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Evidence of variations in bladder filling effecting prostate stability and therefore treatment and side‐effects is well established with intensity modulated radiation therapy ( IMRT ). This study aimed to increase bladder volume reproducibility for prostate radiation therapy by implementing a bladder scanning ( BS ) protocol that could assist patients' bladder filling at computed tomography ( CT ) simulation and treatment.    Methods  Based on a retrospective review of 524 prostate cancer patients, a bladder volume of 250–350 mL was adopted as ‘ideal’ for achieving planning dose constraints. A prospective cohort study was conducted to assess the clinical utility of measuring patients' bladder volumes at  CT  simulation using an ultrasound bladder scanner (Verathon 9400 BladderScan ® ). A revised bladder preparation protocol was utilised by a bladder scan group ( BS ) and a non‐ BS  group followed the standard departmental bladder preparation protocol. Time and volume data for the  BS  group ( n  = 17) were compared with the non‐ BS  group ( n  = 17).    Results  The  BS  cohort had a  CT  bladder volume range of 221–588 mL; mean 379 mL,  SD  125 mL. The non‐ BS  group had a larger range: 184–757 mL; mean 373 mL,  SD  160 mL ( P  = 0.9171). There was a positive correlation between  CT  volume and  BS  volume in the  BS  group ( r  = 0.797;  P  = 0.0002) although  BS  volumes were smaller: range 160–420 mL; mean 251 mL;  SD  91 mL;  P  < 0.0001). The maximum bladder volume receiving 50 Gy (V50) from the  BS  group was 46.4%, mean 24.5%. The maximum bladder V50 from the non‐ BS  group was 50.9%, mean 27.3% ( P  = 0.5178). Treatment data from weekly cone beam  CT  scans were also compared over 6 weeks. They were assessed as being a pass if bladder and bowel requirements were acceptable. The  BS  group proceeded to treatment on the basis of a pass 92.7% of the time, whereas the pass rate for non‐ BS  group was 75%; difference 17.7% ( P  < 0.0001).    Conclusion  The  BS  is a useful tool for achieving consistent, appropriately sized bladder volumes in prostate cancer patients.

journal of medical radiation sciences

Use of a prospective cohort study in the development of a bladder scanning protocol to assist in bladder filling consistency for prostate cancer patients receiving radiation therapy