Computed tomography-based virtual simulation versus ultrasound-based clinical setup in electron breast boost radiotherapy: Methodology for CT-based electron virtual simulation
| Autor: | Christine Lambert, R. Ruo, Ciro Maietta, William Parker, Monica Serban, Tarek Hijal, Michael D.C. Evans |
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| Rok vydání: | 2019 |
| Předmět: |
Breast boost
Aperture Computer science medicine.medical_treatment Biophysics General Physics and Astronomy Breast Neoplasms Electrons Computed tomography Electron Dose distribution 030218 nuclear medicine & medical imaging User-Computer Interface 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Simulation Ultrasonography medicine.diagnostic_test business.industry Radiotherapy Planning Computer-Assisted Ultrasound General Medicine Radiation therapy 030220 oncology & carcinogenesis Tomography X-Ray Computed business |
| Zdroj: | Physica Medica. 67:100-106 |
| ISSN: | 1120-1797 |
| DOI: | 10.1016/j.ejmp.2019.10.030 |
| Popis: | Purpose To compare clinical setup using ultrasound (U/S)-delineated target versus computed tomography (CT) virtual simulation using CT-outlined target in breast electron boost. To describe a methodology for electron virtual simulation and collision testing with the treatment planning system (TPS). Methods The two techniques were compared in a prospective study on 12 patients, who were treated using a clinical setup. Target definition was performed by both U/S and CT imaging. The U/S-based target was made visible on CT images by placing a radio-opaque wire on U/S skin markings. The dose distribution of the clinical setup was reproduced in the TPS using the actual electron patient treatment parameters. A CT-based TPS virtual simulation/dose optimization was compared to the clinical setup technique. Results Mean beam aperture was larger by 16.3 cm2 (p = 0.011) for U/S compared to CT-outlined target. Target mean depth difference (CT minus U/S) was 0.03 cm (p = 0.875). Target coverage at depth was adequate in all cases with CT-based simulation while under/overcovering the target at depth by more than 5 mm in 2 out of 12 cases with clinical setup. Mean target V90% was 98.5% (CT-based simulation) and 84.4% (clinical setup). Ipsilateral lung/breast were better spared with CT-based simulation. To date, the methodology for CT virtual simulation was applied on 152 patients and collision was avoided in all cases. Conclusions CT-based simulation and target delineation allows for improved definition of the en-face electron field with less amount of normal tissue irradiated while including the entire target with an adequate margin and optimal electron energy. |
| Databáze: | OpenAIRE |
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