Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May;9(5):3274-3281.
doi: 10.21037/tcr.2020.04.18.

Comparison of positioning accuracy of different registration methods and dosimetric analysis of adaptive radiotherapy for breast cancer after breast conserving surgery

Xiu-Qing Ai  1 , Cheng-Qiong Tang  2 , Heng Wu  2 , Turd Garbo  1 , Xue Wang  1 , Jiang-Ping Liu  2 , Yao-Feng Cao  2 , Hua Jin  3
Affiliations

Comparison of positioning accuracy of different registration methods and dosimetric analysis of adaptive radiotherapy for breast cancer after breast conserving surgery

Xiu-Qing Ai et al. Transl Cancer Res. 2020 May.

Abstract

Background: This study explores the effect of different registration methods on the placement accuracy and dosimetric analysis of adaptive radiation therapy (ART) after breast conserving surgery for breast cancer, based on cone-beam computed tomography (CBCT).

Methods: Thirty breast cancer patients, who underwent breast conserving surgery, were divided into three groups, with 10 patients in each group: automatic grayscale registration (group A), automatic bony marker registration (group B), and automatic grayscale registration combined with manual bony marker registration (group C). Three registration methods were conducted before the first radiotherapy, and once a week under the guidance of CBCT. The dosimetric comparison was made with the original plan.

Results: The X direction was significantly different between groups A and B (P=0.036). The X and Y direction were significantly different between groups A and C (P=0.001, P=0.019). The placement errors were significantly different between groups B and C in the X and Y directions (P<0.001, P=0.003). The ART plan was significantly better than the original plan, in terms of the Dmax, Dmean, D90, V90, V100, V95, HI and CI of planning target volume (PTV) (P<0.05). Furthermore, the ART plan was significantly better, in terms of the Dmean, V5, V10, V20 and V30 of the affected lung, the Dmean, V5, V10, V20 and V30 of the double lung, and the Dmean, V5, V10, V20 and V30 of the heart. Moreover, the Dmax, V5 and V10 of the contralateral breast were significantly lower than those in the original CT plan (P<0.05).

Conclusions: For the CBCT placement verification after breast conserving surgery, the accuracy and stability of automatic gray-scale registration combined with manual bone markers are better than those of the automatic gray-scale registration and automatic bone marker registration.

Keywords: Cone-beam computed tomography (CBCT); adaptive radiation therapy (ART); breast conserving surgery; radiotherapy setting error; registration method.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr.2020.04.18). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Box diagrams of positioning errors in the X, Y and Z directions of the three registration methods in groups A (A), B (B) and C (C).
See this image and copyright information in PMC

References

    1. Wu CF, Wu JC, Gu K, et al. Using CBCT to study the lower neck positioning error of breast cancer patients treated with breast bracket fixation and radiotherapy. Corresponding CTV External Boundary. Chinese Radiological Medicine and Protection 2016;36:753-6.
    1. Yang ZY, Wang JP, Yuan H, et al. The influence of Cone-beam CT on the positioning accuracy of patients with nasopharyngeal carcinoma undergoing intensity-modulated radiotherapy. Medical Equipment 2018;31:49-51.
    1. Zhao YL, Xie GD, Jin JH, et al. Application of abdominal balloon compression technology with 4DCT in 3D RT of NSCLC. Chinese Journal of Radiation Oncology, 2018;5:509-12.
    1. Wang W, Li JB, Xu M, et al. Self-adaptive prediction and correction of placement errors in cone-beam CT-guided IMRT. Chinese Journal of Oncology 2016;38:197-201. - PubMed
    1. Chai CS. Error analysis of two fixed methods in radiotherapy for breast cancer. Medical Frontier 2017;7:183-4.