Assessment of dose homogeneity in conformal interstitial breast brachytherapy with special respect to ICRU recommendations

T. Major, Georgina Fröhlich, C. Polgár

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: To present the results of dose homogeneity analysis for breast cancer patients treated with image-based conformal interstitial brachytherapy, and to investigate the usefulness of the ICRU recommendations. Material and methods: Treatment plans of forty-nine patients who underwent partial breast irradiation with interstitial brachytherapy were analyzed. Quantitative parameters were used to characterize dose homogeneity. Dose nonuniformity ratio (DNR), dose homogeneity index (DHI), uniformity index (UI) and quality index (QI) were calculated. Furthermore, parameters recommended by the ICRU 58 such as minimum target dose (MTD), mean central dose (MCD), high dose volume, low dose volume and the spread between local minimum doses were determined. Correlations between the calculated homogeneity parameters and usefulness of the ICRU parameters in image-based brachytherapy were investigated. Results: Catheters with mean number of 15 (range: 6-25) were implanted in median 4 (range: 3-6) planes. The volume of the PTV ranged from 15.5 cm3 to 176 cm 3. The mean DNR was 0.32, the DHI 0.66, the UI 1.49 and the QI 1.94. Related to the prescribed dose, the MTD was 69% and the MCD 135%. The mean high dose volume was 8.1 cm3 (10%), while the low dose volume was 63.8 cm3 (96%). The spread between minimum doses in central plane ranged from -14% to +20%. Good correlation was found between the DNR and the DHI (R2 = 0.7874), and the DNR correlated well with the UI (R2 = 0.7615) also. No correlation was found between the ICRU parameters and any other volumetric parameters. Conclusions: To characterize the dose uniformity in high-dose rate breast implants, DVH-related homogeneity parameters representing the full 3D dose distributions were mandatory to be used. In many respects the current recommendations of the ICRU Report 58 are already outdated, and it is well-timed to set up new recommendations, which are more feasible for image-guided conformal interstitial brachytherapy.

Original languageEnglish
Pages (from-to)150-155
Number of pages6
JournalJournal of Contemporary Brachytherapy
Volume3
Issue number3
DOIs
Publication statusPublished - Sep 30 2011

Fingerprint

Brachytherapy
Breast
Breast Implants
Catheters
Breast Neoplasms
Therapeutics

Keywords

  • Breast cancer
  • Dose-volume histogram
  • Homogeneity
  • Image-based brachytherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{4feeeeda3625469cbee4e8f83ab3bd9b,
title = "Assessment of dose homogeneity in conformal interstitial breast brachytherapy with special respect to ICRU recommendations",
abstract = "Purpose: To present the results of dose homogeneity analysis for breast cancer patients treated with image-based conformal interstitial brachytherapy, and to investigate the usefulness of the ICRU recommendations. Material and methods: Treatment plans of forty-nine patients who underwent partial breast irradiation with interstitial brachytherapy were analyzed. Quantitative parameters were used to characterize dose homogeneity. Dose nonuniformity ratio (DNR), dose homogeneity index (DHI), uniformity index (UI) and quality index (QI) were calculated. Furthermore, parameters recommended by the ICRU 58 such as minimum target dose (MTD), mean central dose (MCD), high dose volume, low dose volume and the spread between local minimum doses were determined. Correlations between the calculated homogeneity parameters and usefulness of the ICRU parameters in image-based brachytherapy were investigated. Results: Catheters with mean number of 15 (range: 6-25) were implanted in median 4 (range: 3-6) planes. The volume of the PTV ranged from 15.5 cm3 to 176 cm 3. The mean DNR was 0.32, the DHI 0.66, the UI 1.49 and the QI 1.94. Related to the prescribed dose, the MTD was 69{\%} and the MCD 135{\%}. The mean high dose volume was 8.1 cm3 (10{\%}), while the low dose volume was 63.8 cm3 (96{\%}). The spread between minimum doses in central plane ranged from -14{\%} to +20{\%}. Good correlation was found between the DNR and the DHI (R2 = 0.7874), and the DNR correlated well with the UI (R2 = 0.7615) also. No correlation was found between the ICRU parameters and any other volumetric parameters. Conclusions: To characterize the dose uniformity in high-dose rate breast implants, DVH-related homogeneity parameters representing the full 3D dose distributions were mandatory to be used. In many respects the current recommendations of the ICRU Report 58 are already outdated, and it is well-timed to set up new recommendations, which are more feasible for image-guided conformal interstitial brachytherapy.",
keywords = "Breast cancer, Dose-volume histogram, Homogeneity, Image-based brachytherapy",
author = "T. Major and Georgina Fr{\"o}hlich and C. Polg{\'a}r",
year = "2011",
month = "9",
day = "30",
doi = "10.5114/jcb.2011.24822",
language = "English",
volume = "3",
pages = "150--155",
journal = "Journal of Contemporary Brachytherapy",
issn = "1689-832X",
publisher = "Termedia Publishing House Ltd.",
number = "3",

}

TY - JOUR

T1 - Assessment of dose homogeneity in conformal interstitial breast brachytherapy with special respect to ICRU recommendations

AU - Major, T.

AU - Fröhlich, Georgina

AU - Polgár, C.

PY - 2011/9/30

Y1 - 2011/9/30

N2 - Purpose: To present the results of dose homogeneity analysis for breast cancer patients treated with image-based conformal interstitial brachytherapy, and to investigate the usefulness of the ICRU recommendations. Material and methods: Treatment plans of forty-nine patients who underwent partial breast irradiation with interstitial brachytherapy were analyzed. Quantitative parameters were used to characterize dose homogeneity. Dose nonuniformity ratio (DNR), dose homogeneity index (DHI), uniformity index (UI) and quality index (QI) were calculated. Furthermore, parameters recommended by the ICRU 58 such as minimum target dose (MTD), mean central dose (MCD), high dose volume, low dose volume and the spread between local minimum doses were determined. Correlations between the calculated homogeneity parameters and usefulness of the ICRU parameters in image-based brachytherapy were investigated. Results: Catheters with mean number of 15 (range: 6-25) were implanted in median 4 (range: 3-6) planes. The volume of the PTV ranged from 15.5 cm3 to 176 cm 3. The mean DNR was 0.32, the DHI 0.66, the UI 1.49 and the QI 1.94. Related to the prescribed dose, the MTD was 69% and the MCD 135%. The mean high dose volume was 8.1 cm3 (10%), while the low dose volume was 63.8 cm3 (96%). The spread between minimum doses in central plane ranged from -14% to +20%. Good correlation was found between the DNR and the DHI (R2 = 0.7874), and the DNR correlated well with the UI (R2 = 0.7615) also. No correlation was found between the ICRU parameters and any other volumetric parameters. Conclusions: To characterize the dose uniformity in high-dose rate breast implants, DVH-related homogeneity parameters representing the full 3D dose distributions were mandatory to be used. In many respects the current recommendations of the ICRU Report 58 are already outdated, and it is well-timed to set up new recommendations, which are more feasible for image-guided conformal interstitial brachytherapy.

AB - Purpose: To present the results of dose homogeneity analysis for breast cancer patients treated with image-based conformal interstitial brachytherapy, and to investigate the usefulness of the ICRU recommendations. Material and methods: Treatment plans of forty-nine patients who underwent partial breast irradiation with interstitial brachytherapy were analyzed. Quantitative parameters were used to characterize dose homogeneity. Dose nonuniformity ratio (DNR), dose homogeneity index (DHI), uniformity index (UI) and quality index (QI) were calculated. Furthermore, parameters recommended by the ICRU 58 such as minimum target dose (MTD), mean central dose (MCD), high dose volume, low dose volume and the spread between local minimum doses were determined. Correlations between the calculated homogeneity parameters and usefulness of the ICRU parameters in image-based brachytherapy were investigated. Results: Catheters with mean number of 15 (range: 6-25) were implanted in median 4 (range: 3-6) planes. The volume of the PTV ranged from 15.5 cm3 to 176 cm 3. The mean DNR was 0.32, the DHI 0.66, the UI 1.49 and the QI 1.94. Related to the prescribed dose, the MTD was 69% and the MCD 135%. The mean high dose volume was 8.1 cm3 (10%), while the low dose volume was 63.8 cm3 (96%). The spread between minimum doses in central plane ranged from -14% to +20%. Good correlation was found between the DNR and the DHI (R2 = 0.7874), and the DNR correlated well with the UI (R2 = 0.7615) also. No correlation was found between the ICRU parameters and any other volumetric parameters. Conclusions: To characterize the dose uniformity in high-dose rate breast implants, DVH-related homogeneity parameters representing the full 3D dose distributions were mandatory to be used. In many respects the current recommendations of the ICRU Report 58 are already outdated, and it is well-timed to set up new recommendations, which are more feasible for image-guided conformal interstitial brachytherapy.

KW - Breast cancer

KW - Dose-volume histogram

KW - Homogeneity

KW - Image-based brachytherapy

UR - http://www.scopus.com/inward/record.url?scp=80053459490&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053459490&partnerID=8YFLogxK

U2 - 10.5114/jcb.2011.24822

DO - 10.5114/jcb.2011.24822

M3 - Article

C2 - 23346125

AN - SCOPUS:80053459490

VL - 3

SP - 150

EP - 155

JO - Journal of Contemporary Brachytherapy

JF - Journal of Contemporary Brachytherapy

SN - 1689-832X

IS - 3

ER -