Comparison of Radiotherapy Treatment Plans for Left-sided Breast Cancer Patients based on Three- and Four-dimensional Computed Tomography Imaging

2011 ◽  
Vol 23 (9) ◽  
pp. 601-607 ◽  
Author(s):  
C. Bedi ◽  
T. Kron ◽  
D. Willis ◽  
P. Hubbard ◽  
A. Milner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Treatment Plans ◽  
Radiotherapy Treatment

Value of preoperative staging of breast cancer patients using computed tomography to detect asymptomatic lung and liver metastasis

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1105-1105
Author(s):  
W. Han ◽  
H. Kim ◽  
J. Lee ◽  
K. Lee ◽  
H. Moon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Liver Metastasis ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Lung Metastasis ◽  
Stage Iii ◽  
Breast Cancer Patients ◽  
Metastatic Lesions ◽  
Treatment Plans

1105 Background: Preoperative clinical staging in breast cancer patients is important to determine the most appropriate treatment plans and to predict prognosis for individual patients. Identifying unexpected distant metastases in newly diagnosed breast cancer patients frequently alters initial treatment plans. Routine imaging studies to detect lung or liver metastasis is not indicated in patients with early and operable breast cancer. A recent study showed that routine use of chest radiograph and liver ultrasound does not provide much diagnostic benefit in early breast cancer patients. Methods: We aimed to investigate the value of preoperative computed tomography to detect asymptomatic liver and lung metastasis in breast cancer patients. We performed preoperative CT for 667 breast cancer patients to detect lung and liver metastasis among 1,636 primary breast cancer patients who had been diagnosed and treated between January 2006 and December 2007 at Seoul National University Hospital. Results: CT showed abnormal findings (suspicious of metastasis or indeterminate nodules) in 78 patients (10.5%). Among these, abnormal finding in 13 patients (1.7%) turned out to be true metastatic lesions. There was no CT-detected lung or liver metastasis in patients with T1 tumor and 4 metastases in patients with T2 tumor. There was no CT-detected lung or liver metastasis in patients with negative axillary lymph node metastasis. When patients were classified according to the AJCC staging, CT-detected true metastatic lesions were only present in stage III patients (13 out of 173 patients, 7.5%). The true metastatic lesions in lung or liver were all small sized nodules, ranging from 0.3cm to 1.2cm in largest diameters. In seven patients, the CT-detected metastatic lesions were less than 1cm which is in contrast with the previous studies. Conclusions: Our results demonstrated the lack of usefulness in performing routine CT exams to detect asymptomatic liver and lung metastasis in early breast cancer patients. Staging CT might be useful in stage III patients, since 13 (7.5%) patients were upstaged to stage IV by the use of CT. No significant financial relationships to disclose.

Comparison between different boost dose delivery techniques to the tumor bed of right sided breast cancer patients.

2017 ◽  
Vol 13 (1) ◽  
pp. 4605-4617
Author(s):  
Aly Mahmoud El-Hdidy
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Target Location ◽  
Breast Cancer Patients ◽  
Photon Beams ◽  
Lung Dose ◽  
Dose Volume Histograms ◽  
Tumor Bed ◽  
Boost Dose ◽  
Treatment Plans

Comparisons between three different techniques by which the boost dose was delivered to the tumor bed were carried out , aiming to present the best technique of treatment for right breast cancer patients.In this study, ten right sided breast cancer computed tomography (CT) scans were selected for ten early right breast cancer patients. We made three different treatment plans for each patient CT using three different irradiation techniques to deliver a prescribed boost dose of 10 Gy in 5 fractions to the boost PTV. In the first technique, two tangential photon beams were used, in the second technique we, two oblique photon beams were used and in the third technique, a single electron beam was used. The comparative analyses between the three techniques were performed by comparing the boost PTV- dose volume histograms (DVHs), the ipsilateral breast (right breast) DVHs, the ipsilateral lung (right lung) DVHs and the heart DVHs of the three techniques for each patient. Furthermore the dose that covering 100% , 95% of the volume (D100% , D95%) and the volume covered by 95% of the dose (V95%)of  the boost PTV of all techniques, were calculated for each patient to investigate the dose coverage of the target.Results showed that there were variations of the dose received by tumor bed, right breast and OARs depending on the technique used and the target location and size. A decrease of D100% than 90% of the prescribed dose was observed with the 3rd technique for patients 8, 9 and 10, and was observed with the 2nd technique for patient 5. A reduction of right breast dose was observed when the 3rd technique was use in comparison with the 1st and the 2nd techniques for patients 1, 2, 3, 4, 6 and 8.  Also reduction of right breast was observed when the 2nd technique used in comparison with 1st technique. An increase of lung dose was observed with the 3rd technique for patients 1, 2, 5 and 6, also was observed with 2nd technique in patient 3, 5 and 7. A decrease of lung dose was observed with the 1st technique for patients 2, 4, 5, 6, 7, 8 and 9An individualized treatment, several plans using different irradiation techniques should be developed for each patient individually to reach the best boost PTV dose coverage with minimal OARs’ dose. 

scholarly journals An observational study of post-operative Volumetric Modulated Arc Radiotherapy (VMAT) of breast cancer by immobilizing patients on All-in-one (AIOTM) solution Breast and Lung Board without usingthermoplastic mask: Risk of collusion of gantry with couch exists if acquisition of Cone-beam Computed Tomography (CBCT)is attempted for set-up verification.

2020 ◽  
Author(s):  
Ramaiah Vinay Kumar
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Cancer Patients ◽  
Target Volume ◽  
Cone Beam ◽  
Breast Cancer Patients ◽  
Unilateral Breast Cancer ◽  
Planar Image ◽  
X Ray ◽  
Set Up

Abstract Background: Automatic Cone-beam computed tomography (CBCT) based image matching for set-up verification is recommended as compared to 2-D match for post-operative local / loco-regional radiotherapy of breast cancer patients by Volumetric Modulated Arc Therapy (VMAT) technique. However, in supine position, off-midline peripheral body Clinical Target Volume (CTV) of unilateral breast cancer patients immobilized on Breast and Lung board of All-in-One (AIO) positioning systemmay necessitate augmented movement of couch in ‘x’ and ‘z’ axis thereby raising the risk of collusion of x-ray sources / detectors system with couch. Methods and Materials: VMAT was planned by a pair of partial arc for whole target volume for seven consecutive post-operative breast cancer patients (five post-mastectomy and two post-breast conservation patients). Tattoo based set-up by shift of treatment table in x-, y- and z-axis as determined by Treatment Planning System followed by X-rays with planar image acquisition and online 2-D imaging matching was performed for set-up verification. In-room 360°rotation of x-ray source and detector system of linear accelerator (linac) was performed before x-ray planar image acquisition. Results: Completion of 360°rotation in-room of x-ray source and detector system of linacaround the machine iso-centre was not possible in six out of seven patients due to possibility of collusion of gantry with contralateral side of the couch. Conclusion: Performing CBCT for generating 3D images for computed tomography (CT) reconstruction may not be practical for patient set-up verification of post-operative radiotherapy of unilateral breast cancer patients positioned supine on breast and lung board.

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