Accuracy and efficiency of image-guided radiation therapy (IGRT) for preoperative partial breast radiosurgery.

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Date

2020-01

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Abstract

Objective

To analyze and evaluate accuracy and efficiency of IGRT process for preoperative partial breast radiosurgery.

Methods

Patients were initially setup with skin marks and 5 steps were performed: (1) Initial orthogonal 2D kV images, (2) pre-treatment 3D CBCT images, (3) verification orthogonal 2D kV images, (4) treatment including mid-treatment 2D kV images (for the final 15 patients only), and (5) post-treatment orthogonal 2D kV or 3D CBCT images. Patient position was corrected at each step to align the biopsy clip and to verify surrounding soft tissue positioning.

Results

The mean combined vector magnitude shifts and standard deviations at the 5 imaging steps were (1) 0.96 ± 0.69, (2) 0.33 ± 0.40, (3) 0.05 ± 0.12, (4) 0.15 ± 0.17, and (5) 0.27 ± 0.24 in cm. The mean total IGRT time was 40.2 ± 13.2 minutes. Each step was shortened by 2 to 5 minutes with improvements implemented. Overall, improvements in the IGRT process reduced the mean total IGRT time by approximately 20 minutes. Clip visibility was improved by implementing oblique orthogonal images.

Conclusion

Multiple imaging steps confirmed accurate patient positioning. Appropriate planning and imaging strategies improved the effectiveness and efficiency of the IGRT process for preoperative partial breast radiosurgery.

Department

Description

Provenance

Citation

Scholars@Duke

Yoo

Sua Yoo

Associate Professor of Radiation Oncology

Patient positioning verification for radiation therapy using OBI/CBCT; Treatment planning for breast cancer radiotherapy;

O'Daniel

Jennifer Colleen O'Daniel

Assistant Professor of Radiation Oncology

Adaptive radiotherapy
Calypso
RapidArc
TBI/TSI
2D and 3D patient-specific quality assurance techniques

Yin

Fang-Fang Yin

Gustavo S. Montana Distinguished Professor of Radiation Oncology

Stereotactic radiosurgery, Stereotactic body radiation therapy, treatment planning optimization, knowledge guided radiation therapy, intensity-modulated radiation therapy, image-guided radiation therapy, oncological imaging and informatics


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