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Computed tomography-based virtual simulation versus ultrasound-based clinical setup in electron breast boost
Monica Serban1, Christine Lambert2, Russell Ruo1
1Department of Medical Physics, Cedars Cancer Centre, McGill University Health Centre, Glen Campus, 1001 Décarie Boul., Montreal H4A 3J1, Canada.
Summary
Computed tomography (CT) virtual simulation offers superior target definition for breast electron boost radiation therapy compared to ultrasound (U/S). This method improves accuracy and spares healthy tissue, enhancing treatment outcomes.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Radiotherapy Physics
Background:
- Breast electron boost radiotherapy is a critical treatment modality.
- Accurate target delineation is essential for effective electron boost delivery.
- Current methods may have limitations in defining the target volume precisely.
Purpose of the Study:
- To compare ultrasound (U/S)-delineated targets with computed tomography (CT)-outlined targets for breast electron boost.
- To develop and validate a methodology for CT-based virtual simulation and collision testing in electron radiotherapy.
Main Methods:
- A prospective study involving 12 patients treated with a clinical setup.
- Comparison of U/S and CT imaging for target definition, with U/S markings visualized on CT.
- Reproduction of clinical dose distribution in a treatment planning system (TPS) and comparison with CT-based virtual simulation.
Main Results:
- CT-based simulation resulted in a smaller mean beam aperture (16.3 cm² less) compared to U/S.
- Target coverage at depth was adequate with CT-based simulation, whereas the clinical setup under/over-covered the target in 2/12 cases.
- Mean target V90% was significantly higher with CT-based simulation (98.5%) versus clinical setup (84.4%).
- CT-based simulation demonstrated better sparing of the ipsilateral lung and breast.
Conclusions:
- CT-based simulation and target delineation provide superior definition of the electron beam field.
- This approach minimizes irradiation of normal tissues while ensuring adequate target coverage.
- CT-based virtual simulation optimizes electron energy selection for improved treatment efficacy.
