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Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography.

Publication ,  Journal Article
Fatunase, T; Wang, Z; Yoo, S; Hubbs, JL; Prosnitz, RG; Yin, F-F; Marks, LB
Published in: Int J Radiat Oncol Biol Phys
March 15, 2008

PURPOSE: On-board cone-beam computed tomography (CBCT) provides soft tissue information that may improve setup accuracy in patients undergoing accelerated partial breast irradiation (APBI). We used CBCT to assess the residual error in soft tissue after two-dimensional kV/MV alignment based on bony anatomy. We also assessed the dosimetric impact of this error. METHODS AND MATERIALS: Ten patients undergoing APBI were studied as part of an institutional review board-approved prospective trial. Patients were aligned based on skin/cradle marks plus orthogonal kV/MV images registered based on bony landmarks to digitally reconstructed radiographs from the planning CT. A subsequent CBCT was registered to the planning CT using soft tissue information. This "residual error" and its dosimetric impact was measured. RESULTS: The root-mean-square of the residual error was 3, 4, and 4 mm, in the right-left, anterior-posterior, and superior-inferior directions, respectively. The average vector sum was 6+/-2 mm. Average reductions in mean dose to the lumpectomy cavity, clinical target volume (CTV), and planning target volume were 0.1%, 0.4%, and 1%, respectively. The mean difference in the clinical target and planning target volumes that received 95% of the prescribed dose (V95) were 1% and 4%. CONCLUSIONS: In this initial study with a modest number of patients, the residual error in soft tissue was typically <5 mm, and with the field margins used, the resultant dosimetric consequences were modest. In patients immobilized in a customized cradle, setup using orthogonal kV images thus appears accurate and reproducible. The CBCT technique may have particular utility in patients with larger breast volumes or breast deformations. Further studies involving larger numbers of patients are needed to further assess the utility of CBCT.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

March 15, 2008

Volume

70

Issue

4

Start / End Page

1025 / 1034

Location

United States

Related Subject Headings

  • Reproducibility of Results
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Prospective Studies
  • Particle Accelerators
  • Oncology & Carcinogenesis
  • Mammography
  • Humans
  • Female
  • Cone-Beam Computed Tomography
 

Citation

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MLA
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Fatunase, T., Wang, Z., Yoo, S., Hubbs, J. L., Prosnitz, R. G., Yin, F.-F., & Marks, L. B. (2008). Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography. Int J Radiat Oncol Biol Phys, 70(4), 1025–1034. https://doi.org/10.1016/j.ijrobp.2007.07.2344
Fatunase, Toyosi, Zhiheng Wang, Sua Yoo, Jessica L. Hubbs, Robert G. Prosnitz, Fang-Fang Yin, and Lawrence B. Marks. “Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography.Int J Radiat Oncol Biol Phys 70, no. 4 (March 15, 2008): 1025–34. https://doi.org/10.1016/j.ijrobp.2007.07.2344.
Fatunase T, Wang Z, Yoo S, Hubbs JL, Prosnitz RG, Yin F-F, et al. Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1025–34.
Fatunase, Toyosi, et al. “Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography.Int J Radiat Oncol Biol Phys, vol. 70, no. 4, Mar. 2008, pp. 1025–34. Pubmed, doi:10.1016/j.ijrobp.2007.07.2344.
Fatunase T, Wang Z, Yoo S, Hubbs JL, Prosnitz RG, Yin F-F, Marks LB. Assessment of the residual error in soft tissue setup in patients undergoing partial breast irradiation: results of a prospective study using cone-beam computed tomography. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1025–1034.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

March 15, 2008

Volume

70

Issue

4

Start / End Page

1025 / 1034

Location

United States

Related Subject Headings

  • Reproducibility of Results
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Prospective Studies
  • Particle Accelerators
  • Oncology & Carcinogenesis
  • Mammography
  • Humans
  • Female
  • Cone-Beam Computed Tomography