An Optimized Online Verification Imaging Procedure For External Beam Partial Breast Irradiation

Willis, D, Kron, T and Chua, B 2011, 'An Optimized Online Verification Imaging Procedure For External Beam Partial Breast Irradiation', Medical Dosimetry, vol. 36, no. 2, pp. 171-177.


Document type: Journal Article
Collection: Journal Articles

Title An Optimized Online Verification Imaging Procedure For External Beam Partial Breast Irradiation
Author(s) Willis, D
Kron, T
Chua, B
Year 2011
Journal name Medical Dosimetry
Volume number 36
Issue number 2
Start page 171
End page 177
Total pages 7
Publisher Elsevier Inc
Abstract The purpose of this study was to evaluate the capabilities of a kilovoltage (kV) on-board imager (OBI)-equipped linear accelerator in the setting of on-line verification imaging for external-beam partial breast irradiation. Available imaging techniques were optimized and assessed for image quality using a modified anthropomorphic phantom. Imaging dose was also assessed. Imaging techniques were assessed for physical clearance between patient and treatment machine using a volunteer. Nonorthogonal kV image pairs were identified as optimal in terms of image quality, clearance, and dose. After institutional review board approval, this approach was used for 17 patients receiving accelerated partial breast irradiation. Imaging was performed before every fraction verification with online correction of setup deviations >5 mm (total image sessions = 170). Treatment staff rated risk of collision and visibility of tumor bed surgical clips where present. Image session duration and detected setup deviations were recorded. For all cases, both image projections (n = 34) had low collision risk. Surgical clips were rated as well as visualized in all cases where they were present (n = 5). The average imaging session time was 6 min, 16 sec, and a reduction in duration was observed as staff became familiar with the technique. Setup deviations of up to 1.3 cm were detected before treatment and subsequently confirmed offline. Nonorthogonal kV image pairs allowed effective and efficient online verification for partial breast irradiation. It has yet to be tested in a multicenter study to determine whether it is dependent on skilled treatment staff.
Subject Physical Sciences not elsewhere classified
Keyword(s) Online verification
Accelerated partial breast irradiation
kiloVoltage on-board imager
IGRT
DOI - identifier 10.1016/j.meddos.2010.02.010
Copyright notice © 2011 Published by Elsevier Inc. on behalf of American Association of Medical Dosimetrists.
ISSN 0958-3947
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