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Title: Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation

Abstract

Purpose: To evaluate the role of cone-beam CT (CBCT) guidance for setup error reduction and soft tissue visualization in accelerated partial breast irradiation (APBI). Methods and Materials: Twenty patients were recruited for the delivery of radiotherapy to the postoperative cavity (3850 cGy in 10 fractions over 5 days) using an APBI technique. Cone-beam CT data sets were acquired after an initial skin-mark setup and before treatment delivery. These were registered online using the ipsilateral lung and external contours. Corrections were executed for translations exceeding 3 mm. The random and systematic errors associated with setup using skin-marks and setup using CBCT guidance were calculated and compared. Results: A total of 315 CBCT data sets were analyzed. The systematic errors for the skin-mark setup were 2.7, 1.7, and 2.4 mm in the right-left, anterior-posterior, and superior-inferior directions, respectively. These were reduced to 0.8, 0.7, and 0.8 mm when CBCT guidance was used. The random errors were reduced from 2.4, 2.2, and 2.9 mm for skin-marks to 1.5, 1.5, and 1.6 mm for CBCT guidance in the right-left, anterior-posterior, and superior-inferior directions, respectively. Conclusion: A skin-mark setup for APBI patients is sufficient for current planning target volume margins for the population of patientsmore » studied here. Online CBCT guidance minimizes the occurrence of large random deviations, which may have a greater impact for the accelerated fractionation schedule used in APBI. It is also likely to permit a reduction in planning target volume margins and provide skin-line visualization and dosimetric evaluation of cardiac and lung volumes.« less

Authors:
 [1];  [2];  [3];  [2];  [3];  [3];  [2];  [3];  [3];  [2];  [2];  [2];  [2];  [2];  [3];  [3]
  1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada). E-mail: Elizabeth.White@rmp.uhn.on.ca
  2. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario (Canada)
  3. (Canada)
Publication Date:
OSTI Identifier:
20951677
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2007.01.048; PII: S0360-3016(07)00230-1; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BEAMS; COMPUTERIZED TOMOGRAPHY; CORRECTIONS; ERRORS; IRRADIATION; LUNGS; MAMMARY GLANDS; PATIENTS; PLANNING; RADIOTHERAPY; SKIN

Citation Formats

White, Elizabeth A., Cho, John, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Vallis, Katherine A., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Sharpe, Michael B., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Lee, Grace B.Sc., Blackburn, Helen, Nageeti, Tahani, McGibney, Carol, Jaffray, David A., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, and Department of Medical Biophysics, University of Toronto, Toronto, Ontario. Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2007.01.048.
White, Elizabeth A., Cho, John, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Vallis, Katherine A., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Sharpe, Michael B., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Lee, Grace B.Sc., Blackburn, Helen, Nageeti, Tahani, McGibney, Carol, Jaffray, David A., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, & Department of Medical Biophysics, University of Toronto, Toronto, Ontario. Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation. United States. doi:10.1016/j.ijrobp.2007.01.048.
White, Elizabeth A., Cho, John, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Vallis, Katherine A., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Sharpe, Michael B., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Lee, Grace B.Sc., Blackburn, Helen, Nageeti, Tahani, McGibney, Carol, Jaffray, David A., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, and Department of Medical Biophysics, University of Toronto, Toronto, Ontario. Fri . "Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation". United States. doi:10.1016/j.ijrobp.2007.01.048.
@article{osti_20951677,
title = {Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation},
author = {White, Elizabeth A. and Cho, John and Department of Radiation Oncology, University of Toronto, Toronto, Ontario and Vallis, Katherine A. and Department of Radiation Oncology, University of Toronto, Toronto, Ontario and Department of Medical Biophysics, University of Toronto, Toronto, Ontario and Sharpe, Michael B. and Department of Radiation Oncology, University of Toronto, Toronto, Ontario and Department of Medical Biophysics, University of Toronto, Toronto, Ontario and Lee, Grace B.Sc. and Blackburn, Helen and Nageeti, Tahani and McGibney, Carol and Jaffray, David A. and Department of Radiation Oncology, University of Toronto, Toronto, Ontario and Department of Medical Biophysics, University of Toronto, Toronto, Ontario},
abstractNote = {Purpose: To evaluate the role of cone-beam CT (CBCT) guidance for setup error reduction and soft tissue visualization in accelerated partial breast irradiation (APBI). Methods and Materials: Twenty patients were recruited for the delivery of radiotherapy to the postoperative cavity (3850 cGy in 10 fractions over 5 days) using an APBI technique. Cone-beam CT data sets were acquired after an initial skin-mark setup and before treatment delivery. These were registered online using the ipsilateral lung and external contours. Corrections were executed for translations exceeding 3 mm. The random and systematic errors associated with setup using skin-marks and setup using CBCT guidance were calculated and compared. Results: A total of 315 CBCT data sets were analyzed. The systematic errors for the skin-mark setup were 2.7, 1.7, and 2.4 mm in the right-left, anterior-posterior, and superior-inferior directions, respectively. These were reduced to 0.8, 0.7, and 0.8 mm when CBCT guidance was used. The random errors were reduced from 2.4, 2.2, and 2.9 mm for skin-marks to 1.5, 1.5, and 1.6 mm for CBCT guidance in the right-left, anterior-posterior, and superior-inferior directions, respectively. Conclusion: A skin-mark setup for APBI patients is sufficient for current planning target volume margins for the population of patients studied here. Online CBCT guidance minimizes the occurrence of large random deviations, which may have a greater impact for the accelerated fractionation schedule used in APBI. It is also likely to permit a reduction in planning target volume margins and provide skin-line visualization and dosimetric evaluation of cardiac and lung volumes.},
doi = {10.1016/j.ijrobp.2007.01.048},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 68,
place = {United States},
year = {Fri Jun 01 00:00:00 EDT 2007},
month = {Fri Jun 01 00:00:00 EDT 2007}
}