Isolating the impact of tissue heterogeneities in high dose rate brachytherapy treatment of the breast

IF 3.4 Q2 ONCOLOGY

Physics and Imaging in Radiation Oncology Pub Date : 2025-01-01 DOI:10.1016/j.phro.2025.100737

Jules Faucher , Vincent Turgeon , Boris Bahoric , Shirin A. Enger , Peter G.F. Watson

{"title":"Isolating the impact of tissue heterogeneities in high dose rate brachytherapy treatment of the breast","authors":"Jules Faucher , Vincent Turgeon , Boris Bahoric , Shirin A. Enger , Peter G.F. Watson","doi":"10.1016/j.phro.2025.100737","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and purpose</h3><div>Clinical brachytherapy treatment planning is performed assuming the patient is composed entirely of water and infinite in size. In this work, the effects of this assumption on calculated dose were investigated by comparing dose to water in water (D<sub>w,w</sub>) in an unbound phantom mimicking TG-43 conditions, and dose to medium in medium (D<sub>m,m</sub>) for breast cancer patients treated with high dose rate brachytherapy.</div></div><div><h3>Materials and methods</h3><div>Treatment plans for 123 breast cancer patients were recalculated with a Monte Carlo-based treatment planning software. The dwell times and dwell positions were imported from the clinical treatment planning system. The dose was computed and reported as D<sub>w,w</sub> and D<sub>m,m</sub>. Dose-volume histogram (DVH) metrics were evaluated for target volumes and organs at risk.</div></div><div><h3>Results</h3><div>D<sub>w,w</sub> overestimated the dose for most studied DVH metrics. The largest median overestimations between D<sub>m,m</sub> and D<sub>w,w</sub> were seen for the planning target volume (PTV) V<sub>200%</sub> (5.8%), lung D<sub>0.1 cm</sub><sup>3</sup> (6.0%) and skin D<sub>0.1 cm</sub><sup>3</sup> (4.2%). The differences between D<sub>m,m</sub> and D<sub>w,w</sub> were statistically significant for all investigated DVH metrics<sub>.</sub> The PTV V<sub>90%</sub> had the smallest deviation (0.7%).</div></div><div><h3>Conclusion</h3><div>There was a significant difference in the DVH metrics studied when tissue heterogeneities and patient-specific scattering are accounted for in high dose rate breast brachytherapy. However, for the studied patient cohort, the clinical coverage goal (PTV V<sub>90%</sub>), had the smallest deviation.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100737"},"PeriodicalIF":3.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physics and Imaging in Radiation Oncology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405631625000429","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and purpose

Clinical brachytherapy treatment planning is performed assuming the patient is composed entirely of water and infinite in size. In this work, the effects of this assumption on calculated dose were investigated by comparing dose to water in water (D_w,w) in an unbound phantom mimicking TG-43 conditions, and dose to medium in medium (D_m,m) for breast cancer patients treated with high dose rate brachytherapy.

Materials and methods

Treatment plans for 123 breast cancer patients were recalculated with a Monte Carlo-based treatment planning software. The dwell times and dwell positions were imported from the clinical treatment planning system. The dose was computed and reported as D_w,w and D_m,m. Dose-volume histogram (DVH) metrics were evaluated for target volumes and organs at risk.

Results

D_w,w overestimated the dose for most studied DVH metrics. The largest median overestimations between D_m,m and D_w,w were seen for the planning target volume (PTV) V_200% (5.8%), lung D_{0.1 cm}³ (6.0%) and skin D_{0.1 cm}³ (4.2%). The differences between D_m,m and D_w,w were statistically significant for all investigated DVH metrics_. The PTV V_90% had the smallest deviation (0.7%).

Conclusion

There was a significant difference in the DVH metrics studied when tissue heterogeneities and patient-specific scattering are accounted for in high dose rate breast brachytherapy. However, for the studied patient cohort, the clinical coverage goal (PTV V_90%), had the smallest deviation.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊