Skin dose in breast brachytherapy: Defining a robust metric

Hilts, Michelle; Halperin, Heather; Morton, Daniel; Batchelar, Deidre; Bachand, François; Chowdhury, Rafiqul I.; Crook, Juanita

doi:10.1016/j.brachy.2015.08.002

Cited by 23 publications

(12 citation statements)

References 34 publications

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“…Clinical outcomes published at a median follow-up of 63 months found a local recurrence rate of 1.2 ± 1.2%, comparable to nomogram-based estimates for whole breast irradiation [8]. As the PBSI technique matures, numerous studies in recent literature have investigated how to optimize aspects of the treatment process, including treatment planning [9,10,11,12], training [13,14], clinical practice [15,16], and post-implant analysis [17,18,19,20,21].…”

Section: Purposementioning

confidence: 86%

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Watt¹,

Skarsgard²,

Roumeliotis³

et al. 2019

jcb

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PurposePost-implant analysis in permanent breast seed implant (PBSI) brachytherapy is an important component of the quality assurance process that indicates dosimetric quality relevant to patient outcome, indicating salvage therapy if inadequate, as well as providing feedback to the brachytherapy team to improve future treatments. To measure geometric indices on implant quality, plan reconstruction must be performed to correlate each planned and post-implant seed location. In this work, a simulated-annealing-based algorithm is developed to perform this plan reconstruction automatically.Material and methodsThe plan reconstruction algorithm was developed in MATLAB, taking the patient pre-treatment and post-implant (Day 0) plan and associated contours as inputs. For 19 treated patients, a reconstruction was obtained that defined the correspondence between each planned and post-implant seed. The simulated-annealing algorithm was used to reconstruct each patient 10 times to assess the variability in convergence. Manual reconstructions performed by at least two independent observers to obtain consensus were defined as the ground truth; these were compared to the automatic reconstructions obtained by the algorithm. Metrics on seed placement accuracy and needle strand angulation were calculated for the patients.ResultsThe algorithm performed reconstructions on 19 patients (1235 seeds) with ground-truth reconstructions, obtaining 97 ± 8% correct matches. This strong performance indicates the ability to incorporate this algorithm into the clinical quality assurance workflow.ConclusionsThe plan reconstruction algorithm developed herein performed very well in a 19-patient cohort. This algorithm can be incorporated into the clinical process to assist in the assessment of center-specific seed placement accuracy and can be used to gather implant metrics in an automated, standardized fashion for future PBSI trials.

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Section: Purposementioning

confidence: 86%

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Watt¹,

Skarsgard²,

Roumeliotis³

et al. 2019

jcb

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“…D 0.1cm3 , D 2cm3 ) are generally reported. Regarding the skin, in addition to the maximum surface point dose, reporting D 0.2cm3 or D 1cm3 [52] is recommended. Table 1 lists the most common dose-volume parameters used in interstitial breast brachytherapy.…”

Section: Dose-volume Parameters and Dose Constraintsmentioning

confidence: 99%

“…In the GEC-ESTRO study there was only one requirement for dose uniformity, namely the DNR < 0.35. According to the experience of the centres participating in the GEC-ESTRO study and respecting current available data [19,52,56,57] the recommended dose-volume constraints for the implant, PTV and organs at risk are presented in Tables 2 and 3. Since the dose to contralateral breast and lung is low in interstitial brachytherapy, no threshold is given for these organs, only a few parameters are recommended for reporting.…”

Section: Dose-volume Limits For Ptv and Oarsmentioning

confidence: 99%

ESTRO-ACROP guideline: Interstitial multi-catheter breast brachytherapy as Accelerated Partial Breast Irradiation alone or as boost – GEC-ESTRO Breast Cancer Working Group practical recommendations

Strnad

Major

Polgár

et al. 2018

Radiotherapy and Oncology

129

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Recent standards and guidelines for the use of APBI with different multi-catheter image-guided brachytherapy techniques have been defined. Different techniques are used to insert the catheters. Guidelines are mandatory to assure precise catheter insertion for coverage of the target volume and to guarantee high-quality dosimetry. The same rules apply for brachytherapy based boost irradiation for breast cancer after whole breast irradiation as well as for partial breast re-irradiation.

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“…Hilts et al . [42] recommend using D 0.2cm 3 for a 2-mm thick skin layer as a surrogate for dose to skin area of 1 cm 2 . In a paper of Lettmaier et al .…”

Section: Discussionmentioning

confidence: 99%

Treatment planning for multicatheter interstitial brachytherapy of breast cancer – from Paris system to anatomy-based inverse planning

Major

Polgár

2017

jcb

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In the last decades, treatment planning for multicatheter interstitial breast brachytherapy has evolved considerably from fluoroscopy-based 2D to anatomy-based 3D planning. To plan the right positions of the catheters, ultrasound or computed tomography (CT) imaging can be used, but the treatment plan is always based on postimplant CT images. With CT imaging, the 3D target volume can be defined more precisely and delineation of the organs at risk volumes is also possible. Consequently, parameters calculated from dose-volume histogram can be used for quantitative plan evaluation. The catheter reconstruction is also easier and faster on CT images compared to X-ray films. In high dose rate brachytherapy, using a stepping source, a number of forward dose optimization methods (manual, geometrical, on dose points, graphical) are available to shape the dose distribution to the target volume, and these influence dose homogeneities to different extent. Currently, inverse optimization algorithms offer new possibilities to improve dose distributions further considering the requirements for dose coverage, dose homogeneity, and dose to organs at risk simultaneously and automatically. In this article, the evolvement of treatment planning for interstitial breast implants is reviewed, different forward optimization methods are discussed, and dose-volume parameters used for quantitative plan evaluation are described. Finally, some questions of the inverse optimization method are investigated and initial experiences of the authors are presented.

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Skin dose in breast brachytherapy: Defining a robust metric

Cited by 23 publications

References 34 publications

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

Post-implant analysis in permanent breast seed implant: automated plan reconstruction using simulated annealing

ESTRO-ACROP guideline: Interstitial multi-catheter breast brachytherapy as Accelerated Partial Breast Irradiation alone or as boost – GEC-ESTRO Breast Cancer Working Group practical recommendations

Treatment planning for multicatheter interstitial brachytherapy of breast cancer – from Paris system to anatomy-based inverse planning

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