AI Article Synopsis
- The study examined the use of a 3D ultrasound system for accurately identifying and tracking tumor beds in breast cancer patients prior to radiation therapy.
- The research involved 20 patients who had both CT and 3D ultrasound scans to compare the visibility and positioning of the tumor bed, finding an 78% overlap and small differences in measurement between the two imaging techniques.
- The findings suggest that while 3D ultrasound effectively visualizes the tumor bed for most patients, relying on a 10-mm planning margin could lead to insufficient coverage in half of the cases, indicating the potential for improved precision in radiation treatment through multimodal imaging.
Article Abstract
Purpose: To evaluate the feasibility and usefulness of a three-dimensional ultrasound (3D-US) image-guided system in identifying and tracking the tumor bed (TB) for planning and daily localization before radiation delivery for breast cancer.
Methods And Materials: Twenty breast cancer patients underwent two CT scans at the time of simulation and just before their boost. Three-dimensional ultrasound images were acquired immediately after the CT scans, to which the images were automatically fused. Three-dimensional ultrasound images were also acquired immediately before treatment. Spatial and temporal TB differences between CT and US were evaluated.
Results: The TB was not visible on US and CT in 1 subject who had and 1 subject who had not received chemotherapy before whole-breast radiotherapy. The mean (SD) TB volume overlap was 78% (14%). The mean centroid position of the TB on CT vs. US differed by 0.1, 0.2, and 0.4 mm in the anterior-posterior, left-right, and superior-inferior directions. The mean (SD) absolute radial displacement of the TB on each fraction from the treatment plan was 10.8 (6.3) mm.
Conclusions: The TB was well visualized by US for the majority of patients. Clinically insignificant differences in the displacements calculated by paired CT vs. paired US demonstrate the feasibility of using 3D-US. The present study suggests that a 10-mm planning target volume margin could result in undercoverage of the clinical target volumes in 50% of treatments. Multimodality planning and image-guided radiotherapy with US potentially offers an accurate and non-ionizing solution for the daily definition of the TB position during partial-breast irradiation and boost treatments.
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| http://dx.doi.org/10.1016/j.ijrobp.2009.10.023 | DOI Listing |
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