MRI定位对乳腺癌保乳术后部分乳腺照射的靶区和剂量的影响

doi:10.3760/cma.j.cn113030-20191230-00540

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Abstract Objective To compare magnetic resonance imaging (MRI)-based and computed tomography (CT)-based target volume delineation and dose coverage in partial breast irradiation (PBI) for patients with breast cancer, aiming to explore the application value of MRI localization in PBI after breast-conserving surgery. Methods Twenty-nine patients with early breast cancer underwent simulating CT and MRI scans in a supine position. The cavity visualization score (CVS) of tumor bed (TB) was evaluated. The TB, clinical target volume (CTV), planning target volume (PTV) were delineated on CT and MRI images, and then statistically compared. Conformity indices (CI) between CT- and MRI-defined target volumes were calculated. PBI treatment plan of 40Gy in 10 fractions was designed based on PTV-CT, and the dose coverage for PTV-MRI was evaluated. Results The CVS on CT and MRI images was 2.97±1.40 vs. 3.10±1.40(P=0.408). The volumes of TB, CTV, PTV on MRI were significantly larger than those on CT,(24.48±16.60) cm³ vs. (38.00±19.77) cm³,(126.76±56.81) cm³ vs. (168.42±70.54) cm³,(216.63±81.99) cm³ vs. (279.24±101.55) cm³, respectively,whereas the increasing percentage of CTV and PTV were significantly smaller than those of TB. The CI between CT-based and MRI-based TB, CTV, PTV were 0.43±0.13,0.66±0.11,0.70±0.09(P<0.001), respectively. The median percentage of PTV-MRI receiving 40Gy dose was 81.9%(62.3% to 92.4%),significantly lower than 95.6%(95.0%~97.5%) of PTV-CT. Conclusions The CVS between CT and MRI is not significantly different, but the MRI-based TB, CTV, PTV are significantly larger than CT-based values. The PTV-MRI is of underdose if PBI treatment plan is designed for PTV-CT. As a supplement of CT scan, MRI can enhance the accuracy of TB delineation after breast-onserving surgery.

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	Articles by authors
	Song Yuchun
	Xie Xin
	Che Shunan
	Sun Guangyi
	Tang Yu
	Zhang Jianghu
	Wang Jianyang
	Fang Hui
	Chen Bo
	Song Yongwen
	Jin Jing
	Liu Yueping
	Qi Shunan
	Tang Yuan
	Lu Ningning
	Jing Hao
	Yang Yong
	Li Ning
	Li Jing
	Wang Shulian
	Li Yexiong

Key words： Breast neoplasm/postoperative radiotherapy Breast neoplasm/partial breast irradiation MRI image Target delineation

Received: 30 December 2019

Fund:National Key Project of Research and Development of China (2016YFC0904600);Special Fund of Capital Clinical Characteristic Application Research(Z171100001017116)

Corresponding Authors: Wang Shulian,Email:wsl20040118@yahoo.com;Li Jing,Email:dr.lijing@163.com

Cite this article:

Song Yuchun,Xie Xin,Che Shunan et al. Comparison of MRI and CT for target volume delineation and dose coverage for partial breast irradiation in patients with breast cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(3): 244-248.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20191230-00540 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I3/244

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