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Comparison of target registration errors for multiple image-guided techniques in accelerated partial breast
David P Gierga1, Marco Riboldi, Julie C Turcotte
1Department of Radiation Oncology, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA. dgierga@partners.org
International Journal of Radiation Oncology, Biology, Physics
|January 22, 2008
Summary
Accurate breast cancer treatment localization is crucial. Surface imaging with 3D video and clip-based methods achieved the lowest target registration error (TRE), with gating improving accuracy for accelerated partial breast irradiation.
Area of Science:
- Medical Physics
- Radiation Oncology
- Image Guidance
Background:
- Accurate target volume localization is essential for effective external beam accelerated partial breast irradiation (EB-APBI).
- Target registration error (TRE) is a key metric for evaluating localization accuracy.
- Various image guidance techniques exist, each with potential benefits and drawbacks.
Purpose of the Study:
- To compare the performance of different target localization methods in EB-APBI using TRE.
- To evaluate standard laser-based setup, kilovoltage imaging (chest wall and clips), and 3D surface imaging.
- To assess the impact of reference surface type and respiratory motion gating on localization accuracy.
Main Methods:
- Twelve patients undergoing EB-APBI were included.
- TRE was quantified for four image guidance methods: laser, chest wall imaging, clip imaging, and 3D surface imaging.
- 3D surface imaging was evaluated using two reference surfaces (CT-based and direct 3D video capture) and with/without respiratory gating.
Main Results:
- Clip-based alignment demonstrated a median TRE of 2.4 mm.
- Gated 3D surface imaging with a direct 3D video reference surface yielded a median TRE of 3.2 mm.
- Nongated surface imaging showed a higher median TRE of 6.2 mm, while chest wall imaging was 5.4 mm and laser setup was 7.1 mm.
Conclusions:
- 3D surface imaging using a direct 3D video reference surface and clip-based setup achieved TRE within 1 mm.
- Respiratory motion gating is critical for optimizing the accuracy of surface imaging in EB-APBI.
- These findings support the use of advanced image guidance techniques for improved APBI precision.
