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Center displacement of surgical cavity delineated by metal clips and/or seroma on 4DCT in patients for external-beam partial breast irradiation:a comparative study
DING Yun, LI Jian-bin, WANG Wei, FAN Ting-yong, XU Min, SHAO Qian, MA Zhi-fang, WANG Su-zhen
Department of Radiation Oncology, Shandong Tumor Hospital, Medicine and Life Sciences College of Shandong Academy of Medical Sciences, Ji′nan University, Ji′nan 250117, China
Abstract Objective To conduct a comparative study on the center displacement of surgical cavity delineated by metal clips and/or seroma on four-dimensional computed tomography (4DCT) in patients for external-beam partial breast irradiation (EBPBI) during free breathing. Methods Fourteen breast cancer patients, who had underwent breast-conserving surgery and met the requirements of EBPBI and who underwent 4DCT simulation scans and had a seroma clarity score of ≥3, were included in the study. On the 10 phases of 4DCT images, GTVs were delineated based on metal clips plus seroma, metal clips, and seroma to obtain GTVc+s, GTVc, and GTVs, respectively, and all the metal clips at the boundaries of surgical cavity were marked to obtain the geometry. The three-dimensional center displacements of the geometry, GTVc+s, GTVc, and GTVs as well as four selected metal clips were measured and compared. Results The center displacements of the geometry, GTVc+s, GTVc, and GTVs were 2.20, 0.90, 0.90, and 0.90 mm, respectively, in the left-right (LR) direction, 1.80, 1.20, 1.05, and 1.05 mm, respectively, in the anterior-posterior (AP) direction, and 2.70, 1.40, 1.20, and 0.80 mm, respectively, in the superior-inferior (SI) direction. For each of the geometry, GTVc+s, GTVc, and GTVs, there were no significant differences between the center displacements in the LR, AP and SI directions (χ2=2.05—3.84, P=0.147—0.359). In each of the LR, AP and SI directions, the geometry had a significantly larger displacement than GTVc+s, GTVc, GTVs, and the four selected clips (χ2=15.38—21.022, P=0.000—0.002). The center displacement of GTVc was larger than that of GTVs in the SI direction (Z=－2.05, P=0.041). Conclusions During free breathing, the geometry consisted of all the metal clips has a larger center displacement than GTVc+s, GTVc, GTVs, and the four selected metal clips in the LR, AP and SI directions, but there are no significant differences in center displacement between GTVc+s, GTVc, and GTVs.
Corresponding Authors:
LI Jian-bin, Email:lijianbin@msn.com
E-mail: lijianbin@msn.com
Cite this article:
DING Yun,LI Jian-bin,WANG Wei et al. Center displacement of surgical cavity delineated by metal clips and/or seroma on 4DCT in patients for external-beam partial breast irradiation:a comparative study[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 270-273.
DING Yun,LI Jian-bin,WANG Wei et al. Center displacement of surgical cavity delineated by metal clips and/or seroma on 4DCT in patients for external-beam partial breast irradiation:a comparative study[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 270-273.
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2013, Vol. 22 
