{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:45:41Z","timestamp":1792759541637,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100013741","name":"Royal Australian and New Zealand College of Radiologists","doi-asserted-by":"publisher","award":["2024"],"award-info":[{"award-number":["2024"]}],"id":[{"id":"10.13039\/100013741","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Medical Radiation Sci"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To evaluate insertion feasibility of a stabilised hyaluronic acid (sHA) gel rectal spacer in gynaecological cancer high dose rate brachytherapy (GynBT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single institution prospective study included patients with gynaecological cancers receiving magnetic resonance imaging (MRI)\u2010guided GynBT. Feasibility was assessed by technical success, clinician user experience, spacer visibility on MRI and spacer stability over the GynBT course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve patients were included in this study. Insertion of sHA gel into the rectovaginal space was achieved in all 12 patients without spacer\u2010related complications. Clinicians reported sHA gel as easy to use, with high visibility on TRUS (rated 4\u20135) and excellent visibility on MRI. Target\u2010to\u2010rectum distance increased with sHA spacer insertion (mean 7.82\u2009mm, 95% CI: 5.27\u201310.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). During GynBT, there was a reduction in sHA gel spacer volume (mean 1.75\u2009cc, 95% CI: 0.57\u20132.93,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) and craniocaudal distance (mean \u22123.87\u2009mm, 95% CI: \u22127.37 to \u22120.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). However, there were no significant changes in target\u2010to\u2010rectum distance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.490) and spacer level measurements (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Insertion of sHA gel rectal spacer is technically feasible and safe in GynBT, increasing the separation between the target and rectum. The sHA gel spacer is easy to use, highly visible on both TRUS and MRI, and stable during the entire GynBT course. Further studies are required to ascertain patient suitability, dosimetric comparison, patient\u2010reported outcomes, toxicities, and optimal technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12625000167460)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmrs.70048","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T17:00:52Z","timestamp":1768410052000},"page":"196-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Stabilised Hyaluronic Acid Gel Rectal Spacers in\n                    <scp>MRI<\/scp>\n                    \u2010Guided Brachytherapy for Gynaecological Cancers: A Prospective Feasibility Study"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2596-1353","authenticated-orcid":false,"given":"Carminia","family":"Lapuz","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Austin Health  Melbourne Victoria Australia"},{"name":"Department of Medical Imaging and Radiation Sciences Faculty of Medicine, Nursing and Health Sciences, Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1261-7775","authenticated-orcid":false,"given":"Eddie","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Radiology Austin Health  Melbourne Victoria Australia"},{"name":"Department of Radiology University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Tacey","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1947-9694","authenticated-orcid":false,"given":"Daryl","family":"Lim Joon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Austin Health  Melbourne Victoria Australia"},{"name":"Department of Medical Imaging and Radiation Sciences Faculty of Medicine, Nursing and Health Sciences, Monash University  Melbourne Victoria 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3497-3746","authenticated-orcid":false,"given":"Michael","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Austin Health  Melbourne Victoria Australia"},{"name":"Department of Medical Imaging and Radiation Sciences Faculty of Medicine, Nursing and Health Sciences, Monash University  Melbourne Victoria 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