Effects of Setup Errors and Shape Changes on Breast Radiotherapy

Mourik, A. Van; Kranen, S. Van; Hollander, Suzanne den; Sonke, Jan‐Jakob; Herk, Marcel van; Vliet-Vroegindeweij, Corine van

doi:10.1016/j.ijrobp.2010.07.032

Cited by 61 publications

(49 citation statements)

References 14 publications

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“…Cone‐beam computed tomography (CBCT) has been integrated into routine clinical practice in many tumour sites, as it has been shown to offer advantages over EPI 8, 9, 10. The main advantages of using CBCT instead of EPI are the use of 3D instead of two‐dimensional (2D) images of the patient's internal anatomy, and its ability to offer better soft tissue and anatomical contrast 11, 12. In breast RT, only one study has examined this and shown that EPI registration underestimated the bony anatomy setup error compared to CBCT, however, EPI was deemed adequate for tangential breast RT 13.…”

Section: Introductionmentioning

confidence: 99%

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy

et al. 2016

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IntroductionTo compare the differences in setup errors measured with electronic portal image (EPI) and cone‐beam computed tomography (CBCT) in patients undergoing tangential breast radiotherapy (RT). Relationship between setup errors, body mass index (BMI) and breast size was assessed.MethodsTwenty‐five patients undergoing postoperative RT to the breast were consented for this study. Weekly CBCT scans were acquired and retrospectively registered to the planning CT in three dimensions, first using bony anatomy for bony registration (CBCT‐B) and again using breast tissue outline for soft tissue registration (CBCT‐S). Digitally reconstructed radiographs (DRR) generated from CBCT to simulate EPI were compared to the planning DRR using bony anatomy in the V (parallel to the cranio‐caudal axis) and U (perpendicular to V) planes. The systematic (Σ) and random (σ) errors were calculated and correlated with BMI and breast size.ResultsThe systematic and random errors for EPI (Σ V = 3.7 mm, Σ U = 2.8 mm and σ V = 2.9 mm, σ U = 2.5) and CBCT‐B (Σ V = 3.5 mm, Σ U = 3.4 mm and σ V = 2.8 mm, σ U = 2.8) were of similar magnitude in the V and U planes. Similarly, the differences in setup errors for CBCT‐B and CBCT‐S in three dimensions were less than 1 mm. Only CBCT‐S setup error correlated with BMI and breast size.Conclusions CBCT and EPI show insignificant variation in their ability to detect setup error. These findings suggest no significant differences that would make one modality considered superior over the other and EPI should remain the standard of care for most patients. However, there is a correlation with breast size, BMI and setup error as detected by CBCT‐S, justifying the use of CBCT‐S for larger patients.

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Section: Introductionmentioning

confidence: 99%

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy

et al. 2016

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“…At present, much of the use of DIR in RT is in the context of external beam adaptive RT to enable contour deformation and dose accumulation. This includes studies using deformable registration to predict cumulative doses to the breast CTV in whole breast and external beam APBI treatments (19,20). Recently, deformable registration has been introduced to brachytherapy to aid in dose accumulation in fractionated HDR treatment of gynecologic cancer (21e24) and also in prostate brachytherapy (25,26).…”

Section: Discussionmentioning

confidence: 99%

Deformable image registration for defining the postimplant seroma in permanent breast seed implant brachytherapy

Hilts¹,

Batchelar²,

Rose³

et al. 2015

Brachytherapy

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“…9 Furthermore, studies evaluating the dose distribution changes originating from setup errors were focused on only target volume dose changes and did not evaluate organs at risk doses and healthy tissues within the irradiated breast. 10 In a study by van Mourik et al 18 , the effects of setup errors and breast changes on dose distribution have been evaluated for wedge, simple IMRT, and full IMRT plans. The authors found that wedge and simple IMRT plans were primarily affected by patient errors (6% loss of coverage near the dorsal field edge and 2% near the skin) and plan deterioration due to breast errors was primarily observed in full IMRT plans (2% loss of coverage near the dorsal field edge and 4% near the skin).…”

Section: Discussionmentioning

confidence: 99%

Effects of Setup Errors on Dose Distribution for Tangential Wedge Field and Field-in-Field Techniques During Breast Irradiation

Önal¹

2014

UHOD

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This study is aimed to evaluate the effects of setup errors on dose distribution for target volume and healthy tissue within the irradiated volume and also critical surrounding organs for breast radiotherapy (RT) using both the tangential field and the field-in-field (FIF) technique. Ten patients with breast cancer were enrolled. For each patients two plans were generated; tangential field plan and FIF-plan. The setup errors were simulated for a series of displacements of ±5 mm and ±10 mm in superior-inferior (x-axis), medial-lateral (y-axis), and anteriorposterior (z-axis) directions and dose volume comparisons were made both between and within groups. The most prominent changes were observed in setup errors at z-axis. In wedge plan, 10-mm setup error at the +z axis caused a significant decrease in tumor coverage compared with the plan with no setup error (96.5% vs. 99.2%; p= 0.01). The 5 and 10 mm setup errors at the +z-axis resulted in significantly higher healthy tissue doses in wedge plans compared with FIF plans. The setup errors along z-axis had a significant effect on the dose distribution for target volume and also to the lungs. The setup error in the isocenter should be kept strictly below 5 mm.Keywords: Breast cancer, Radiotherapy, Field-in-field technique, Setup errors ÖZET Meme Radyoterapisi Sırasında Set-up Hatalarının Tanjansiyel Wedge ve Field-in-field Tekniklerindeki Doz Dağılımına EtkileriBu çalışmanın amacı, meme radyoterapisi (RT) sırasında kullanılan tanjansiyel alan ve 'field-in-field' (FIF) tekniklerindeki set-up hatalarının hedef hacim, ışınlanan hacimdeki sağlıklı doku ve çevre organ dozları üzrindeki etkilerini değerlendirmektir. Meme kanseri tanılı 10 hasta çalışmaya dahil edilmiştir. Her hasta için ikişer plan oluşturulmuştur: tanjansiyel alan ve FIF tekniği. Set-up hataları superior-inferior (x-axis), medial-lateral (y-axis), and anterior-posterior (z-axis) istikamatte ±5 mm ve ±10 mm olarak oluşturulmuş olup, doz volüm karşılaştırmaları hem grup içinde hem de gruplar arasında yapılmıştır. En belirgin değişiklik z-axis de gözlenmiştir. Tanjansiyel planda +z-axis de oluşan 10 mm lik setup hatasındaki hedef hacimi kapsama, set up hatası olmayan plana gore anlamlı düşük bulunmuştur (%96.5 vs. %99.2; p= 0.01). +z-axisteki 5 ve 10 mm'lik setup hataları sonucunda oluşan sağlıklı doku dozları tanjansiyel planda FIF planına gore anlamlı olarak yüksek bulunmuştur. z-axisteki hatalar hem hedef volüm hem de akciğer dozlarında belirgin bir etki yaratmaktadır. İzosentrdaki hataların 5 mm nin altında olması güvenlidir.Anahtar Kelimeler: Meme kanseri, Radyoterapi, Field-in-field tekniği, Setup hataları

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Effects of Setup Errors and Shape Changes on Breast Radiotherapy

Cited by 61 publications

References 14 publications

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy

Deformable image registration for defining the postimplant seroma in permanent breast seed implant brachytherapy

Effects of Setup Errors on Dose Distribution for Tangential Wedge Field and Field-in-Field Techniques During Breast Irradiation

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