Comparison among four immobilization devices for whole breast irradiation with Helical Tomotherapy
Comparison among four immobilization devices for whole breast irradiation with Helical Tomotherapy
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DOI：
10.1016/j.ejmp.2019.12.023
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发表时间：
2020-01-01
影响因子：
3.4
通讯作者：
Racadot, Severine
中科院分区：
文献类型：
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作者：
Biston, Marie-Claude;Jarril, Jimmy;Racadot, Severine
目的：评估用于全乳房螺旋ct治疗的4种固定装置（ID）的重新定位准确性：带有VacFix的臂浮子(R)（丹麦Par Scientific）， all-in-one (R) （AIO (R)）系统（比利时Orfit）， MacroCast热塑性罩（荷兰Macromedics）和带有ArmShuttle的BlueBag (R)系统（Elekta，瑞典）。材料与方法：24例乳腺癌合并PTV包括乳腺/胸壁及淋巴结，每组6例。预处理配准结果首先通过自动骨配准+椎体手动调整收集，然后对代表每个治疗区域（腋窝、乳腺链、锁骨、乳房/胸壁）的不同roi进行独立配准。计算参考配准与上述roi之间平移和旋转的差异。共分析了120张MVCT图像。结果：在检查3D平移向量时，在观察到的移位上，发现id (p < 0.0001), roi （p = 0.0002）和会话数（p < 0.0001）之间存在显著差异。BlueBag (R)的3d载体含量显著低于VacFix (R)或AIO (R) (p < 0.0001)，但与mask （p = 0.674）相比差异不显著（p = 0.674）。最后，BlueBag (R)的设置边界总体上小于其他id，其乳腺链区为1.53 ~ 1.91 mm，锁骨区为4.52 ~ 6.07 mm，腋窝区为2.71 ~ 4.62 mm，乳房为3.39 ~ 5.10 mm。结论：在本研究中，我们证明了BlueBag (R)联合臂梭是HT治疗期间乳房和淋巴结固定的可靠解决方案。
Purpose: To evaluate the repositioning accuracy of 4 immobilization devices (ID) used for whole breast Helical Tomotherapy treatments: arm float with VacFix (R) (Par Scientific, Denmark), all-in-one (R) (AIO (R)) system (Orfit, Belgium), MacroCast thermoplastic mask (Macromedics, The Netherlands) and BlueBag (R) system with ArmShuttle (Elekta, Sweden).Materials and methods: Twenty four women with breast cancer with PTV including the breast/chest wall and lymph nodes were involved in this study (6 women per group). Pretreatment registration results were first collected using automatic bone registration + manual adjustment on the vertebra followed by independent registrations on different ROIs representing each treated area (axillary, mammary chain, clavicular, breast/chest wall). The differences in translations and rotations between reference registration and the above mentionned ROIs were calculated. A total of 120 MVCT images were analyzed.Results: Significant differences were found between IDs (p < 0.0001), ROIs (p = 0.0002) and the session number (p < 0.0001) on the observed shifts, when examining 3D translation vectors. 3D-vectors were significantly lower for the BlueBag (R) than for the VacFix (R) or for the AIO (R) (p < 0.0001), but differences were not significant compared to the mask (p = 0.674). Finally, setup margins were overall smaller for the BlueBag (R) than for other IDs, with values ranging from 1.53 to 1.91 mm on the mammary chain area, 4.52-6.07 mm on the clavicular area, 2.71-4.62 mm on the axillary area, and 3.39-5.10 mm on the breast.Conclusion: We demonstrated in this study that the BlueBag (R) combined with arm shuttle is a robust solution for breast and nodes immobilization during HT treatments.