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https://www.readbyqxmd.com/read/28100239/elective-breast-radiotherapy-including-level-i-and-ii-lymph-nodes-a-planning-study-with-the-humeral-head-as-planning-risk-volume
#1
Kathrin Surmann, Jorien van der Leer, Tammy Branje, Maurice van der Sangen, Maarten van Lieshout, Coen W Hurkmans
BACKGROUND: The aim of this study was to assess the dose to the humeral head planning risk volume with the currently used high tangential fields (HTF) and compare different planning techniques for breast radiotherapy including axillary level I and II lymph nodes (PTVn) while sparing the humeral head. METHODS: Ten patients with left-sided breast cancer were enrolled in a planning study with 16 fractions of 2.66 Gy. Four planning techniques were compared: HTF, HTF with sparing of the humeral head, 6-field IMRT with sparing of the humeral head and VMAT with sparing of the humeral head...
January 18, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28087071/development-of-delineation-for-the-left-anterior-descending-coronary-artery-region-in-left-breast-cancer-radiotherapy-an-optimized-organ-at-risk
#2
Jie Lee, Kai-Lung Hua, Shih-Ming Hsu, Jhen-Bin Lin, Chou-Hsien Lee, Kuo-Wei Lu, Kun-Yao Dai, Xu-Nian Huang, Jun-Zhao Huang, Meng-Hao Wu, Yu-Jen Chen
BACKGROUND AND PURPOSE: The left anterior descending coronary artery (LAD) and diagonal branches (DBs) are blurred on computed tomography (CT). We aimed to define the LAD region (LADR) with adequate inclusion of the LAD and DBs and contouring consistency. METHODS AND MATERIALS: The LADR was defined using coronary CT angiograms. The inclusion ratio was used to assess the LAD and DBs inclusion by the LADR. Four radiation oncologists delineated the LAD and LADR, using contrast-enhanced CT of 15 patients undergoing left breast radiotherapy...
January 10, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28064235/outcomes-in-patients-with-pt1-t2-pn0-n1-breast-cancer-after-conservative-surgery-and-whole-breast-radiotherapy
#3
Marianna Trignani, Clelia DI Carlo, Carmen Cefalogli, Marianna Nuzzo, Lucia Anna Ursini, Luciana Caravatta, Francesca Perrotti, Marta DI Nicola, Ambra Pamio, Domenico Genovesi
AIM: To evaluate locoregional recurrence, overall survival, disease-free survival and prognostic influence of the number of positive lymph nodes and other variables in breast cancer treatment. PATIENTS AND METHODS: A total of 377 patients with pT1-T2, pN0-N1 invasive breast carcinoma treated from 2005 to 2013 were retrospectively evaluated. Patients underwent conservative surgery followed by whole-breast radiotherapy. Clavicular region irradiation was not performed...
January 2017: In Vivo
https://www.readbyqxmd.com/read/28063695/ipsilateral-axillary-recurrence-after-breast-conservative-surgery-the-protective-effect-of-whole-breast-radiotherapy
#4
Oreste Gentilini, Edoardo Botteri, Maria Cristina Leonardi, Nicole Rotmensz, Jose Vila, Nickolas Peradze, Maria Virginia Thomazini, Barbara Alicja Jereczek, Viviana Galimberti, Alberto Luini, Paolo Veronesi, Roberto Orecchia
BACKGROUND AND PURPOSE: Whole breast radiotherapy (WBRT) is one of the possible reasons for the low rate of axillary recurrence after breast-conserving surgery (BCS). PATIENTS AND METHODS: We retrospectively collected data from 4,129 consecutive patients with breast cancer ⩽2cm and negative sentinel lymph node who underwent BCS between 1997 and 2007. We compared the risk of axillary lymph node recurrence between patients treated by WBRT (n=2939) and patients who received partial breast irradiation (PBI; n=1,190) performed by a single dose of electron intraoperative radiotherapy...
January 4, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28053630/displacement-of-surgical-clips-during-postoperative-radiotherapy-in-breast-cancer-patients-who-received-breast-conserving-surgery
#5
SooYoon Sung, Joo Hwan Lee, Jong Hoon Lee, Sung Hwan Kim, Yoo-Kang Kwak, Sea-Won Lee, Ye Won Jeon, Young Jin Suh
PURPOSE: Surgical clips are used as a target for postoperative breast radiotherapy, and displacement of surgical clips would result in inaccurate delivery of radiation. We investigated the displacement range of surgical clips in the breast during postoperative radiotherapy following breast-conserving surgery. METHODS: A total of 178 patients who received breast-conserving surgery and postoperative radiation of 59.4 Gy in 33 fractions to the involved breast for 6...
December 2016: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28048831/su-g-jep4-01-an-assessment-of-a-microsoft-kinect-v2-sensor-for-voluntary-breath-hold-monitoring-in-radiotherapy
#6
D Edmunds, E Donovan
PURPOSE: To determine whether the Microsoft Kinect Version 2 (Kinect v2), a commercial off-the-shelf (COTS) depth sensors designed for entertainment purposes, were robust to the radiotherapy treatment environment and could be suitable for monitoring of voluntary breath-hold compliance. This could complement current visual monitoring techniques, and be useful for heart sparing left breast radiotherapy. METHODS: In-house software to control Kinect v2 sensors, and capture output information, was developed using the free Microsoft software development kit, and the Cinder creative coding C++ library...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048808/su-f-j-19-robust-region-of-interest-roi-for-consistent-registration-on-deteriorated-surface-images
#7
H Kang, M Malin, S Chmura, Y Hasan, H Al-Hallaq
PURPOSE: For African-American patients receiving breast radiotherapy with a bolus, skin darkening can affect the surface visualization when using optical imaging for daily positioning and gating at deep-inspiration breath holds (DIBH). Our goal is to identify a region-of-interest (ROI) that is robust against deteriorating surface image quality due to skin darkening. METHODS: We study four patients whose post-mastectomy surfaces are imaged daily with AlignRT (VisionRT, UK) for DIBH radiotherapy and whose surface image quality is degraded toward the end of treatment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048804/su-g-brb-15-verifications-of-absolute-and-relative-dosimetry-of-a-novel-stereotactic-breast-device-gammapodtm
#8
S Becker, Y Niu, S Mossahebi, B Yi, C Yu, K Prado, Y Mutaf
PURPOSE: A dedicated stereotactic breast radiotherapy device, GammaPod, was developed to treat early stage breast cancer. The first clinical unit was installed and commissioned at University of Maryland. We report our methodology of absolute dosimetry in multiple calibration conditions and dosimetric verifications of treatment plans produced by the system. METHODS: GammaPod unit is comprised of a rotating hemi-spherical source carrier containing 36 Co-60 sources and a concentric tungsten collimator providing beams of 15 and 25 mm...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048744/su-f-t-119-development-of-heart-prediction-model-to-increase-accuracy-of-dose-reconstruction-for-radiotherapy-patients
#9
E Mosher, M Choi, E Jones, C Lee
PURPOSE: To assess individual variation in heart volume and location in order to develop a prediction model of the heart. This heart prediction model will be used to calculate individualized heart doses for radiotherapy patients in epidemiological studies. METHODS: Chest CT images for 30 adult male and 30 adult female patients were obtained from NIH Clinical Center. Image-analysis computer programs were used to segment the whole heart and 8 sub-regions and to measure the volume of each sub- region and the dimension of the whole heart...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048684/su-f-t-115-uncertainty-in-the-esophagus-dose-in-retrospective-epidemiological-study-of-breast-cancer-radiotherapy-patients
#10
E Mosher, S Kim, C Lee, C Pelletier, J Jung, E Jones, C Lee
PURPOSE: Epidemiological studies of second cancer risks in breast cancer radiotherapy patients often use generic patient anatomy to reconstruct normal tissue doses when CT images of patients are not available. To evaluate the uncertainty involved in the dosimetry approach, we evaluated the esophagus dose in five sample patients by simulating breast cancer treatments. METHODS: We obtained the diagnostic CT images of five anonymized adult female patients in different Body Mass Index (BMI) categories (16- 36kg/m2) from National Institutes of Health Clinical Center...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048390/su-f-t-415-differences-in-lung-sparing-in-deep-inspiration-breath-hold-and-free-breathing-breast-plans-calculated-in-pinnacle-and-monaco
#11
D Saenz, S Stathakis
PURPOSE: Deep inspiration breath-hold (DIBH) is used for left-sided breast radiotherapy to spare the heart and lung. The magnitude of sparing has been shown to be significant. Monte Carlo, furthermore, has the potential to calculate most accurately the dose in the heterogeneous lung medium at the interface with the lung wall. The lung dose was investigated in Monaco to determine the level of sparing relative to that calculated in Pinnacle(3) . METHODS: Five patients undergoing DIBH radiotherapy on an Elekta Versa HD linear accelerator in conjunction with the Catalyst C-RAD surface imaging system were planned using Phillips Pinnacle(3) ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047917/tu-h-campus-jep2-01-inter-observer-delineation-comparison-of-visible-glandular-breast-tissue-on-magnetic-resonance-imaging-and-computed-tomography-prone-and-supine
#12
E M Pogson, G Delaney, V Ahern, M Boxer, S David, M Dimigen, J Harvey, E Koh, K Lim, G Papadatos, M Yap, V Batumalai, P Metcalfe, L Holloway
PURPOSE: Breast cancers predominantly arise from Glandular Breast Tissue (GBT). If the GBT can be treated effectively post-operatively utilising radiotherapy this may be adequate volumetric coverage for adjuvant breast radiotherapy. Adequate imaging of the GBT is necessary and will be assessed between MRI and CT modalities. GBT visualisation is acknowledged to be qualitatively superior on Magnetic Resonance Image (MRI) compared to Computed Tomography (CT), the current radiotherapy imaging standard, however this has not been quantitatively assessed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047837/su-f-sps-04-dosimetric-evaluation-of-the-dose-calculation-accuracy-of-different-algorithms-for-two-different-treatment-techniques-during-whole-breast-irradiation
#13
P Pacaci, M Cebe, H Mabhouti, G Codel, E Serin, E Sanli, E Kucukmorkoc, M Doyuran, N Kucuk, D Canoglu, A Altinok, H Acar, H Caglar Ozkok
PURPOSE: In this study, dosimetric comparison of field in field (FIF) and intensity modulated radiation therapy (IMRT) techniques used for treatment of whole breast radiotherapy (WBRT) were made. The dosimetric accuracy of treatment planning system (TPS) for Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) algorithms in predicting PTV and OAR doses was also investigated. METHODS: Two different treatment planning techniques of left-sided breast cancer were generated for rando phantom...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047548/we-h-brc-03-failure-mode-and-effects-analysis-in-the-first-clinical-implementation-of-a-novel-stereotactic-breast-radiotherapy-device-gammapod%C3%A2
#14
S Mossahebi, S Feigenberg, E Nichols, Y Niu, S Becker, K Prado, B Yi, C Yu, Y Mutaf
PURPOSE: GammaPod™, the first stereotactic radiotherapy device for early stage breast cancer treatment, has been recently installed and commissioned at our institution. A multidisciplinary working group applied the failure mode and effects analysis (FMEA) approach to perform a risk analysis. METHODS: FMEA was applied to the GammaPod™ treatment process by: 1) generating process maps for each stage of treatment; 2) identifying potential failure modes and outlining their causes and effects; 3) scoring the potential failure modes using the risk priority number (RPN) system based on the product of severity, frequency of occurrence, and detectability (ranging 1-10)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047439/su-f-j-132-evaluation-of-ctv-to-ptv-expansion-for-whole-breast-radiotherapy
#15
B Burgdorf, G Freedman, B Teo
PURPOSE: The current standard CTV-to-PTV expansion for whole breast radiotherapy (WBRT) is 7mm, as recommended by RTOG-1005.This expansion is derived from the uncertainty due to patient positioning (±5mm) and respiratory motion (±5mm). We evaluated the expansion needed for respiratory motion uncertainty using 4DCT. After determining the appropriate expansion margins, RT plans were generated to evaluate the reduction in heart and lung dose. METHODS: 4DCT images were acquired during treatment simulation and retrospectively analyzed for 34 WBRT patients...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046975/su-f-j-130-margin-determination-for-hypofractionated-partial-breast-irradiation
#16
C Geady, B Keller, M Ruschin, E Hahn, N Makhani, S Bosnic, D Vesprini, H Soliman, J Lee, C McCann
PURPOSE: To determine the Planning Target Volume (PTV) margin for Hypofractionated Partial Breast Irradiation (HPBI) using the van Herk formalism (M=2.5∑+0.7σ). HPBI is a novel technique intended to provide local control in breast cancer patients not eligible for surgical resection, using 40 Gy in 5 fractions prescribed to the gross disease. METHODS: Setup uncertainties were quantified through retrospective analysis of cone-beam computed tomography (CBCT) data sets, collected prior to (prefraction) and after (postfraction) treatment delivery...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046787/su-g-brc-13-model-based-classification-for-optimal-position-selection-for-left-sided-breast-radiotherapy-free-breathing-dibh-or-prone
#17
H Lin, T Liu, C Shi, S Petillion, I Kindts, X Tang, X Xu
PURPOSE: There are clinical decision challenges to select optimal treatment positions for left-sided breast cancer patients-supine free breathing (FB), supine Deep Inspiration Breath Hold (DIBH) and prone free breathing (prone). Physicians often make the decision based on experiences and trials, which might not always result optimal OAR doses. We herein propose a mathematical model to predict the lowest OAR doses among these three positions, providing a quantitative tool for corresponding clinical decision...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046484/we-ab-209-05-development-of-an-ultra-fast-high-quality-whole-breast-radiotherapy-treatment-planning-system
#18
Y Sheng, T Li, S Yoo, F Yin, R Blitzblau, J Horton, M Palta, C Hahn, Y Ge, Q Wu
PURPOSE: To enable near-real-time (<20sec) and interactive planning without compromising quality for whole breast RT treatment planning using tangential fields. METHODS: Whole breast RT plans from 20 patients treated with single energy (SE, 6MV, 10 patients) or mixed energy (ME, 6/15MV, 10 patients) were randomly selected for model training. Additional 20 cases were used as validation cohort. The planning process for a new case consists of three fully automated steps:1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28044346/technical-note-issues-related-to-external-marker-block-placement-for-deep-inspiration-breath-hold-breast-radiotherapy
#19
Leigh Conroy, Alexandra Guebert, Wendy L Smith
PURPOSE: It has been suggested that the Real-time Position Management (RPM) marker block should be placed directly on the breast or sternum to verify deep inspiration breath hold (DIBH) level for breast radiotherapy. We explore three potential issues with this practice: (a) surface dose effect of placing the marker block in the primary beam; (b) effect of marker block tilt on the accuracy of the RPM system; and (c) correlation between marker block positions on the patient surface and internal chest wall position...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/27997358/dosimetric-evaluation-of-the-skin-sparing-effects-of-3-dimensional-conformal-radiotherapy-and-intensity-modulated-radiotherapy-for-left-breast-cancer
#20
In Young Jo, Shin-Wook Kim, Seok Hyun Son
The purpose of this study was to evaluate the skin-sparing effects of 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with early left-sided breast cancer. Twenty left breast cancer patients treated with whole breast radiotherapy following breast-conserving surgery were enrolled in this study, and the 3D-CRT and IMRT plans were generated for each patient. To evaluate the dose delivered to the skin, 2 mm thickness skin (2-mm skin) and 3 mm thickness skin (3-mm skin) were contoured and a dosimetric comparison between the 2 plans was performed...
December 9, 2016: Oncotarget
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