The TiLOOP Bra mesh is a breast-implant-surrounding material that supports the pectoralis muscle and keeps the implant stable in the subpectoral area during breast reconstruction surgery. This study aimed to investigate the dosimetric effect of TiLOOP Bra mesh on dose distribution of radiotherapy in patients requiring postoperative treatment.
METHODSThe metal oxide semiconductor field effect transistor (MOSFET) and nanoDot optically stimulated luminescence dosimeter (OSLD) were used for dose measurements at different depths in solid phantoms. The measurements were performed above and below the mesh, and at 1 cm deep to the mesh for 6 MV photon energy. The relative dose differences were obtained by measuring doses using the dosimeters and comparing the results with calculated values in Eclipse TPS (Treatment Planning System). The relative dose differences between the cases where the mesh had been present and where the mesh had been removed were evaluated.
RESULTSThe results were found less than 1%. The findings showed that the TiLOOP Bra mesh used in breast surgery did not affect the dose calculations for radiotherapy. In addition, there were no metallic artifacts on computed tomography image.
CONCLUSIONTherefore, the quality of the computed tomography image was not affected by the TiLOOP Bra mesh, and it was not necessary to correct the artifact and change the HU (Hounsfield Unit) value in TPS.
12, 24, and 60 months post RT. Parameters analyzed included perfusion defects, wall thickening (WT), wall motion abnormalities (WM) and dyssynchronous contractions (DS). Analyses were done using spearman R correlation analysis, Mann-Whitney U test and Dunnett's multiple comparisons test. Results: There were no significant differences seen in baseline characteristics (age, pathology, hormone status, technique, use of adjuvant chemo, or cardiac risk factors) between left-sided (n Z 102) and rightsided (n Z 79) RT patients. As expected, those receiving RT to left side had significantly greater mean cardiac dose (4.3 vs. 0.9Gy; p<0.001) and Dmax (45.4 vs. 6.3Gy; p<0.001). Radiation to the left breast did not significantly alter end diastolic volume, end systolic volume or ejection fraction at any timepoint. There was a significant increase in total perfusion defects seen post RT compared to baseline in left sided patients (4.1% vs. 2.8% p Z 0.042) which was not seen in right sided patients. The perfusion defect returned to baseline by 1-year post RT, and remains normal at 2-and 5-years post RT. The global scoring of myocardial perfusion as measured by summed rest score (SRS) also showed a significant increase by 1.35 pts (4.1 vs. 2.8; p Z 0.006) post RT for left sided patients. These changes were significantly correlated with max cardiac dose (p Z 0.03). No localized perfusion defect, DS, WT, WM changes were seen. No adverse cardiac outcomes were reported. Conclusion: Patients receiving left breast RT did not show differ in standard measures of cardiac function such as ESV, EDV, and EF at any timepoint. There were mild perfusion defects seen post-RT, evidenced by worsened global non-gated SRS and total perfusion defect post RT in left sided patients. Worsened non-gated SRS was correlated with mean cardiac dose. Perfusion deficits normalized by 1-year post RT, and remained unchanged out to 5 years, suggesting a potential for cardiac remodeling post-RT.
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