Automatic Generation of a Plan Optimization Volume for Tangential Field Breast Cancer Radiation Therapy

Vaerenbergh, Koen Van; Gersem, Werner De; Vakaet, Luc; Coghe, M.; Boterberg, Tom; Bakker, Marie-Elisabeth; Derie, C.; Willaert, Wouter; Seij, Patricia; Duthoy, Wim; Wagter, Carlos De; Neve, Wilfried De

doi:10.1007/s00066-005-1310-1

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…Because of the shortness of manually indicated contour parts the PTV differences might decrease. A comparable method was developed by van Vaerenbergh et al [39], with "plan optimization volume" simulation, breast tissue being overlapped by two tangents and an orthogonal field.…”

Section: Discussionmentioning

confidence: 99%

Multisegmented Tangential Breast Fields: a Rational Way to Treat Breast Cancer

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Multisegmented Tangential Breast Fields: a Rational Way to Treat Breast Cancer

et al. 2008

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“…Various methods have been used in the past to delineate the breast CTV: anatomic references have been used as a guide [ 10 , 11 ], but also radiopaque wires marking the palpable breast [ 6 , 12 ]. In some studies, a conventional beam set-up was used even when CT data were available [ 13 , 14 ]. In these studies, CT data were used for dose calculation and evaluation of the dose to organs at risk, while the breast CTV was not explicitly defined.…”

Section: Discussionmentioning

confidence: 99%

Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

et al. 2008

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Background: The shift from conventional two-dimensional (2D) to three-dimensional (3D)-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT)-based breast and boost planning target volumes (PTV), absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy.

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“…Gantry angles expressed in the Elekta coordinate system. The most inclined medial beam has the gantry angle of a tangential beam set by virtual simulation [21]. The gantry angles are 0°, |α|, |2α|, 180° - 0.5|α|, 180° + 0.5|α|, and 180° + 1.5|α| for supine MB-IMRT.…”

Section: Methodsmentioning

confidence: 99%

“…The convolution-superposition dose engine of a Pinnacle version 9.0 treatment planning system (Philips Medical Systems, Andover, US) was used for dose computations between optimization cycles of intensity-modulated plans as well as for final plans. Monitor units and MLC shapes were optimized using the optimization tools described before [21]. During optimization, two patient geometries were taken into account: 1) dose computation for PTV WBI was performed using a density override (1 g/cm 3 ) to the above-mentioned flash region; 2) dose computation for the PTV WBI without build-up and OARs was performed without density overrides.…”

Section: Methodsmentioning

confidence: 99%

Whole breast radiotherapy in prone and supine position: is there a place for multi-beam IMRT?

et al. 2013

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BackgroundEarly stage breast cancer patients are long-term survivors and finding techniques that may lower acute and late radiotherapy-induced toxicity is crucial. We compared dosimetry of wedged tangential fields (W-TF), tangential field intensity-modulated radiotherapy (TF-IMRT) and multi-beam IMRT (MB-IMRT) in prone and supine positions for whole-breast irradiation (WBI).MethodsMB-IMRT, TF-IMRT and W-TF treatment plans in prone and supine positions were generated for 18 unselected breast cancer patients. The median prescription dose to the optimized planning target volume (PTVoptim) was 50 Gy in 25 fractions. Dose-volume parameters and indices of conformity were calculated for the PTVoptim and organs-at-risk.ResultsProne MB-IMRT achieved (p<0.01) the best dose homogeneity compared to WTF in the prone position and WTF and MB-IMRT in the supine position. Prone IMRT scored better for all dose indices. MB-IMRT lowered lung and heart dose (p<0.05) in supine position, however the lowest ipsilateral lung doses (p<0.001) were in prone position. In left-sided breast cancer patients population averages for heart sparing by radiation dose was better in prone position; though non-significant. For patients with a PTVoptim volume ≥600 cc heart dose was consistently lower in prone position; while for patients with smaller breasts heart dose metrics were comparable or worse compared to supine MB-IMRT. Doses to the contralateral breast were similar regardless of position or technique. Dosimetry of prone MB-IMRT and prone TF-IMRT differed slightly.ConclusionsMB-IMRT is the treatment of choice in supine position. Prone IMRT is superior to any supine treatment for right-sided breast cancer patients and left-sided breast cancer patients with larger breasts by obtaining better conformity indices, target dose distribution and sparing of the organs-at-risk. The influence of treatment techniques in prone position is less pronounced; moreover dosimetric differences between TF-IMRT and MB-IMRT are rather small.

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Automatic Generation of a Plan Optimization Volume for Tangential Field Breast Cancer Radiation Therapy

Abstract: This automated planning method is capable of replacing the contouring of the clinical target volume as well as the trial-and-error procedure of assigning weights of wedged and unwedged beams by an experienced planner.

Cited by 7 publications

References 17 publications

Multisegmented Tangential Breast Fields: a Rational Way to Treat Breast Cancer

Multisegmented Tangential Breast Fields: a Rational Way to Treat Breast Cancer

Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

Whole breast radiotherapy in prone and supine position: is there a place for multi-beam IMRT?

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