Three-dimensional intrafractional internal target motions in accelerated partial breast irradiation using three-dimensional conformal external beam radiotherapy

Hirata, Kimiko; Yoshimura, Masataka; Mukumoto, Nobutaka; Nakamura, Mitsuhiro; Inoue, Minoru; Sasaki, Makoto; Fujimoto, Takahiro; Yano, Shinsuke; Nakata, Manabu; Mizowaki, Takashi; Hiraoka, Masahiro

doi:10.1016/j.radonc.2017.04.023

Cited by 13 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main intra-fraction baseline drifts were in the posterior direction; this finding was similar to the findings in two recent studies, where intra-fraction motion was evaluated in patients receiving supine breast radiotherapy [28, 29]. It might also be attributed to the compression of back subcutaneous fat or muscle relaxation during treatment [28]. However, the magnitude of intra-fraction translational and rotational motion was not correlated with body weight and BMI in this study.…”

Section: Discussionsupporting

confidence: 89%

“…The patients in the present study received tangential radiotherapy with a mean treatment time of 4.1 ± 0.8 min; however, intra-fraction motion was not correlated with treatment time. The main intra-fraction baseline drifts were in the posterior direction; this finding was similar to the findings in two recent studies, where intra-fraction motion was evaluated in patients receiving supine breast radiotherapy [28, 29]. It might also be attributed to the compression of back subcutaneous fat or muscle relaxation during treatment [28].…”

Section: Discussionsupporting

confidence: 87%

“…The inter-fraction rotational errors in the roll and yaw were also significantly larger for heavier patients. These findings might be attributed to differences in the magnitude of compression of the subcutaneous back fat in each fraction [28], although set-up included matching to skin tattoos. In addition, the inter-fraction set-up error did not change significantly as a function of time in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, the calculated PTV margin with CBCT correction was smaller for heavier patients in this study. In addition to CBCT, three-dimensional surface imaging or an optical tracking system might also be useful to compensate for the inter-fraction set-up errors and intra-fraction motion in breast radiotherapy, without the use of additional radiation [28, 29, 34]. However, the evaluation of set-up variability during RSD breast radiotherapy by three-dimensional surface imaging is beyond the scope of this study and must be addressed in future studies.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Image-guided study of inter-fraction and intra-fraction set-up variability and margins in reverse semi-decubitus breast radiotherapy

et al. 2018

View full text Add to dashboard Cite

BackgroundThis study aimed to evaluate the inter-fraction set-up error and intra-fraction motion during reverse semi-decubitus (RSD) breast radiotherapy, and to determine a planning target volume (PTV) margin.Material and methodsPre- and post-treatment cone-beam computed tomography (CBCT) scans were prospectively acquired at fractions 1, 4, 7, 8, 11, and 14 for 30 patients who underwent RSD breast radiotherapy. Online correction for initial set-up error greater than 5 mm or 2° was performed and post-correction CBCT was acquired. An off-line analysis was performed to quantify initial and residual inter-fraction set-up errors and intra-fraction motion in three-dimensions. Patient inter-fraction errors were analysed for time trends during the course of radiotherapy. PTV margins were calculated from the systematic and random errors.ResultsThe initial inter-fraction population systematic errors were 1.8–3.3 mm (translation) and 0.5° (rotation); random errors were 1.8–2.1 mm (translation) and 0.3–0.5° (rotation). After online correction, the residual inter-fraction population systematic errors were 1.2–1.8 mm (translation) and 0.3–0.4° (rotation); random errors were 1.4–1.6 mm (translation) and 0.3–0.4° (rotation). Intra-fraction population systematic and random errors were ≤ 1.3 mm (translation) and ≤ 0.2° (rotation). The magnitude of inter-fraction set-up errors in the anterior-posterior direction, roll, and yaw were significantly correlated with higher body weight and body mass index (BMI). The inter-fraction set-up error did not change significantly as a function of time during the course of radiotherapy. The magnitude of intra-fraction motion was not correlated with patient characteristics and treatment time. The total PTV margins accounting for pre-correction and intra-fraction errors were 6.5–10.2 mm; those accounting for post-correction and intra-fraction errors were 4.7–6.3 mm.ConclusionsCBCT is an effective modality to evaluate and improve the inter-fraction set-up reproducibility in RSD breast radiotherapy, particularly for patients with higher BMI. Intra-fraction motion was minimal during RSD breast radiotherapy.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Image-guided study of inter-fraction and intra-fraction set-up variability and margins in reverse semi-decubitus breast radiotherapy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…X-ray imaging as described by Hirata et al represents one of the options. [19] The authors used orthogonal X-ray imaging on 23 patients before and after a treatment session to observe internal target motions referring to surgical clips displacements in accelerated partial breast irradiation. The magnitude of intra-fractional motion was depending on the direction, e.g.…”

Section: Discussionmentioning

confidence: 99%

Real-time intra-fraction motion management in breast cancer radiotherapy: analysis of 2028 treatment sessions

et al. 2018

View full text Add to dashboard Cite

BackgroundIntra-fraction motion represents a crucial issue in the era of precise radiotherapy in several settings, including breast irradiation. To date, only few data exist on real-time measured intra-fraction motion in breast cancer patients. Continuous surface imaging using visible light offers the capability to monitor patient movements in three-dimensional space without any additional radiation exposure. The aim of the present study was to quantify the uncertainties of possible intra-fractional motion during breast radiotherapy.Material and methodsOne hundred and four consecutive patients that underwent postoperative radiotherapy following breast conserving surgery or mastectomy were prospectively evaluated during 2028 treatment sessions. During each treatment session the patients’ motion was continuously measured using the Catalyst™ optical surface scanner (C-RAD AB, Sweden) and compared to a reference scan acquired at the beginning of each session. The Catalyst system works through an optical surface imaging with light emitting diode (LED) light and reprojection captured by a charge coupled device (CCD) camera, which provide target position control during treatment delivery with a motion detection accuracy of 0.5 mm. For 3D surface reconstruction, the system uses a non-rigid body algorithm to calculate the distance between the surface and the isocentre and using the principle of optical triangulation. Three-dimensional deviations and relative position differences during the whole treatment fraction were calculated by the system and analyzed statistically.ResultsOverall, the maximum magnitude of the deviation vector showed a mean change of 1.93 mm ± 1.14 mm (standard deviation [SD]) (95%-confidence interval: [0.48–4.65] mm) and a median change of 1.63 mm during dose application (beam-on time only). Along the lateral and longitudinal axis changes were quite similar (0.18 mm ± 1.06 mm vs. 0.17 mm ± 1.32 mm), on the vertical axis the mean change was 0.68 mm ± 1.53 mm. The mean treatment session time was 154 ± 53 (SD) seconds and the mean beam-on time only was 55 ± 16 s. According to Friedman’s test differences in the distributions of the three possible directions (lateral, longitudinal and vertical) were significant (p < 0.01), in post-hoc analysis there were no similarities between any two of the three directions.ConclusionThe optical surface imaging system is an accurate and easy tool for real-time motion management in breast cancer radiotherapy. Intra-fraction motion was reported within five millimeters in all directions. Thus, intra-fraction motion in our series of 2028 treatment sessions seems to be of minor clinical relevance in postoperative radiotherapy of breast cancer.

show abstract

Factors impacting on patient setup analysis and error management during breast cancer radiotherapy

Costin

Marcu

2022

Critical Reviews in Oncology/Hematology

View full text Add to dashboard Cite

Three-dimensional intrafractional internal target motions in accelerated partial breast irradiation using three-dimensional conformal external beam radiotherapy

Cited by 13 publications

References 21 publications

Image-guided study of inter-fraction and intra-fraction set-up variability and margins in reverse semi-decubitus breast radiotherapy

Image-guided study of inter-fraction and intra-fraction set-up variability and margins in reverse semi-decubitus breast radiotherapy

Real-time intra-fraction motion management in breast cancer radiotherapy: analysis of 2028 treatment sessions

Factors impacting on patient setup analysis and error management during breast cancer radiotherapy

Contact Info

Product

Resources

About