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Li J, Yang L, Yao X, Xu L, Zhao L, Bai F. A retrospective study on improving the accuracy of radiotherapy for patients with breast cancer with lymph node metastasis using Styrofoam. Radiol Oncol 2024; 58:124-132. [PMID: 38183274 PMCID: PMC10878773 DOI: 10.2478/raon-2024-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/15/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND To retrospectively analyze the accuracy of radiotherapy using cone beam computed tomography (CBCT), Styrofoam fixation, and breast bracket fixation in the chest wall target area and supraclavicular lymphatic drainage area (supraclavicular target area) of patients with breast cancer.and compare the setting efficiency and comfort satisfaction. PATIENTS AND METHODS A total of 65 patients with postoperative lymphatic metastasis of breast cancer, including 36 cases of Styrofoam fixation and 29 cases of breast bracket fixation, were recruited from March 2021 to August 2022 and retrospectively analyzed. All the patients underwent CBCT scans weekly, and the setup errors of the chest wall and supraclavicular target volume were compared and recorded. The planning target volume (PTV) margins of the two groups were calculated using the correlation MPTV = 2.5Σ + 0.7σ. The setup time and comfort satisfaction scores of the two groups were recorded and analyzed. The correlations among errors in each direction were analyzed using the Pearson correlation analysis. RESULTS There was a significant difference in the left-right direction (X) axis of the chest wall target area between the Styrofoam and breast bracket groups (1.59 ± 1.47 mm vs. 2.05 ± 1.64 mm, P = 0.012). There were statistical differences in the ventrodorsal direction (Z) and bed angle of the supraclavicular target area, the data were (1.36 ± 1.27 mm vs. 1.75 ± 1.55 mm, P = 0.046; 0.47 ± 0.47° vs. 0.66 ± 0.59°, P = 0.006, respectively). In the X, Y, and Z directions, the respective PTV margins of the two groups in the chest wall target area were 5.01 mm, 5.99 mm, and 5.47 mm in the Styrofoam group, while those in the breast bracket group were 6.10 mm, 6.34 mm, and 6.10 mm, respectively. Moreover, the PTV margins of the supraclavicular target in the three directions were 3.69 mm, 3.86 mm, and 4.28 mm in the Styrofoam group, while those in the breast bracket group were 3.99 mm, 3.72 mm, and 5.45 mm, respectively. The setup time of the two groups was 3.4 ± 1.1 min and 5.5 ± 3.1 min (P = 0.007). The subjective comfort satisfaction scores of the two groups were 27.50 ± 1.24 and 25.44 ± 1.23 (P < 0.001). CONCLUSIONS The application of Styrofoam fixation in radiotherapy of breast cancer in the supraclavicular lymph node area has several advantages as compared to breast bracket fixation, including higher positioning accuracy, smaller external expansion boundary, improved work efficiency, and patients' comfort, which might provide a reference for clinical work.
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Affiliation(s)
- Jie Li
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
| | - Lin Yang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
| | - Xiaowei Yao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
| | - Linlin Xu
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
| | - Lina Zhao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
| | - Fei Bai
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University. Xi’an, China
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Heikkilä A, Boman E, Rossi M, Vanhanen A, Mankinen M, Postema M, Koivumäki T. Dosimetric effect of rotational setup errors in volumetric modulated arc therapy and field-in-field treatment of left-sided breast cancer. Phys Med 2024; 117:103203. [PMID: 38171219 DOI: 10.1016/j.ejmp.2023.103203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/06/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Setup errors are an important factor in the dosimetric accuracy of radiotherapy delivery. In this study, we investigated how rotational setup errors influence the dose distribution in volumetric modulated arc therapy (VMAT) and tangential field-in-field (FiF) treatment of left-sided breast cancer with supraclavicular lymph node involvement in deep inspiration breath hold. Treatment planning computed tomography images and radiotherapy plans of 20 patients were collected retrospectively for the study. Rotational setup errors up to 3° were simulated by rotating the planning images, and the resulting dosimetric changes were calculated. With rotational setup errors up to 3°, the median decrease of V95% to clinical target volume was less than 0.8 percentage point in both VMAT and FiF plans. The dose distribution of the heart and left anterior descending artery was more stable with respect to rotations in VMAT plans compared to FiF plans. Correction of ≥1° setup errors is recommended due to increased doses to the heart and left anterior descending artery after 1° setup errors.
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Affiliation(s)
- Annele Heikkilä
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, 33720 Tampere, Finland; Department of Medical Physics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland.
| | - Eeva Boman
- Department of Medical Physics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland; Department of Oncology, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
| | - Maija Rossi
- Department of Medical Physics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland; Department of Oncology, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
| | - Antti Vanhanen
- Department of Medical Physics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland; Department of Oncology, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
| | - Mikko Mankinen
- Department of Medical Physics, Central Finland Health Care District, Hoitajantie 3, 40620, Jyväskylä, Finland
| | - Michiel Postema
- BioMediTech, Faculty of Medicine and Health Technology, Tampere University, Korkeakoulunkatu 3, 33720 Tampere, Finland; School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, 1 Jan Smutslaan, 2050 Braamfontein, South Africa
| | - Tuomas Koivumäki
- Department of Medical Physics, Central Finland Health Care District, Hoitajantie 3, 40620, Jyväskylä, Finland
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Fu M, Cui Y, Qiu W, Cui Z, Zhang Y, Wang D, Yan S, Zhao Z, Wang Y, Zhu J. In Silico Studies of the Impact of Rotational Errors on Translation Shifts and Dose Distribution in Image-Guided Radiotherapy. Technol Cancer Res Treat 2023; 22:15330338231168763. [PMID: 37050884 PMCID: PMC10102941 DOI: 10.1177/15330338231168763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Objective: To compare the 6-dimensional errors of different immobilization devices and body regions based on 3-dimensional cone beam computed tomography for image-guided radiotherapy and to further quantitatively evaluate the impact of rotational corrections on translational shifts and dose distribution based on anthropomorphic phantoms. Materials and Methods: Two hundred ninety patients with cone beam computed tomographies from 3835 fractions were retrospectively analyzed for brain, head & neck, chest, abdomen, pelvis, and breast cases. A phantom experiment was conducted to investigate the impact of rotational errors on translational shifts using cone beam computed tomography and the registration system. For the dosimetry study, pitch rotations were simulated by adjusting the breast bracket by ±2.5°. Roll and yaw rotations were simulated by rotating the gantry and couch in the planning system by ±3.0°, respectively. The original plan for the breast region was designed in the computed tomography image space without rotation. With the same planning parameters, the original plan was transplanted into the image space with different rotations for dose recalculation. The effect of these errors on the breast target and organs at risk was assessed by dose-volume histograms. Results: Most of the mean rotational errors in the breast region were >1°. A single uncorrected yaw of 3° caused a change of 2.9 mm in longitudinal translation. A phantom study for the breast region demonstrated that when the pitch rotations were -2.5° and 2.5° and roll and yaw were both 3°, the reductions in the planning target volumes-V50 Gy were 20.07% and 29.58% of the original values, respectively. When the pitch rotation was +2.5°, the left lung V5 Gy and heart Dmean were 7.49% and 165.76 Gy larger, respectively, than the original values. Conclusions: Uncorrected rotations may cause changes in the values and directions of translational shifts. Rotational corrections may improve the patient setup and dose distribution accuracy.
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Affiliation(s)
- Min Fu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Yanhua Cui
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Wenlong Qiu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Zhen Cui
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Yan Zhang
- Department of Radiation Oncology Physics and Technology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and Nanjing Medical University Affiliated Cancer Hospital, Nanjing, People's Republic of China
| | - Dandan Wang
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Shaojie Yan
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Zengjing Zhao
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Yungang Wang
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Jian Zhu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China
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Zhou J, Li S, Ye C, Shen K, Li A, Chen G, Li X, Bai S, Wang W, Zhong R. Analysis of local setup errors of sub-regions in cone-beam CT-guided post-mastectomy radiation therapy. JOURNAL OF RADIATION RESEARCH 2021; 61:457-463. [PMID: 32100830 PMCID: PMC7299271 DOI: 10.1093/jrr/rraa007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/27/2019] [Indexed: 02/05/2023]
Abstract
The purpose of the study was to quantify local setup errors and evaluate the planning target volume (PTV) margins for sub-regions in cone-beam computed tomography (CBCT)-guided post-mastectomy radiation therapy (PMRT). The local setup errors of 20 patients undergoing CBCT-guided PMRT were analysed retrospectively. Image registration between CBCT and planning CT was performed using four sub-regions of interest (ROIs): the supraclavicular area (SROI), ipsilateral chest wall region (CROI), ipsilateral chest wall plus supraclavicular region (SROI + CROI) and vertebral region (TROI). Bland–Altman analysis, correlation, local setup errors and PTV margins among these ROIs were evaluated. There was no significant consistency or correlation for registration results between the TROI and the CROI or SROI regions on any translational axis. When using the SROI + CROI as the ROI, the systematic error (Σ) and random error (σ) of the local setup errors for the CROI region were 1.81, 1.19 and 1.76 mm and 1.84, 2.64 and 3.00 mm along the medial–lateral (ML), superior–inferior (SI) and anterior–posterior (AP) directions, respectively. The PTV margins for the CROI region were 5.80, 4.82 and 6.50 mm. The Σ and σ of the local setup errors for the SROI region were 1.29, 1.15 and 0.77 mm and 1.96, 2.65 and 2.2 mm, respectively, and the PTV margins were 4.59, 4.73 and 3.47 mm. Large setup errors and local setup errors occur in PMRT. The vertebral body should not be a position surrogate for the supraclavicular region or chest wall. To compensate for the local setup errors, different PTV margins are required, even with CBCT guidance.
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Affiliation(s)
- Jidan Zhou
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Shuai Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Chengwei Ye
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Konglong Shen
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - An Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Gang Chen
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Xiaoyu Li
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Sen Bai
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Weifeng Wang
- Department of Radiotherapy, Jingzhou Central Hospital, the Second Clinical Medical College, Yangtze University, Jingzhou 434020, P.R. China
| | - Renming Zhong
- Department of Radiotherapy, Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
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Liang X, Mailhot Vega RB, Li Z, Zheng D, Mendenhall N, Bradley JA. Dosimetric consequences of image guidance techniques on robust optimized intensity-modulated proton therapy for treatment of breast Cancer. Radiat Oncol 2020; 15:47. [PMID: 32103762 PMCID: PMC7045466 DOI: 10.1186/s13014-020-01495-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/17/2020] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To investigate the consequences of residual setup error on target dose distribution using various image registration strategies for breast cancer treated with intensity-modulated proton therapy (IMPT). MATERIALS AND METHODS Among 11 post-lumpectomy patients who received IMPT, 44 dose distributions were computed. For each patient, the original plan (Plan-O) and three verification plans were calculated using different alignments: bony anatomy (VPlan-B), breast tissue (VPlan-T), and skin (VPlan-S). The target coverage were evaluated for each alignment technique. Additionally, 2 subvolumes-BreastNearSkin (1-cm rim of anterior CTV) and BreastNearCW (1-cm rim of posterior CTV)-were created to help localize CTV underdosing. Furthermore, we divided the setup error into the posture error and breast error. Patients with a large posture error and those with good posture setup but a large breast error were identified to evaluate the effect of posture error and breast error. RESULTS For Plan-O, VPlan-B, VPlan-T, and VPlan-S, respectively, the median (interquartile range) breast CTV D95 was 95.7%(94.7-96.3%), 95.1% (93.9-95.7%), 95.2% (94.8-95.6%), and 95.2% (94.9-95.7%); BreastNearCW D95 was 96.9% (95.6-97.3%), 94.8% (93.5-97.0%), 95.6% (94.8-97.0%), 95.6% (94.8-97.1%); and BreastNearSkin D95 was 94.1% (92.7-94.4%), 93.6% (92.2-94.5%), 93.5% (92.4-94.5%), and 94.4% (92.2-94.5%) of the prescription dose. 4/11 patients had ≥1% decrease in breast CTV D95, 1 of whom developed breast edema while the other 3 all had a > 2o posture error. The CTV D95 variation was within 1% for the patients with good posture setup but >2o breast error. CONCLUSION Acceptable target coverage was achieved with all three alignment strategies. Breast tissue and skin alignment maintained the breast target coverage marginally better than bony alignment, with which the posterior CTV along the chest wall is the predominant area affected by under-dosing. For target dose distribution, posture error appears more influential than breast error.
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Affiliation(s)
- Xiaoying Liang
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA.
| | - Raymond B Mailhot Vega
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Zuofeng Li
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Dandan Zheng
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Nancy Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Julie A Bradley
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, USA
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Introducing operator characteristic curves to define appropriate frequency of quality control tests: A case study involving whole breast radiotherapy image guidance. Phys Med 2020; 69:275-280. [DOI: 10.1016/j.ejmp.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 11/21/2022] Open
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Hamming VC, Visser C, Batin E, McDermott LN, Busz DM, Both S, Langendijk JA, Sijtsema NM. Evaluation of a 3D surface imaging system for deep inspiration breath-hold patient positioning and intra-fraction monitoring. Radiat Oncol 2019; 14:125. [PMID: 31296245 PMCID: PMC6624957 DOI: 10.1186/s13014-019-1329-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/27/2019] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To determine the accuracy of a surface guided radiotherapy (SGRT) system for positioning of breast cancer patients in breath-hold (BH) with respect to cone-beam computed tomography (CBCT). Secondly, to evaluate the thorax position stability during BHs with SGRT, when using an air-volume guidance system. METHODS AND MATERIALS Eighteen left-sided breast cancer patients were monitored with SGRT during CBCT and treatment, both in BH. CBCT scans were matched on the target volume and the patient surface. The setup error differences were evaluated, including with linear regression analysis. The intra-fraction variability and stability of the air-volume guided BHs were determined from SGRT measurements. The variability was determined from the maximum difference between the different BH levels within one treatment fraction. The stability was determined from the difference between the start and end position of each BH. RESULTS SGRT data correlated well with CBCT data. The correlation was stronger for surface-to-CBCT (0.61) than target volume-to-CBCT (0.44) matches. Systematic and random setup error differences were ≤ 2 mm in all directions. The 95% limits of agreement (mean ± 2SD) were 0.1 ± 3.0, 0.6 ± 4.1 and 0.4 ± 3.4 mm in the three orthogonal directions, for the surface-to-CBCT matches. For air-volume guided BHs, the variability detected with SGRT was 2.2, 2.8 and 2.3 mm, and the stability - 1.0, 2.1 and 1.5 mm, in three orthogonal directions. Furthermore, the SGRT system could detect unexpected patient movement, undetectable by the air-volume BH system. CONCLUSION With SGRT, left-sided breast cancer patients can be positioned and monitored continuously to maintain position errors within 5 mm. Low intra-fraction variability and good stability can be achieved with the air-volume BH system, however, additional patient position information is available with SGRT, that cannot be detected with air-volume BH systems.
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Affiliation(s)
- Vincent C. Hamming
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Christa Visser
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Estelle Batin
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Leah N. McDermott
- Department of Radiation Oncology, Northwest Clinics, Alkmaar, The Netherlands
| | - Dianne M. Busz
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Stefan Both
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Johannes A. Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Nanna M. Sijtsema
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
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Walker A, Metcalfe P, Liney G, Batumalai V, Dundas K, Glide‐Hurst C, Delaney GP, Boxer M, Yap ML, Dowling J, Rivest‐Henault D, Pogson E, Holloway L. MRI geometric distortion: Impact on tangential whole-breast IMRT. J Appl Clin Med Phys 2016; 17:7-19. [PMID: 28297426 PMCID: PMC5495026 DOI: 10.1120/jacmp.v17i5.6242] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 03/21/2016] [Indexed: 12/04/2022] Open
Abstract
The purpose of this study was to determine the impact of magnetic resonance imaging (MRI) geometric distortions when using MRI for target delineation and planning for whole-breast, intensity-modulated radiotherapy (IMRT). Residual system distortions and combined systematic and patient-induced distortions are considered. This retrospective study investigated 18 patients who underwent whole-breast external beam radiotherapy, where both CT and MRIs were acquired for treatment planning. Distortion phantoms were imaged on two MRI systems, dedicated to radiotherapy planning (a wide, closed-bore 3T and an open-bore 1T). Patient scans were acquired on the 3T system. To simulate MRI-based planning, distortion maps representing residual system distortions were generated via deformable registration between phantom CT and MRIs. Patient CT images and structures were altered to match the residual system distortion measured by the phantoms on each scanner. The patient CTs were also registered to the corresponding patient MRI scans, to assess patient and residual system effects. Tangential IMRT plans were generated and optimized on each resulting CT dataset, then propagated to the original patient CT space. The resulting dose distributions were then evaluated with respect to the standard clinically acceptable DVH and visual assessment criteria. Maximum residual systematic distortion was measured to be 7.9 mm (95%<4.7mm) and 11.9 mm (95%<4.6mm) for the 3T and 1T scanners, respectively, which did not result in clinically unacceptable plans. Eight of the plans accounting for patient and systematic distortions were deemed clinically unacceptable when assessed on the original CT. For these plans, the mean difference in PTV V95 (volume receiving 95% prescription dose) was 0.13±2.51% and -0.73±1.93% for right- and left-sided patients, respectively. Residual system distortions alone had minimal impact on the dosimetry for the two scanners investigated. The combination of MRI systematic and patient-related distortions can result in unacceptable dosimetry for whole-breast IMRT, a potential issue when considering MRI-only radiotherapy treatment planning. PACS number(s): 87.61.-c, 87.57.cp, 87.57.nj, 87.55.D.
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Affiliation(s)
- Amy Walker
- Centre for Medical Radiation Physics, University of WollongongWollongongNSWAustralia
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
| | - Peter Metcalfe
- Centre for Medical Radiation Physics, University of WollongongWollongongNSWAustralia
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
| | - Gary Liney
- Centre for Medical Radiation Physics, University of WollongongWollongongNSWAustralia
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
- Institute of Medical Physics, School of Physics, University of SydneySydneyNSWAustralia
| | - Vikneswary Batumalai
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
- South Western Clinical School, University of New South WalesSydneyNSWAustralia
| | - Kylie Dundas
- Centre for Medical Radiation Physics, University of WollongongWollongongNSWAustralia
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
| | - Carri Glide‐Hurst
- Department of Radiation OncologyHenry Ford Health SystemDetroitMIUSA
| | - Geoff P Delaney
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- South Western Clinical School, University of New South WalesSydneyNSWAustralia
- Collaboration for Cancer Outcomes Research and Evaluation, Liverpool HospitalLiverpoolNSWAustralia
- School of Medicine, University of Western SydneySydneyNSWAustralia
| | - Miriam Boxer
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- South Western Clinical School, University of New South WalesSydneyNSWAustralia
| | - Mei Ling Yap
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
- South Western Clinical School, University of New South WalesSydneyNSWAustralia
- Collaboration for Cancer Outcomes Research and Evaluation, Liverpool HospitalLiverpoolNSWAustralia
- School of Medicine, University of Western SydneySydneyNSWAustralia
| | - Jason Dowling
- Commonwealth Scientific and Industrial Research Organisation Computational Informatics, Australian E‐Health Research CentreBrisbaneAustralia
| | - David Rivest‐Henault
- Commonwealth Scientific and Industrial Research Organisation Computational Informatics, Australian E‐Health Research CentreBrisbaneAustralia
| | - Elise Pogson
- Centre for Medical Radiation Physics, University of WollongongWollongongNSWAustralia
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
| | - Lois Holloway
- Centre for Medical Radiation Physics, University of WollongongWollongongNSWAustralia
- Liverpool and Macarthur Cancer Therapy CentresNSWAustralia
- Ingham Institute for Applied Medical Research, Liverpool HospitalSydneyNSWAustralia
- South Western Clinical School, University of New South WalesSydneyNSWAustralia
- Institute of Medical Physics, School of Physics, University of SydneySydneyNSWAustralia
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Batumalai V, Holloway L, Delaney GP. A review of setup error in supine breast radiotherapy using cone-beam computed tomography. Med Dosim 2016; 41:225-9. [DOI: 10.1016/j.meddos.2016.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/22/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
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Michalski A, Atyeo J, Cox J, Rinks M. Inter- and intra-fraction motion during radiation therapy to the whole breast in the supine position: A systematic review. J Med Imaging Radiat Oncol 2012; 56:499-509. [DOI: 10.1111/j.1754-9485.2012.02434.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 04/25/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - John Atyeo
- Faculty of Health Science (MRS) Radiation Therapy; The University of Sydney
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