A cervix-to-rectum measuring device to be used in the treatment of cervical cancer is described. It includes a handle and a probe pivotably connected to the handle for insertion in the rectum. The measuring device further includes means for coupling the handle to an intrauterine radiation applicator when the latter is positioned in the uterine cervix and the probe is inserted in the rectum to pivot the handle about the probe. A gear is provided which is adapted to pivot with the probe. A pinion pivotably connected to the handle meshes with the gear. A pointer fixed to the pinion is displaced in response to the pivoting of the handle about the probe, and this displacement can be read from a scale on the handle, providing an indication of the cervix-to-rectum distance

Fischell, D. R.

Mazique, J. C.

English

NASA Technical Reports Server

United States Patent [111 4 2 9 4,2 6 4 
CERVIX-TO-RECTUM MEASURING DEVICE 
IN A RADIATION APPLICATOR FOR USE 
IN THE TREATMENT OF CERVICAL 
CANCER 
Inventors: David R. Fischell, Ithaca, N.Y.; 
Jeffrey C. Mazique, Mt. Rainier, Md. 
Assignee: The United States of America as 
represented by the Administrator of 
the National Aeronautics and Space 
Administration, Washington, D.C. 
Appl. NO.: 796,258 
Filed: May 12, 1977 
Related US.  Application Data 
Continuation of Ser. No. 672,209, Mar. 31, 1976, aban- 
doned. 
Int. c I . 3  ................................................ A61B 5/10 
U.S. C1. ..................................... 128/778; 128A.2; 
33/143 C 
Field of Search ................... 128/1.1, 1.2, 25, 774, 
128/778; 33/174 D, 148 E, 143 C 
References Cited 
U.S. PATENT DOCUMENTS 
396,479 1/1889 Green ................................ 33/148 E 
673,944 5/1901 Doty ................................. 33/148E 
1,295,327 2/1919 Kaplan .............................. 33/148 E 
1,317,708 10/1919 Kaplan .............................. 33/148 E 
1,621,778 3/1927 Haglund ............................ 33/148 E 
1,849,959 3/1932 Schneider ......................... 33/148 E 
2,544,939 3/1951 Ritala .................................. 128/1.2 
3,740,779 6/1973 Rubricuis ..................... 33/174 D X 
Primary Examiner-Kyle L. Howell 
Attorney, Agent, or Firm-Robert D. Marchant; John R. 
Manning; John 0. Tresansky 
[571 ABSTRACT 
A cervix-to-rectum measuring device to be used in the 
treatment of cervical cancer which includes a handle 
and a probe pivotably connected to the handle for inser- 
tion in the rectum. The measuring device further in- 
cludes means for coupling the handle to an intrauterine 
radiation applicator when the latter is positioned in the 
uterine cervix and the probe is inserted in the rectum to 
pivot the handle about the probe. A gear is provided 
which is adapted to pivot with the probe. A pinion 
pivotably connected to the handle meshes with the 
gear. A pointer fixed to the pinion is displaced in re- 
sponse to the pivoting of the handle about the probe, 
and this displacement can be read from a scale on the 
handle, providing an indication of the cervix-to-rectum 
distance. 
1 Claim, 4 Drawing Figures 
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https://ntrs.nasa.gov/search.jsp?R=19820015001 2020-03-21T16:27:19+00:00Z
U.S. Patent oct. 13, 1981 Sheet 1 of 2 4,294,264 
FIG. 
U.S. Patent oct. 13, 1981 Sheet 2 of 2 4,294,264 
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‘39 27’ 
FIG.4 
4,294,264 
1 
CERVIX-TO-RECTUM MEASURING DEVICE IN A 
RADIATION APPLICATOR FOR USE IN THE 
TREATMENT OF CERVICAL CANCER 
ORIGIN O F  INVENTION 
The invention described herein was made in the per- 
formance of work under a NASA contract and is sub- 
ject to the provisions of Section 305 of the National 
Aeronautics and Space Act of 1958, Public Law 85-568 
(72 Stat. 435; U.S.C. 2457). 
This is a continuation of application Ser. No. 672,209, 
filed Mar. 31, 1976 now abandoned. 
BACKGROUND O F  T H E  INVENTION 
1. Field of the Invention 
The present invention relates generally to radiation 
applicators for use in the treatment of cancerous tissue 
and, more particularly, to such an applicator having a 
measuring device to indicate the distance between the 
radiation sources and healthy tissues. 
2. Description of the Prior Art 
One of the most common sites of cancer in women is 
the uterine cervix, and it is customary to treat the can- 
cer by irradiation with radioactive sources. A radioac- 
tive source applicator to which the present invention 
typically relates is the Henschke afterloading applicator 
described below. Typical patents directed to radioac- 
tive source applicators include: 
U.S. Pat. No. 3,789,829 
US.  Pat. No. 3,323,511 
US.  Pat. No. 3,060,924 
US.  Pat. No. 2,888,917 
U.S. Pat. No. 2,544,939. 
The major problem with such devices is that they 
place the source of radioactivity so close to the rectum 
that it makes the rectal dose of radiation the limiting 
factor in the internal treatment. Thus, the rectal dose 
must be measured accurately to avoid over-irradiating 
the rectal area and harming healthy tissues in the pro- 
cess of treating diseased tissues. 
To determine the rectal dose in most patients, the 
following procedure is followed. The radioactive 
source applicator is inserted and positioned in the va- 
gina. A material not penetrated by X-rays is injected in 
the rectum, and an X-ray is then taken. The cervix-rec- 
tum distance is determined from the X-ray. This infor- 
mation along with the radioactive strength and position 
of each of the sources is fed into a computer. The com- 
puter determines the radiation levels in a series of what 
are called isodose curves. Isodose curves give a some- 
what 3-dimensional view of the fall off of the radiation 
level with distance from the radioactive sources. The 
doctors can site the location of the rectum on this set of 
curves and thus estimate the rectal dose. 
Among the problems associated with the isodose 
curve method are that the X-ray does not give an accu- 
rate measurement of the cervix-rectum distance mea- 
surement while it exposes the patient to additional radi- 
ation and requires computer facilities which are not 
always readily available. 
For more accurate measurements there are several 
devices for determining the radiation level exactly. The 
first of these is an ion chamber which produces small 
pulses of current when the X-rays ionize the air inside. 
The pulses are so small they require a special preampli- 
fier and counter. The second method used involves a 
scintillation detector, a material that takes in X-rays and 
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turns out small amounts of visible light. The visible light 
is then light piped to a photo multiplier and then to a 
special counter. Both of these methods ace expensive 
and somewhat complex and therefore do not afford 
simplicity and economy. 
Because cervical cancer is a disease found, to a large 
degree, in underdeveloped countries, and 111 the lower 
economic communities of this country, any solution to 
this problem must be applicable to such areas where 
large and expensive facilities generally do not exist. 
BRIEF SUMMARY O F  T H E  INVENTION 
It is therefore one object of the present invention to 
provide an improved radiation applicator for treatment 
of cancerous tissue in the uterine cervix. 
It is another object to provide such an applicator 
wherein the cervix-to-rectum distance can be directly 
determined. 
It is a further object to provide such an applicator 
where the means for determining the cervix-to-rectum 
distance can be coupled to the applicator and also posi- 
tioned in the rectum without distorting the overall anat- 
omy. 
It is another object to provide such an applicator 
where the means for determining the cervix-to-rectum 
distance is simple to use and does not require additional 
instrumentation. 
The objects of the present invention are achieved by 
providing a cervix-to-rectum measuring device in the 
radiation applicator. The measuring device includes a 
handle, a probe pivotably connected to the handle and 
insertable in the rectum, means for coupling the handle 
to the applicator when the latter is positioned in the 
uterine cervix and the probe is inserted in the rectum to 
pivot the handle about the probe, and means responsive 
to the pivoting of the handle for indicating the distance 
between the applicator and the tip of the probe, so that 
the cervix-to-rectum distance can be determined. 
The foregoing as well as other objects, features and 
advantages of the present invention will become more 
apparent from the following detailed description taken 
in conjunction with the appended drawings. 
BRIEF DESCRIPTION OF THE DRAWINGS 
FIG. 1 is a top plan view of an afterloading radiation 
applicator being shown positioned in the vaginal tract 
and uterus, shown in section, to treat the uterus and 
cervix, including surrounding areas. 
FIG. 2 is a top plan view of the unassernbled after- 
loading radiation applicator and cervix-to-rectum mea- 
suring device. 
FIG. 3 is a perspective view of the assembled after- 
loading radiation applicator and cervix-to-rectum mea- 
suring device. 
FIG. 4 is a side view of the cervix-to-rectum measur- 
ing device without the probe taken through line 3-3 of 
FIG. 3. 
DETAILED DESCRIPTION OF THE 
PREFERRED EMBODIMENTS 
Referring now to the drawings, wherein like refer- 
ence numerals designate identical elements, and more 
particularly to FIG. 1 there IS illustrated the Henschke 
afterloading radiation applicator with which the cervix- 
to-rectum measuring device of the present invention has 
been incorporated. Since such applicators are well 
known in the field of radio-therapy and the use of the 
4,294,264 
3 4 
present invention need not be limited to this particular 
applicator it will be described only insofar as necessary 
to set forth the cooperative relationship of the cervix- 
to-rectum measuring device Of the present invention. 
'The afterloading radiation applicator generally Corn- 5 
Prises a central tubular member 11 having a Pair of 
pivotable hollow arms 13 and 15 connected thereto by 
a linkage 17. The applicator can be inserted in the vagi- 
nal tract, the central tubular member 11 and pivotable 
tainers to receive needles of radioactive material, such 
probe arm 33 is turned, the pointer 49 is deflected and 
its displacement can be read from a scale 25. The nu- 
merals on the scale 25 indicate directly the distance 
between the probe tip 38 and the applicator. 
In operation, the afterloading radiation applicator is 
first positioned in the uterine cervix. The probe tip 38 of 
the cervix-to-rectum measuring device is next inserted 
into the rectum. When the probe 37 is in place, the 
handle 23 of the measuring device is coupled to the 
tor. The distance between the probe tip 38 and the 
hollow arms 13 and 15 thereafter forming tubular con- 10 central tubular member 11 of the afterloading applica- 
as radium Or (not shown). The upper central tubular member 11 of the applicator, which 
portion Of the represents the cervix-to-rectum distance is then read on member l1 can be inserted into the uterine cervix so that the pivotable arms 13 and the calibrated scale 25 of the measuring device. The 15 lie adjacent to the cervix with their upper ends abut- 15 rectal dose is calculated, the measuring device is re- 
ting the latter. The radioactive needle bearing portions moved, and the radioactive needles are inserted in tubu- of the pivotable arms 13 and 15 are provided with lar containers 11,13 and 15, of the afterloading applica- spherically shaped hoods 19 and 21 respectively of 
protective metal to shield portions of the anatomy tor' 
Obviously, numerous modifications and variations of which are not diseased. 
Referring to FIGS. 2, 3, and 4, there is illustrated the the present invention are possible in light of the above 
cervix-to-rectum measuring device ofthe present inven- teachings. It is therefore to be understood that within 
end of the handle 23 is shaped as a shank 27 with a 25 herein. 
lengthwise cavity 29 for with a set Screw 31 
the central tubular member 11 of the applicator. A 
probe arm 33 is pivotably mounted to the handle 23 by 
means of a shoulder screw 35. The probe arm 33 is 
fashioned to accommodate slender flexible rods or 30 
probes 37 of varying curvature. As more clearly shown 
in FIG. 4, a hubless gear 39 is secured in a recess in the 
underside of the probe arm 33 by machine screws 41,43 
and 45 (FIG. 2) and the probe arm and hubless gear turn 
about the pivot provided by the shoulder screw 35 so 35 
that the distance between the probe tip 38 and the cen- 
tral tubular member 11 of the applicator can be de- 
creased or increased. A pinion 47 pivotably connected 
to the handle 23 by screw 24 and having a pointer 49 
2o 
tion. The measuring device includes a handle 23 pro- 
vided with a calibrated scale 25 at one end. The other 
the scope of the appended claims, the invention may be 
practiced otherwise than as specificab' described 
What is claimed as new and desired to be secured by 
1. A device for use with a radiation applicator com- 
a handle, 
a single Probe Pivotably Connected to said handle and 
insertable in a rectum, 
means on said handle for coupling said handle to the 
applicator, and 
means on said handle responsive to the displacement 
of said probe when inserted into a rectum relative 
to the applicator when inserted into an uterine 
cervix for indicating the distance between said 
cervix and rectum. 
Letters Patent of the United States is: 
prising: 
fixed thereto meshes with the hubless gear 39. When the 40 * * * * *  
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Cervix-to-rectum measuring device in a radiation applicator for use in the treatment of cervical cancer

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