Three-dimensional ultrasound system for guided breast brachytherapy.

Abstract:

:Breast-conserving surgery combined with subsequent radiation therapy is a standard procedure in breast cancer treatment. The disadvantage of whole-breast beam irradiation is that it requires 20-25 treatment days, which is inconvenient for patients with limited mobility or who reside far from the treatment center. However, interstitial high-dose-rate (HDR) brachytherapy is an irradiation method requiring only 5 treatment days and that delivers a lower radiation dose to the surrounding healthy tissue. It involves delivering radiation through 192Ir seeds placed inside the catheters, which are inserted into the breast. The catheters are attached to a HDR afterloader, which controls the seed placement within the catheters and irradiation times to deliver the proper radiation dose. One disadvantage of using HDR brachytherapy is that it requires performing at least one CT scan during treatment planning. The procedure at our institution involves the use of two CT scans. Performing CT scans requires moving the patient from the brachytherapy suite with catheters inserted in their breasts. One alternative is using three-dimensional ultrasound (3DUS) to image the patient. In this study, the authors developed a 3DUS translation scanning system for use in breast brachytherapy. The new system was validated using CT, the current clinical standard, to image catheters in a breast phantom. Once the CT and 3DUS images were registered, the catheter trajectories were then compared. The results showed that the average angular separation between catheter trajectories was 2.4 degrees, the average maximum trajectory separation was 1.0 mm, and the average mean trajectory separation was found to be 0.7 mm. In this article, the authors present the 3DUS translation scanning system's capabilities as well as its potential to be used as the primary treatment planning imaging modality in breast brachytherapy.

journal_name

Med Phys

journal_title

Medical physics

authors

De Jean P,Beaulieu L,Fenster A

doi

10.1118/1.3243865

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

5099-106

issue

11

eissn

0094-2405

issn

2473-4209

journal_volume

36

pub_type

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