Dose Modeling of Noninvasive Image-Guided Breast Brachytherapy in Comparison to Electron Beam Boost and Three-Dimensional Conformal Accelerated Partial Breast Irradiation

Journal Article · Wed Jun 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.01.052· OSTI ID:21491761

Sioshansi, Shirin ^[1]; Rivard, Mark J ^[1]; Hiatt, Jessica R; Hurley, Amanda A ^[2]; Lee, Yoojin ^[3]; Wazer, David E ^[1]

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1. Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (United States)
2. Department of Radiation Oncology, Rhode Island Hospital, Warren Alpert Medical School at Brown University, Providence, RI (United States)
3. Biostatistics Research Center, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (United States)

Purpose: To perform dose modeling of a noninvasive image-guided breast brachytherapy (NIIGBB) for comparison to electrons and 3DCRT. Methods and Materials: The novel technology used in this study is a mammography-based, noninvasive breast brachytherapy system whereby the treatment applicators are centered on the planning target volume (PTV) to direct {sup 192}Ir emissions along orthogonal axes. To date, three-dimensional dose modeling of NIIGBB has not been possible because of the limitations of conventional treatment planning systems (TPS) to model variable tissue deformation associated with breast compression. In this study, the TPS was adapted such that the NIIGBB dose distributions were modeled as a virtual point source. This dose calculation technique was applied to CT data from 8 patients imaged with the breast compressed between parallel plates in the cranial-caudal and medial-lateral axes. A dose-volume comparison was performed to simulated electron boost and 3DCRT APBI. Results: The NIIGBB PTV was significantly reduced as compared with both electrons and 3DCRT. Electron boost plans had a lower D{sub min} than the NIIGBB technique but higher V{sub 100}, D{sub 90}, and D{sub 50}. With regard to PTV coverage for APBI, the only significant differences were minimally higher D{sub 90}, D{sub 100}, V{sub 80}, and V{sub 90}, with 3DCRT and D{sub max} with NIIGBB. The NIIGBB technique, as compared with electrons and 3D-CRT, achieved a lower maximum dose to skin (60% and 10%, respectively) and chest wall/lung (70-90%). Conclusions: NIIGBB achieves a PTV that is smaller than electron beam and 3DCRT techniques. This results in significant normal tissue sparing while maintaining dosimetric benchmarks to the target tissue.

• OSTI ID: 21491761
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2010.01.052; PII: S0360-3016(10)00221-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
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POINT SOURCES
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
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IRIDIUM ISOTOPES
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