A feasibility study of a hybrid breast-immobilization system for early breast cancer in proton beam therapy
A feasibility study of a hybrid breast-immobilization system for early breast cancer in proton beam therapy
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DOI：
10.1002/mp.12166
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发表时间：
2017-04-01
期刊：
影响因子：
3.8
通讯作者：
Hishikawa, Yoshio
中科院分区：
文献类型：
--
作者：
Arimura, Takeshi;Ogino, Takashi;Hishikawa, Yoshio
目的：我们的目的是开发一种新的乳房固定系统，用于早期乳腺癌（EBC）的质子束治疗（PBT），在治疗过程中提供最佳的乳房形状，并通过减少呼吸运动的影响来增加固定的可靠性。（HyBIS;混合乳房固定系统）由全身固定系统（WBIS）、位置转换装置这些设备包括：乳房支撑装置（用于改变患者位置）、照片扫描系统、乳房杯（使用三维打印机制造）、乳房杯装配设备、乳房杯保持装置（用于确保乳房保持在仰卧位）和固定到WBIS的专用担架（用于承载患者）。我们进行了一个体模实验，以评估在呼吸周期中的乳房制动的HyBIS的效果。13个标记嵌入在右侧乳房的女性体模，模拟呼吸胸部运动的幅度为15 mm，和他们的位移在四维计算机断层扫描进行了比较，与不固定的条件下，通过HyBIS.Results：当固定应用与HyBIS，乳房突出保持在仰卧位治疗的幻影。使用HyBIS时，标记的前后、上下、侧向和三维（3D）位移的平均值分别为2.7 +/- 1.7、0.3 +/- 0.5、0.9 +/- 0.8和3.1 +/- 1.6 mm，使用HyBIS时，标记的前后、上下、侧向和三维（3D）位移的平均值分别为5.5 +/- 2.9、0.6 +/- 0.8、0.5 +/- 0.4、结论：HyBIS能有效地改善患者的前后位（P = 0.014）和三维（P = 0.007）位移，并能减少呼吸运动的影响。因此，HyBIS可以帮助可靠和精确地执行EBC的PBT。(C)2017年美国医学物理学家协会
Purpose: We aimed to develop a new breast-immobilizing system for proton beam therapy (PBT) of early breast cancer (EBC) that would provide the optimum breast shape during the treatment as well as increased fixation reliability by reducing the influence of respiratory movement.Methods: The breast-immobilizing system (HyBIS; hybrid breast-immobilizing system) consists of a whole body immobilization system (WBIS), position-converting device (to change patient position), photo-scanning system, breast cup (made using a three-dimensional printer), breast cup-fitting apparatus, breast cup-holding device (to ensure the breast remains lifted in the supine position), and dedicated stretcher fixed to the WBIS (to carry the patient). We conducted a phantom experiment to evaluate the effect of the HyBIS on breast immobilization during the respiratory cycle. Thirteen markers were embedded in the right breast of a female phantom that simulated respiratory thoracic movement at an amplitude of 15 mm, and their displacements on four-dimensional computed tomography were compared between conditions with and without immobilization by HyBIS.Results: When immobilization was applied with the HyBIS, breast protrusion was maintained in the phantom in the supine treatment position. The mean values of the anteroposterior, superoinferior, lateral, and three-dimensional (3D) displacement of the markers were 2.7 +/- 1.7, 0.3 +/- 0.5, 0.9 +/- 0.8, and 3.1 +/- 1.6 mm with HyBIS, and 5.5 +/- 2.9, 0.6 +/- 0.8, 0.5 +/- 0.4, and 5.6 +/- 2.9 mm without HyBIS, respectively; thus, the anteroposterior (P = 0.014) and 3D (P = 0.007) displacements significantly improved with HyBIS.Conclusions: We demonstrated that the HyBIS can help retain the protruded breast shape in the supine position during treatment and can reduce the influence of respiratory movement. Thus, the HyBIS can help to reliably and precisely perform PBT for EBC. (C) 2017 American Association of Physicists in Medicine