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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Breast-shape changes during radiation therapy after breast-conserving surgery.

Tanja Alderliesten1, Wilma D Heemsbergen1, Anja Betgen1

  • 1Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Physics and Imaging in Radiation Oncology
|January 18, 2021
PubMed
Summary

Breast shape changes up to 4mm are common during radiation therapy after breast-conserving surgery, particularly in larger breasts. These variations impact treatment planning for partial breast irradiation and boost techniques.

Keywords:
Breast cancerBreast-conserving surgeryCone-beam computed tomographyRadiation therapyShape variability

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Area of Science:

  • Oncology
  • Medical Imaging
  • Radiation Therapy

Background:

  • Advancements in conformal radiation therapy for breast cancer necessitate improved motion management.
  • Breast-conserving surgery (BCS) is a common treatment modality, often followed by radiation therapy (RT).

Purpose of the Study:

  • To investigate and quantify breast shape variability during RT following BCS.
  • To assess the impact of breast volume and seroma on shape changes during RT.

Main Methods:

  • Utilized planning CT and follow-up CBCT scans from 17 patients (71 fractions) undergoing RT post-BCS.
  • Registered CT and CBCT scans on bony anatomy, generated breast contours, and analyzed 3D deviations in specific breast quadrants and the axilla.

Main Results:

  • Regional systematic and random standard deviations for breast quadrants ranged from 1.0-2.1 mm; axilla showed larger deviations (3.0 mm).
  • Significant shape changes (≥4.0 mm) occurred in 30% of fractions, especially in larger breasts (>800 cc).
  • Seroma presence was associated with increased breast shape changes (p=0.04).

Conclusions:

  • Breast shape variability is anatomically dependent and frequently reaches 4 mm during RT.
  • These findings are crucial for developing precise treatment protocols for partial breast irradiation and boost RT.
  • Consideration of breast size and seroma is essential for accurate radiation therapy planning post-BCS.