Image-Guided Gynecologic Brachytherapy

Inclusion Criteria: * Participants must have histologically or cytologically confirmed carcinoma. Central pathology review is not required; however, pathology will be reviewed at the SKCCC at Johns Hopkins. * Site/Stage * Any patient eligible for internal implantation without MR guidance will be considered eligible for this protocol. Standard criteria for internal implantation include: * Carcinoma of the cervix: Stage I-IVA or vaginal recurrence * Carcinoma of the uterus: Stage IIIB (vaginal involvement), inoperable, or vaginal recurrence * Carcinoma of the vagina: Stage I-IVA or vaginal recurrence * Carcinoma of the vulva: Stage I-IVA or recurrence * Carcinoma of the urethra based on treating physician's discretion * Patients who have received prior radiation or chemotherapy may be enrolled on this study. * Age \> 18 years. Children do not develop these malignancies and therefore are not considered candidates for this trial. * Life expectancy of greater than 6 months. * ECOG performance status of \<2 or greater, based on treating physician's discretion * MRI of the pelvis or PET-CT within 4 months before registration * Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: * Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. * Absolute neutrophil count \< 500 at the time of enrollment * A history of metal in the head or eyes