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Comparison of dosimetry with magnetic resonance and computed tomography imaging delineation of surgical bed volume in breast cancer irradiation

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收录情况: ◇ 卓越:高起点新刊 ◇ ESCI ◇ 中华系列

机构: [1]Ctr Oncol Fiorentino, Med Phys Dept, I-50019 Sesto Fiorentino, FI, Italy [2]Azienda USL Toscana Ctr, Med Phys Dept, I-51100 Pistoia, PT, Italy [3]Sichuan Canc Hosp & Res Inst, Radiat Oncol Dept, Chengdu 610041, Sichuan, Peoples R China [4]Diagnost Inst Santo Stefano, Diagnost Dept, I-59100 Prato, PO, Italy [5]Azienda Sanitaria Locale Asti, Radiat Oncol Dept, I-14100 Asti, AT, Italy [6]Ctr Oncol Fiorentino, Radiat Oncol Dept, I-50019 Sesto Fiorentino, FI, Italy
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关键词: Breast radiotherapy MRI Boost delineation Seroma Dosimetry

摘要:
Background: Postoperative radiotherapy after conservative surgery for patients with breast cancer usually includes focal over-irradiation (boost) to the surgical bed (SB). Irradiation planning using computed tomography (CT) is difficult in many cases because of insufficient intrinsic soft tissue contrast. To ensure appropriate radiation to the tumor, large boost volumes are delineated, resulting in a higher dose to the normal tissue. Magnetic resonance imaging (MRI) provides superior soft tissue contrast than CT and can better differentiate between normal tissue and the SB. However, for SB delineation CT images alone remain the pathway followed in patients undergoing breast irradiation. This study aimed to evaluate the potential advantages in boost dosimetry by using MRI and CT as pre-treatment imaging. Methods: Eighteen boost volumes were drawn on CT and MRI and elastically co-registered using commercial image registration software. The radiotherapy treatment plan was optimized using the CT volumes as the baseline. The dose distributions of the target volumes on CT and MRI were compared using dose-volume histogram cutoff points. Results: The radiation volumes to the SB varied considerably between CT and MRI (conformity index between 0.24 and 0.67). The differences between the MRI and CT boost doses in terms of the volume receiving 98% of the prescribed dose (V98%) varied between 10% and 30%. Smaller differences in the V98% were observed when the boost volumes were delineated using MRI. Conclusion: Using MRI to delineate the volume of the SB may increase the accuracy of boost dosimetry.

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第一作者机构: [1]Ctr Oncol Fiorentino, Med Phys Dept, I-50019 Sesto Fiorentino, FI, Italy [2]Azienda USL Toscana Ctr, Med Phys Dept, I-51100 Pistoia, PT, Italy
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通讯机构: [1]Ctr Oncol Fiorentino, Med Phys Dept, I-50019 Sesto Fiorentino, FI, Italy [3]Sichuan Canc Hosp & Res Inst, Radiat Oncol Dept, Chengdu 610041, Sichuan, Peoples R China
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