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Title: Using injectable hydrogel markers to assess resimulation for boost target volume definition in a patient undergoing whole-breast radiotherapy

Several publications have recommended that patients undergoing whole-breast radiotherapy be resimulated for boost planning. The rationale for this is that the seroma may be smaller when compared with the initial simulation. However, the decision remains whether to use the earlier or later images to define an appropriate boost target volume. A patient undergoing whole-breast radiotherapy had new, injectable, temporary hydrogel fiducial markers placed 1 to 3 cm from the seroma at the time of initial simulation. The patient was resimulated 4.5 weeks later for conformal photon boost planning. Computed tomography (CT) scans acquired at the beginning and the end of whole-breast radiotherapy showed that shrinkage of the lumpectomy cavity was not matched by a corresponding reduction in the surrounding tissue volume, as demarcated by hydrogel markers. This observation called into question the usual interpretation of cavity shrinkage for boost target definition. For this patient, it was decided to define the boost target volume on the initial planning CT instead of the new CT.
Authors:
 [1] ;  [2] ;  [2]
  1. Rutgers Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, Piscataway, NJ (United States)
  2. Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, the State University of New Jersey, New Brunswick, NJ (United States)
Publication Date:
OSTI Identifier:
22577848
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 40; Journal Issue: 4; 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:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; COMPUTERIZED TOMOGRAPHY; FIDUCIAL MARKERS; HYDROGELS; IMAGE PROCESSING; IMAGES; MAMMARY GLANDS; NEOPLASMS; PATIENTS; PLANNING; RADIOTHERAPY; SHRINKAGE; SIMULATION