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On-Board Imager-based MammoSite treatment verification.

Jadwiga Wojcicka¹, Rafael Yankelevich, Stephen Iorio

¹York Cancer Center, Apple Hill Medical Center, Suite 94, 25 Monument Road, York, PA 17403, USA. jwojcicka@wellspan.org

Medical & Biological Engineering & Computing

|July 13, 2007

Summary

This study introduces a filmless verification protocol for MammoSite brachytherapy using CT scans and an On-Board Imager (OBI). This method accurately assesses balloon placement and integrity, offering a rapid alternative to conventional simulators.

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Area of Science:

Radiation Oncology
Medical Physics
Brachytherapy

Background:

Conventional simulators are increasingly absent in radiation oncology departments.
Image-guided radiation therapy and virtual simulation are becoming standard practices.
There is a need for efficient and precise verification methods in MammoSite brachytherapy.

Purpose of the Study:

To develop and evaluate a CT-based protocol for MammoSite brachytherapy using an On-Board Imager (OBI) for daily verification.
To assess the feasibility and accuracy of OBI-based simulation for MammoSite procedures.
To establish a rapid, filmless verification process as an alternative to conventional simulators.

Main Methods:

A protocol utilizing CT-based planning, a Source Position Simulator (SPS) with a Simulator Wire, and an OBI was developed.
MammoSite balloon implantation was followed by CT imaging for evaluation.
OBI fluoroscopy was used for daily verification of balloon integrity and dwell position coincidence.

Main Results:

The OBI-based verification process is filmless, rapid (under 10 min), and precise.
Balloon diameter correlated well (within 1 mm) between CT and OBI images.
Balloon symmetry was accurately defined (1 mm accuracy) using OBI console tools.

Conclusions:

OBI-based simulation is a feasible and effective alternative for MammoSite balloon evaluation and daily verification.
The developed protocol ensures precision without undermining accuracy.
This method streamlines the verification process, replacing the need for conventional simulators.