Comparison of set-up errors by breast size on wing board by portal imaging

Raza, Waseem; Agarwal, Sushma; Das, K.J. Maria; Kumar, Sellepolyam Kaliyaperumal Senthil; Lal, Punita

doi:10.1016/j.rpor.2016.04.001

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…They found that the root mean square of the residual error was 3, 4, and 4 mm in the RL, AP, and SI directions, respectively. Discrepancies between ours and Fatunase et al might be caused by ethnic differences, the fact that the breast sits on the chest and is not a fixed structure, as European and American breasts are larger than Asian breasts, interfraction displacement, 7,27 and different experimental techniques.…”

Section: Discussioncontrasting

confidence: 77%

Setup Error Assessment and Correction in Planar kV Image- Versus Cone Beam CT Image-Guided Radiation Therapy: A Clinical Study of Early Breast Cancer Treated With External Beam Partial Breast Irradiation

Wang

et al. 2019

Technol Cancer Res Treat

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Objective: To compare differences in setup error assessment and correction between planar kilovolt images and cone beam computed tomography images for external beam partial breast irradiation during free breathing. Methods: Nineteen patients who received external beam partial breast irradiation after breast-conserving surgery were recruited. Interfraction setup error was acquired using planar kilovolt images and cone beam computed tomography. After online setup correction, the residual error was calculated, and the setup error was compared. The residual error and setup margin were quantified for planar kilovolt and cone beam computed tomography images. Results: The largest setup error was observed in the anteroposterior direction for both cone beam computed tomography and planar kilovolt imaging (−1.45 mm, 1.74 mm). The cone beam computed tomography–based setup error (systematic error [Σ]) was less than the planar kilovolt images based on Σ in the anteroposterior direction (–1.2 mm vs 2.00 mm; P = .005), and no significant differences were observed for random error (σ) in 3 dimensions ( P = .948, .376, .314). After online setup correction, cone beam computed tomography significantly reduced the residual setup error compared with planar kilovolt images in the anteroposterior direction (Σ: −0.20 mm vs 0.50 mm, P = .008; σ: 0.45 mm vs 1.34 mm, P = .002). The cone beam computed tomography–based setup margin was smaller than the planar kilovolt image-based setup margin in the anteroposterior direction (−1.39 mm vs 5.57 mm, P = .003; 0.00 mm vs 3.20 mm, P = .003). Conclusions: Discrepancy between the setup errors observed with planar kilovolt and cone beam computed tomography was obvious in the anteroposterior direction. Compared to cone beam computed tomography, the elapsed treatment time was smaller when the initial alignment used kilovolt planar imaging. Whether using planar kilovolt or cone beam computed tomography, residual errors can be reduced to 1.5 mm for external beam partial breast irradiation procedures.

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Section: Discussioncontrasting

confidence: 77%

Setup Error Assessment and Correction in Planar kV Image- Versus Cone Beam CT Image-Guided Radiation Therapy: A Clinical Study of Early Breast Cancer Treated With External Beam Partial Breast Irradiation

Wang

et al. 2019

Technol Cancer Res Treat

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“…Previous studies have shown that an oversized breast volume will reduce the daily patient setup reproducibility. [24][25][26][27] TE volumes ranging from 150 to 250 mL are recommended for radiotherapy treatment according to our data, while greater or lesser TE volumes may lead to an increase in the measured dose difference from the plan dose.…”

Section: Discussionmentioning

confidence: 74%

Critical Factors of Dose Distribution in Breast Cancer Tomotherapy With Metallic Port Breast Tissue Expander: Image Correction, Delivery Mode, and Volume Impact

Lee

Yen

Tsai

et al. 2022

Technol Cancer Res Treat

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Objectives: Breast reconstruction helps patients enhance their body image after mastectomy. Metallic ports in tissue expanders lead to dose attenuation during radiotherapy. Tissue expander volume shifts the metallic port position, possibly causing various dose alterations. This study aimed to evaluate the impact of the MAGNA-SITETM tissue expander volume on tomotherapy. Methods: Boluses and MAGNA-SITETM were placed on a Rando phantom to simulate the tissue expander under the pectoralis major. Computed tomography simulation images were transformed through replacing the electron density of (a) metallic artifact region only (Image metallic port) and (b) metallic port and artifact regions (Image Homo). Planning was calculated using fixed-beam and helical-mode techniques. Radiation was delivered with different volumes of the tissue expander. Results: Integrated 997 dose points were calculated. Planning with Image metallic port provided a calculated dose significantly closer to a realistic dose. The percentage of doses achieving the prescribed dose was significantly higher in the helical mode. In layer 2, the 100-mL tissue expander had a significantly lower measurement dose than all other volumes. Volume 150 mL had the highest increase in the measured dose difference from the plan dose at layer 2. Volume 250 mL had the highest percentage of measurement doses passing the 5% dose difference from plan dose. The coldest dose areas were noted in layers 1 and 2, especially in the metallic port–direct image mode. The average dose reduction of the measured cold areas was 6.03 ± 1.94%. Conclusion: Dose distribution was affected by the volume of the metallic port tissue expander. Tomotherapy with proper image heterogeneity correction and helical mode can reduce the attenuation from the metallic port. A tissue expander volume of 150 to 250 mL is suitable. Patients with high risk at the chest wall should be evaluated carefully to avoid underdosing. Radiation oncologists should closely cooperate with plastic surgeons to optimize treatment for each patient.

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“…This places our immobilization technique for S-APBI in line with other well established SBRT immobilization techniques 30,36,37 . To contrast our setups with conventional whole breast irradiation, setup uncertainties over 1cm in multiple directions have been reported 38 . In the context of repeatable setup, our immobilization demonstrated consistency and reproducibility based on statistical analysis in the three fraction trial.…”

Section: Discussionmentioning

confidence: 99%

Implementing stereotactic accelerated partial breast irradiation using magnetic resonance guided radiation therapy

Price

Kennedy

Henke

et al. 2021

Radiotherapy and Oncology

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Comparison of set-up errors by breast size on wing board by portal imaging

Cited by 11 publications

References 25 publications

Setup Error Assessment and Correction in Planar kV Image- Versus Cone Beam CT Image-Guided Radiation Therapy: A Clinical Study of Early Breast Cancer Treated With External Beam Partial Breast Irradiation

Setup Error Assessment and Correction in Planar kV Image- Versus Cone Beam CT Image-Guided Radiation Therapy: A Clinical Study of Early Breast Cancer Treated With External Beam Partial Breast Irradiation

Critical Factors of Dose Distribution in Breast Cancer Tomotherapy With Metallic Port Breast Tissue Expander: Image Correction, Delivery Mode, and Volume Impact

Implementing stereotactic accelerated partial breast irradiation using magnetic resonance guided radiation therapy

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