Radiological, dosimetric and mechanical properties of a deformable breast phantom for radiation therapy and surgical...

The displacement of tumor bed walls during oncoplastic breast surgery (OBS) decreases the accuracy of using surgical clips as the sole surrogate for tumor bed location. This highlights the need for better communication of OBS techniques to radiation oncologists. To facilitate OBS practice and investigate clip placement reliability, a realistic silicone-based breast phantom was constructed with components emulating a breast parenchyma, epidermis, areola, nipple, chest wall, and a tumor. OBS was performed on the phantom and surgical clips were placed to mark the tumor bed. The phantom was imaged with CT, MRI, and ultrasound (US). The parenchyma's signal-to-noise ratio (SNR) and clips to parenchyma's contrast-to-noise ratio (CNR) were measured. The phantom's CT Hounsfield Unit (HU), relative electron density (RED), and mass density were determined. 6 and 10 MV photon beam attenuation measurements were performed in phantom material. The Young's Modulus and ultimate tensile strength (UTS) of the phantom parenchyma and epidermis were measured. Results showed that the breast phantom components were visible on all imaging modalities with adequate SNR and CNR. The phantom's HU is 130 ± 10. The RED is 0.983. Its mass density is 1.01 ± 0.01 g cm^-3. Photon attenuation measurements in phantom material were within 1% of those in water. The Young's Moduli were 13.4 ± 4.2 kPa (mechanical) and 30.2 ± 4.1 kPa (US elastography) for the phantom parenchyma. The UTS' were 0.05 ± 0.01 MPa (parenchyma) and 0.23 ± 0.12 MPa (epidermis). We conclude that the phantom's imaging characteristics resemble a fibroglandular breast's and allow clear visualization of high-density markers used in radiation therapy. The phantom material is suitable for dose measurements in MV photon beams. Mechanical results confirmed the phantom's similarity to breast tissue. The phantom enables investigation of surgical clip displacements pre- and post-OBS, and is useful for radiation therapy quality assurance applications.