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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Breast Cancer Treatment

Background:

  • Accelerated partial breast irradiation (APBI) is an evolving treatment for early-stage breast cancer.
  • Precise patient positioning and target registration are critical for effective APBI.
  • Accurate isocenter placement is vital for delivering the prescribed radiation dose to the target volume while sparing healthy tissue.

Purpose of the Study:

  • To compare the accuracy of different patient setup methods for APBI.
  • To evaluate laser-based alignment, orthogonal kilovoltage imaging, and video surface mapping for isocenter placement.
  • To determine the impact of setup accuracy on planning target volume (PTV) coverage.

Main Methods:

  • Twenty-three patients undergoing APBI with surgical clips were studied.
  • Computed tomography (CT) simulation was used to create a reference surface map.
  • Patient setup was performed using laser alignment, orthogonal kilovoltage imaging, and video surface mapping; accuracy was assessed against clip position.

Main Results:

  • Video surface mapping achieved the lowest residual setup error (1.9 ± 2.2 mm P-A, 1.8 ± 1.9 mm I-S, 1.8 ± 2.1 mm L-R).
  • Laser alignment resulted in 3.9 ± 3.7 mm (P-A) error, and orthogonal imaging showed 3.2 ± 2.9 mm (P-A) error.
  • Video surface mapping significantly improved PTV coverage (V100 96.0% vs 89.3%) compared to orthogonal imaging.

Conclusions:

  • Video surface mapping is a more accurate method for isocenter placement in APBI.
  • This technique offers superior precision compared to traditional laser alignment and orthogonal kilovoltage imaging.
  • Enhanced setup accuracy with video surface mapping leads to better dosimetric coverage of the target volume.