patients with cervical cancers. In placing 20 implants, there were 9
placed in less than satisfactory relation to the anatomy of the uterus
. In 6 patients, occult perforations occurred, with two-thirds not det
ected by the operator. Increased difficulty was seen at the time of pl
acement of a second implant after external radiation. By using ultraso
und, correction of the misplaced tandem could be made immediately with
out resorting to more invasive surgical approaches. (C) 1994 Academic
Press, Inc.