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Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging

PURPOSE: Accurate localization of the lumpectomy cavity during accelerated partial breast radiation (APBR) is essential for daily setup to ensure the prescribed dose encompasses the target and avoids unnecessary irradiation to surrounding normal tissues. Three-dimensional ultrasound (3D-US) allows d...

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Autores principales: Sayan, Mutlay, Vergalasova, Irina, Hard, Daphne, Wrigth, Heather, Archambault, Jessica, Gagne, Havaleh, Nelson, Carl, Heimann, Ruth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Radiation Oncology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952713/
https://www.ncbi.nlm.nih.gov/pubmed/31918463
http://dx.doi.org/10.3857/roj.2019.00052
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author Sayan, Mutlay
Vergalasova, Irina
Hard, Daphne
Wrigth, Heather
Archambault, Jessica
Gagne, Havaleh
Nelson, Carl
Heimann, Ruth
author_facet Sayan, Mutlay
Vergalasova, Irina
Hard, Daphne
Wrigth, Heather
Archambault, Jessica
Gagne, Havaleh
Nelson, Carl
Heimann, Ruth
author_sort Sayan, Mutlay
collection PubMed
description PURPOSE: Accurate localization of the lumpectomy cavity during accelerated partial breast radiation (APBR) is essential for daily setup to ensure the prescribed dose encompasses the target and avoids unnecessary irradiation to surrounding normal tissues. Three-dimensional ultrasound (3D-US) allows direct visualization of the lumpectomy cavity without additional radiation exposure. The purpose of this study was to evaluate the feasibility of 3D-US in daily target localization for APBR.Materials and methods: Forty-seven patients with stage I breast cancer who underwent breast conserving surgery were treated with a 2-week course of APBR. Patients with visible lumpectomy cavities on high quality 3D-US images were included in this analysis. Prior to each treatment, X-ray and 3D-US images were acquired and compared to images from simulation to confirm accurate position and determine shifts. Volume change of the lumpectomy cavity was determined daily with 3D-US. RESULTS: A total of 118 images of each modality from 12 eligible patients were analyzed. The average change in cavity volume was 7.8% (range, -24.1% to 14.4%) on 3D-US from simulation to the end-of-treatment. Based on 3D-US, significantly larger shifts were necessary compared to portal films in all three dimensions: anterior/posterior (p = 7E-11), left/right (p = 0.002), and superior/inferior (p = 0.004). CONCLUSION: Given that the lumpectomy cavity is not directly visible via X-ray images, accurate positioning may not be fully achieved by X-ray images. Therefore, when the lumpectomy cavity is visible on US, 3D-US can be considered as an alternative to X-ray imaging during daily positioning for selected patients treated with APBR, thus avoiding additional exposure to ionizing radiation.
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spelling pubmed-69527132020-01-17 Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging Sayan, Mutlay Vergalasova, Irina Hard, Daphne Wrigth, Heather Archambault, Jessica Gagne, Havaleh Nelson, Carl Heimann, Ruth Radiat Oncol J Original Article PURPOSE: Accurate localization of the lumpectomy cavity during accelerated partial breast radiation (APBR) is essential for daily setup to ensure the prescribed dose encompasses the target and avoids unnecessary irradiation to surrounding normal tissues. Three-dimensional ultrasound (3D-US) allows direct visualization of the lumpectomy cavity without additional radiation exposure. The purpose of this study was to evaluate the feasibility of 3D-US in daily target localization for APBR.Materials and methods: Forty-seven patients with stage I breast cancer who underwent breast conserving surgery were treated with a 2-week course of APBR. Patients with visible lumpectomy cavities on high quality 3D-US images were included in this analysis. Prior to each treatment, X-ray and 3D-US images were acquired and compared to images from simulation to confirm accurate position and determine shifts. Volume change of the lumpectomy cavity was determined daily with 3D-US. RESULTS: A total of 118 images of each modality from 12 eligible patients were analyzed. The average change in cavity volume was 7.8% (range, -24.1% to 14.4%) on 3D-US from simulation to the end-of-treatment. Based on 3D-US, significantly larger shifts were necessary compared to portal films in all three dimensions: anterior/posterior (p = 7E-11), left/right (p = 0.002), and superior/inferior (p = 0.004). CONCLUSION: Given that the lumpectomy cavity is not directly visible via X-ray images, accurate positioning may not be fully achieved by X-ray images. Therefore, when the lumpectomy cavity is visible on US, 3D-US can be considered as an alternative to X-ray imaging during daily positioning for selected patients treated with APBR, thus avoiding additional exposure to ionizing radiation. The Korean Society for Radiation Oncology 2019-12 2019-12-31 /pmc/articles/PMC6952713/ /pubmed/31918463 http://dx.doi.org/10.3857/roj.2019.00052 Text en Copyright © 2019 The Korean Society for Radiation Oncology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Sayan, Mutlay
Vergalasova, Irina
Hard, Daphne
Wrigth, Heather
Archambault, Jessica
Gagne, Havaleh
Nelson, Carl
Heimann, Ruth
Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
title Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
title_full Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
title_fullStr Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
title_full_unstemmed Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
title_short Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
title_sort daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952713/
https://www.ncbi.nlm.nih.gov/pubmed/31918463
http://dx.doi.org/10.3857/roj.2019.00052
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