Radiat Oncol J.
2019 Dec;37(4):259-264. 10.3857/roj.2019.00052.
Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging
- Affiliations
-
- 1Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
- 2Department of Radiation Oncology, University of Vermont Medical Center, Burlington, VT, USA. Ruth.Heimann@uvmhealth.org
- 3Department of Internal Medicine, University of Vermont Medical Center, Burlington, VT, USA.
- KMID: 2468734
- DOI: http://doi.org/10.3857/roj.2019.00052
Abstract
- 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.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Recent Development of Radiation Therapy for Breast Cancer
- Ultrasonography-Guided Breast Tissue Marker Insertion
- A Technical Note on a Novel Technique for the Evaluation of Breast Excision Specimen: Automated Breast Ultrasound System
- Ultrasound-Guided Intervention for Breast Lesions
- The Results of Mammography and Ultrasound-Guided Localization Biopsy of Nonpalpable Breast Lesions, and the Differences between Them
