skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Intrafraction Variability and Deformation Quantification in the Breast

Abstract

Purpose: To evaluate intrafraction variability and deformation of the lumpectomy cavity (LC), breast, and nearby organs. Methods and Materials: Sixteen left-sided postlumpectomy and 1 bilateral breast cancer cases underwent free-breathing CT (FBCT) and 10-phase 4-dimensional CT (4DCT). Deformable image registration was used for deformation analysis and contour propagation of breast, heart, lungs, and LC between end-exhale and end-inhale 4DCT phases. Respiration-induced motion was calculated via centroid analysis. Two planning target volumes (PTVs) were compared: PTV{sub FBCT} from the FBCT volume with an isotropic 10 mm expansion (5 mm excursion and 5 mm setup error) and PTV{sub 4DCT} generated from the union of 4DCT contours with isotropic 5 mm margin for setup error. Volume and geometry were evaluated via percent difference and bounding box analysis, respectively. Deformation correlations between breast/cavity, breast/lung, and breast/heart were evaluated. Associations were tested between cavity deformation and proximity to chest wall and breast surface. Results: Population-based 3-dimensional vector excursions were 2.5 ± 1.0 mm (range, 0.8-3.8 mm) for the cavity and 2.0 ± 0.8 mm (range, 0.7-3.0 mm) for the ipsilateral breast. Cavity excursion was predominantly in the anterior and superior directions (1.0 ± 0.8 mm and −1.8 ± 1.2 mm, respectively). Similarly, for all cases, LCs and ipsilateral breasts yielded median deformation values in the superior direction. For 14more » of 17 patients, the LCs and breast interquartile ranges tended toward the anterior direction. The PTV{sub FBCT} was 51.5% ± 10.8% larger (P<.01) than PTV{sub 4DCT}. Bounding box analysis revealed that PTV{sub FBCT} was 9.8 ± 1.2 (lateral), 9.0 ± 2.2 (anterior–posterior), and 3.9 ± 1.8 (superior–inferior) mm larger than PTV{sub 4DCT}. Significant associations between breast and cavity deformation were found for 6 of 9 axes. No dependency was found between cavity deformation and proximity to chest wall or breast surface. Conclusions: Lumpectomy cavity and breast deformation and motion demonstrated large variability. A PTV{sub 4DCT} approach showed value in patient-specific margins, particularly if robust interfraction setup analysis can be performed.« less

Authors:
 [1];  [1];  [1];  [2]; ; ; ; ; ; ; ;  [1]
  1. Department of Radiation Oncology, Henry Ford Health Systems, Detroit, Michigan (United States)
  2. (United States)
Publication Date:
OSTI Identifier:
22458631
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 91; Journal Issue: 3; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The 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; CHEST; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; DEFORMATION; ERRORS; EXCURSIONS; EXPANSION; GEOMETRY; HEART; IMAGE PROCESSING; LUNGS; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PLANNING; RESPIRATION

Citation Formats

Glide-Hurst, Carri K., E-mail: churst2@hfhs.org, Shah, Mira M., Price, Ryan G., Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan, Liu, Chang, Kim, Jinkoo, Mahan, Meredith, Fraser, Correen, Chetty, Indrin J., Aref, Ibrahim, Movsas, Benjamin, and Walker, Eleanor M.. Intrafraction Variability and Deformation Quantification in the Breast. United States: N. p., 2015. Web. doi:10.1016/J.IJROBP.2014.11.003.
Glide-Hurst, Carri K., E-mail: churst2@hfhs.org, Shah, Mira M., Price, Ryan G., Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan, Liu, Chang, Kim, Jinkoo, Mahan, Meredith, Fraser, Correen, Chetty, Indrin J., Aref, Ibrahim, Movsas, Benjamin, & Walker, Eleanor M.. Intrafraction Variability and Deformation Quantification in the Breast. United States. doi:10.1016/J.IJROBP.2014.11.003.
Glide-Hurst, Carri K., E-mail: churst2@hfhs.org, Shah, Mira M., Price, Ryan G., Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan, Liu, Chang, Kim, Jinkoo, Mahan, Meredith, Fraser, Correen, Chetty, Indrin J., Aref, Ibrahim, Movsas, Benjamin, and Walker, Eleanor M.. Sun . "Intrafraction Variability and Deformation Quantification in the Breast". United States. doi:10.1016/J.IJROBP.2014.11.003.
@article{osti_22458631,
title = {Intrafraction Variability and Deformation Quantification in the Breast},
author = {Glide-Hurst, Carri K., E-mail: churst2@hfhs.org and Shah, Mira M. and Price, Ryan G. and Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan and Liu, Chang and Kim, Jinkoo and Mahan, Meredith and Fraser, Correen and Chetty, Indrin J. and Aref, Ibrahim and Movsas, Benjamin and Walker, Eleanor M.},
abstractNote = {Purpose: To evaluate intrafraction variability and deformation of the lumpectomy cavity (LC), breast, and nearby organs. Methods and Materials: Sixteen left-sided postlumpectomy and 1 bilateral breast cancer cases underwent free-breathing CT (FBCT) and 10-phase 4-dimensional CT (4DCT). Deformable image registration was used for deformation analysis and contour propagation of breast, heart, lungs, and LC between end-exhale and end-inhale 4DCT phases. Respiration-induced motion was calculated via centroid analysis. Two planning target volumes (PTVs) were compared: PTV{sub FBCT} from the FBCT volume with an isotropic 10 mm expansion (5 mm excursion and 5 mm setup error) and PTV{sub 4DCT} generated from the union of 4DCT contours with isotropic 5 mm margin for setup error. Volume and geometry were evaluated via percent difference and bounding box analysis, respectively. Deformation correlations between breast/cavity, breast/lung, and breast/heart were evaluated. Associations were tested between cavity deformation and proximity to chest wall and breast surface. Results: Population-based 3-dimensional vector excursions were 2.5 ± 1.0 mm (range, 0.8-3.8 mm) for the cavity and 2.0 ± 0.8 mm (range, 0.7-3.0 mm) for the ipsilateral breast. Cavity excursion was predominantly in the anterior and superior directions (1.0 ± 0.8 mm and −1.8 ± 1.2 mm, respectively). Similarly, for all cases, LCs and ipsilateral breasts yielded median deformation values in the superior direction. For 14 of 17 patients, the LCs and breast interquartile ranges tended toward the anterior direction. The PTV{sub FBCT} was 51.5% ± 10.8% larger (P<.01) than PTV{sub 4DCT}. Bounding box analysis revealed that PTV{sub FBCT} was 9.8 ± 1.2 (lateral), 9.0 ± 2.2 (anterior–posterior), and 3.9 ± 1.8 (superior–inferior) mm larger than PTV{sub 4DCT}. Significant associations between breast and cavity deformation were found for 6 of 9 axes. No dependency was found between cavity deformation and proximity to chest wall or breast surface. Conclusions: Lumpectomy cavity and breast deformation and motion demonstrated large variability. A PTV{sub 4DCT} approach showed value in patient-specific margins, particularly if robust interfraction setup analysis can be performed.},
doi = {10.1016/J.IJROBP.2014.11.003},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 91,
place = {United States},
year = {Sun Mar 01 00:00:00 EST 2015},
month = {Sun Mar 01 00:00:00 EST 2015}
}