Dosimetric comparisons between high dose rate interstitial and MammoSite™ balloon brachytherapy for breast cancer

T. Major, Peter Niehoff, György Kovács, J. Fodor, C. Polgár

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background and purpose: To make a quantitative dosimetric comparison between treatment plans of multicatheter-based interstitial brachytherapy (IB) and MammoSite™ brachytherapy (MSB) for breast cancer. Patients and methods: Seventeen patients treated with IB and twenty-four with MSB were selected for the study. The irradiations for IB patients were planned using conventional two-film reconstruction technique. Following the implantation each patient was CT scanned, then the planning target volume (PTV) was retrospectively defined on the CT data set, and the original plan was reconstructed (CONV plans). Furthermore, conformal plans were also created by dose optimization on target (CONF plans). The planning for MammoSite™ applicator was based on CT imaging. The dose distributions were evaluated with dose-volume histograms. The following parameters were calculated and compared: volume of the PTV and its percentage receiving 90, 100, 150 and 200% of the prescribed dose (V90, V100, V150 and V200, respectively), percentage dose covering 90% of the PTV (D90), minimum dose in the PTV (Dmin), maximum dose in the PTV (Dmax) for MSB only, dose homogeneity index (DHI), and conformal index (COIN). To assess the dose to organs at risk maximum point dose to skin, lung and heart was used. Results: The median number of implanted catheters for IB was 11 (range: 6-13), the average balloon volume for MSB was 59.1 cm3 (range: 43.4-75.3 cm3). The average volume of PTV was 63.4 and 109.6 cm3 for IB and MSB patients, respectively. The average V90, V100, V150, V200 were 76, 70, 26 and 9% for IBCONV; 92, 87, 55 and 32% for IBCONF and 96, 88, 27 and 3% for MSB, respectively. The average D90 was 72, 94 and 99%, the Dmin was 47, 58 and 67%, respectively. The mean Dmax was 258% for MSB. The average DHI was 0.63, 0.37 and 0.70 for IBCONV, IBCONF and MSB, respectively. Dmax to skin, lung and heart were 45, 54 and 31% for IBCONV, 50, 55 and 29% for IBCONF, 97, 66 and 27% for MSB, respectively. Conclusions: Target volume coverage was better for MSB than conventional IB, and it was comparable to conformal IB. The suboptimal coverage for IB patients is due to radiography based planning, which is unable to provide 3D information of the target. Dose homogeneity was somewhat better for MSB than IBCONV, but the dose to skin and lung was higher for MSB. The MSB provides dosimetrically acceptable dose plans. The quality of interstitial implants can be improved with image-guided catheter insertions regarding both homogeneity and conformality.

Original languageEnglish
Pages (from-to)321-328
Number of pages8
JournalRadiotherapy and Oncology
Volume79
Issue number3
DOIs
Publication statusPublished - Jun 2006

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Brachytherapy
Breast Neoplasms
Lung
Skin
Catheters
Organs at Risk

Keywords

  • Dose homogeneity and conformality
  • Interstitial breast implants
  • MammoSite brachytherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Urology

Cite this

Dosimetric comparisons between high dose rate interstitial and MammoSite™ balloon brachytherapy for breast cancer. / Major, T.; Niehoff, Peter; Kovács, György; Fodor, J.; Polgár, C.

In: Radiotherapy and Oncology, Vol. 79, No. 3, 06.2006, p. 321-328.

Research output: Contribution to journalArticle

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abstract = "Background and purpose: To make a quantitative dosimetric comparison between treatment plans of multicatheter-based interstitial brachytherapy (IB) and MammoSite™ brachytherapy (MSB) for breast cancer. Patients and methods: Seventeen patients treated with IB and twenty-four with MSB were selected for the study. The irradiations for IB patients were planned using conventional two-film reconstruction technique. Following the implantation each patient was CT scanned, then the planning target volume (PTV) was retrospectively defined on the CT data set, and the original plan was reconstructed (CONV plans). Furthermore, conformal plans were also created by dose optimization on target (CONF plans). The planning for MammoSite™ applicator was based on CT imaging. The dose distributions were evaluated with dose-volume histograms. The following parameters were calculated and compared: volume of the PTV and its percentage receiving 90, 100, 150 and 200{\%} of the prescribed dose (V90, V100, V150 and V200, respectively), percentage dose covering 90{\%} of the PTV (D90), minimum dose in the PTV (Dmin), maximum dose in the PTV (Dmax) for MSB only, dose homogeneity index (DHI), and conformal index (COIN). To assess the dose to organs at risk maximum point dose to skin, lung and heart was used. Results: The median number of implanted catheters for IB was 11 (range: 6-13), the average balloon volume for MSB was 59.1 cm3 (range: 43.4-75.3 cm3). The average volume of PTV was 63.4 and 109.6 cm3 for IB and MSB patients, respectively. The average V90, V100, V150, V200 were 76, 70, 26 and 9{\%} for IBCONV; 92, 87, 55 and 32{\%} for IBCONF and 96, 88, 27 and 3{\%} for MSB, respectively. The average D90 was 72, 94 and 99{\%}, the Dmin was 47, 58 and 67{\%}, respectively. The mean Dmax was 258{\%} for MSB. The average DHI was 0.63, 0.37 and 0.70 for IBCONV, IBCONF and MSB, respectively. Dmax to skin, lung and heart were 45, 54 and 31{\%} for IBCONV, 50, 55 and 29{\%} for IBCONF, 97, 66 and 27{\%} for MSB, respectively. Conclusions: Target volume coverage was better for MSB than conventional IB, and it was comparable to conformal IB. The suboptimal coverage for IB patients is due to radiography based planning, which is unable to provide 3D information of the target. Dose homogeneity was somewhat better for MSB than IBCONV, but the dose to skin and lung was higher for MSB. The MSB provides dosimetrically acceptable dose plans. The quality of interstitial implants can be improved with image-guided catheter insertions regarding both homogeneity and conformality.",
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AU - Major, T.

AU - Niehoff, Peter

AU - Kovács, György

AU - Fodor, J.

AU - Polgár, C.

PY - 2006/6

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N2 - Background and purpose: To make a quantitative dosimetric comparison between treatment plans of multicatheter-based interstitial brachytherapy (IB) and MammoSite™ brachytherapy (MSB) for breast cancer. Patients and methods: Seventeen patients treated with IB and twenty-four with MSB were selected for the study. The irradiations for IB patients were planned using conventional two-film reconstruction technique. Following the implantation each patient was CT scanned, then the planning target volume (PTV) was retrospectively defined on the CT data set, and the original plan was reconstructed (CONV plans). Furthermore, conformal plans were also created by dose optimization on target (CONF plans). The planning for MammoSite™ applicator was based on CT imaging. The dose distributions were evaluated with dose-volume histograms. The following parameters were calculated and compared: volume of the PTV and its percentage receiving 90, 100, 150 and 200% of the prescribed dose (V90, V100, V150 and V200, respectively), percentage dose covering 90% of the PTV (D90), minimum dose in the PTV (Dmin), maximum dose in the PTV (Dmax) for MSB only, dose homogeneity index (DHI), and conformal index (COIN). To assess the dose to organs at risk maximum point dose to skin, lung and heart was used. Results: The median number of implanted catheters for IB was 11 (range: 6-13), the average balloon volume for MSB was 59.1 cm3 (range: 43.4-75.3 cm3). The average volume of PTV was 63.4 and 109.6 cm3 for IB and MSB patients, respectively. The average V90, V100, V150, V200 were 76, 70, 26 and 9% for IBCONV; 92, 87, 55 and 32% for IBCONF and 96, 88, 27 and 3% for MSB, respectively. The average D90 was 72, 94 and 99%, the Dmin was 47, 58 and 67%, respectively. The mean Dmax was 258% for MSB. The average DHI was 0.63, 0.37 and 0.70 for IBCONV, IBCONF and MSB, respectively. Dmax to skin, lung and heart were 45, 54 and 31% for IBCONV, 50, 55 and 29% for IBCONF, 97, 66 and 27% for MSB, respectively. Conclusions: Target volume coverage was better for MSB than conventional IB, and it was comparable to conformal IB. The suboptimal coverage for IB patients is due to radiography based planning, which is unable to provide 3D information of the target. Dose homogeneity was somewhat better for MSB than IBCONV, but the dose to skin and lung was higher for MSB. The MSB provides dosimetrically acceptable dose plans. The quality of interstitial implants can be improved with image-guided catheter insertions regarding both homogeneity and conformality.

AB - Background and purpose: To make a quantitative dosimetric comparison between treatment plans of multicatheter-based interstitial brachytherapy (IB) and MammoSite™ brachytherapy (MSB) for breast cancer. Patients and methods: Seventeen patients treated with IB and twenty-four with MSB were selected for the study. The irradiations for IB patients were planned using conventional two-film reconstruction technique. Following the implantation each patient was CT scanned, then the planning target volume (PTV) was retrospectively defined on the CT data set, and the original plan was reconstructed (CONV plans). Furthermore, conformal plans were also created by dose optimization on target (CONF plans). The planning for MammoSite™ applicator was based on CT imaging. The dose distributions were evaluated with dose-volume histograms. The following parameters were calculated and compared: volume of the PTV and its percentage receiving 90, 100, 150 and 200% of the prescribed dose (V90, V100, V150 and V200, respectively), percentage dose covering 90% of the PTV (D90), minimum dose in the PTV (Dmin), maximum dose in the PTV (Dmax) for MSB only, dose homogeneity index (DHI), and conformal index (COIN). To assess the dose to organs at risk maximum point dose to skin, lung and heart was used. Results: The median number of implanted catheters for IB was 11 (range: 6-13), the average balloon volume for MSB was 59.1 cm3 (range: 43.4-75.3 cm3). The average volume of PTV was 63.4 and 109.6 cm3 for IB and MSB patients, respectively. The average V90, V100, V150, V200 were 76, 70, 26 and 9% for IBCONV; 92, 87, 55 and 32% for IBCONF and 96, 88, 27 and 3% for MSB, respectively. The average D90 was 72, 94 and 99%, the Dmin was 47, 58 and 67%, respectively. The mean Dmax was 258% for MSB. The average DHI was 0.63, 0.37 and 0.70 for IBCONV, IBCONF and MSB, respectively. Dmax to skin, lung and heart were 45, 54 and 31% for IBCONV, 50, 55 and 29% for IBCONF, 97, 66 and 27% for MSB, respectively. Conclusions: Target volume coverage was better for MSB than conventional IB, and it was comparable to conformal IB. The suboptimal coverage for IB patients is due to radiography based planning, which is unable to provide 3D information of the target. Dose homogeneity was somewhat better for MSB than IBCONV, but the dose to skin and lung was higher for MSB. The MSB provides dosimetrically acceptable dose plans. The quality of interstitial implants can be improved with image-guided catheter insertions regarding both homogeneity and conformality.

KW - Dose homogeneity and conformality

KW - Interstitial breast implants

KW - MammoSite brachytherapy

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