| WANG Dong-qing,LI Hong-sheng,ZHOU Tao,LIU Tong-hai,YU Ning-sha,LI Bao-sheng.Optimization of registration template of cone-beam CT guided whole breast irradiation after lumpectomy of breast cancer[J].Chinese Journal of Radiological Medicine and Protection,2010,30(3):299-302 |
| Optimization of registration template of cone-beam CT guided whole breast irradiation after lumpectomy of breast cancer |
| Received:December 11, 2009 |
| DOI：10.3760/cma.j.issn.0254-5098.2010.03.018 |
| KeyWords:Breast cancer/radiotherapy Image guided Cone-beam CT |
| FundProject:国家自然科学基金资助项目 (30670617) |
| Author Name | Affiliation | E-mail | | WANG Dong-qing | 6 Department of Radiation Oncology, Shandong Tumor Hospital(Institute), Key Laboratory of Oncology of Shandong Province, Jinan 250117, China | | | LI Hong-sheng | 6 Department of Radiation Oncology, Shandong Tumor Hospital(Institute), Key Laboratory of Oncology of Shandong Province, Jinan 250117, China | | | ZHOU Tao | 6 Department of Radiation Oncology, Shandong Tumor Hospital(Institute), Key Laboratory of Oncology of Shandong Province, Jinan 250117, China | | | LIU Tong-hai | 250117 济南, 山东省肿瘤医院物理室 | | | YU Ning-sha | 250117 济南, 山东省肿瘤医院放射治疗区 | | | LI Bao-sheng | 6 Department of Radiation Oncology, Shandong Tumor Hospital(Institute), Key Laboratory of Oncology of Shandong Province, Jinan 250117, China | baoshli@yahoo.com |
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| Abstract:: |
| Objective To optimize the registration template of kilovoltage cone-beam CT (CBCT) guided radiotherapy in whole breast irradiation (WBI) after lumpectomy of breast cancer.Methods From April 2006 to July 2009, twelve patients undergoing WBI with intensity-modulated radiotherapy (IMRT) were recruited in this study. All patients were performed with both conventional planning CT and CBCT integrated on Varian 23EX. Six distinguishable reference points (the diameter 1 mm) around the lumpectomy cavity and the surrounding gland on the planning CT image were marked. The images were manually registered offline based on the breast surface, surgical clips, breast gland, contiguous rib, ipsilateral lung and its external contours, respectively. The same six reference points were then marked on the CBCT image. The performance of the five registration templates was compared using the concept of registration error, while the registration time was taken into account. The registration error was calculated based on the six reference points' translations between the planning CT image and CBCT image, and analyzed with SPSS 13.0 software using one-way ANOVA.Results The values of the registration error for the breast surface, surgical clips, breast gland, contiguous rib, ipsilateral lung and its external contours were (0.60 ± 0.20), (0.43 ± 0.15), (0.49 ± 0.19), (0.69 ± 0.36) and (0.94 ± 0.49) cm, respectively, and the registration time were (3.8 ± 1.1), (3.0 ± 0.9), (4.7 ± 1.7), (4.3 ± 1.3) and (4.5 ± 1.3) min, respectively. There was no statistical difference between the breast surface, surgical clips and breast gland registration template (t = 0.48-1.36, P＞0.05), the same result trend to contiguous rib compared with ipsilateral lung (t = 2.00, P= 0.055), however, there was significant difference between surgical clips and the last two registration methods (t = 2.08-4.08, P＜0.05).ConclusionIn this initial study with a modest number of patients, surgical clips show a best registration template from the standpoint of accuracy and efficiency, whereas contiguous rib and ipsilateral lung are not an ideal method. |
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