Abstract Objective To investigate the correlations between the displacements of surgical clips, skin markers and the gross tumor volume (GTV) delineated by surgical clip and seroma based on four-dimensional computed tomography (4DCT) during normal breathing. Methods On each of the 10 respiratory phases of 4DCT with 15 patients of breast cancer, the surgical cavity, which was defined as GTV and formed by both surgical clips and seroma, all surgical clips in the cavity, and skin markers on the skin were delineated by the same radiation oncologist. The center displacements of GTV, selected boundary surgical clips and skin markers in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions were recorded and analyzed by Pearson method. Results In the AP direction, there was a positive correlation between the displacements of the GTV and the inner clip (r=0.643, P=0.013). In the SI direction, the displacement of GTV was positively correlated with those of the lower clip and the skin marker at anterior body midline (r=0.857 and 0.643, P=0.002 and 0.013). In the LR and AP directions, there was a positive correlation between the displacements of the outer clip and the ipsilateral skin marker (r=0.757 and 0.697, P=0.001 and 0.025), but they were negatively correlated with each other in the SI direction (r=－0.647, P=0.043). In the AP direction, there was a positive correlation between the displacements of the inner clip and the skin marker at the anterior body midline (r=0.738, P=0.015). Conclusions The correlations between the displacement of GTV delineated by surgical clips and seroma and the displacements of surgical slips and skin markers vary under different conditions, and so does the correlation between the displacements of surgical clips and skin markers.
Ding Yun,Li Jianbin,Wang Wei et al. Correlations between displacements of GTV, surgical clips, and skin markers in external-beam partial breast irradiation:a study based on 4DCT[J]. Chinese Journal of Radiation Oncology, 2014, 23(3): 216-219.
Ding Yun,Li Jianbin,Wang Wei et al. Correlations between displacements of GTV, surgical clips, and skin markers in external-beam partial breast irradiation:a study based on 4DCT[J]. Chinese Journal of Radiation Oncology, 2014, 23(3): 216-219.
[1] Kirby AM,Coles CE,Yamold JR,et al.Target volume definition for external beam partial breast radiotherapy:clinical,pathological and technical studies informing current approaches[J]. Radiother Oncol,2010,94:255-263. [2] 王玮,李建彬.保乳术后外照射靶区位移的确定与校正[J].中华放射肿瘤学杂志,2011,20:259-262. [3] Kim LH,Goyal S,Haffty BG,et al. Using respiratory motion to guide planning target volume margins for external beam partial breast irradiation[J]. Int J Radiat Oncol Biol Phys,2012,82:1303-1306. [4] 徐敏,李建彬,范廷勇,等.早期乳腺癌保乳术后部分乳腺三维适形外照射的远期观察[J].中华放射肿瘤学杂志,2012,21:439-442. [5] Kader HA,Truong PT,Pai R,et al. When is CT-based postoperative seroma most useful to plan partial breast radiotherapy? Evaluation of clinical factors affecting seroma volume and clarity[J]. Int J Radiat Oncol Biol Phys,2008,72:1064-1069. [6] Yue NJ,Goyal S,Zhou J,et al. Intrafractional target motions and uncertainties of treatment setup reference systems in accelerated partial breast irradiation[J]. Int J Radiat Oncol Biol Phys,2011,79:1549-1556. [7] 刘翠翠,李建彬,范廷勇,等. 锥形束CT引导自助呼吸控制保乳术后三维适形部分乳腺外照射术腔金属夹位移的研究[J].中华放射肿瘤学杂志,2008,17:43-46. [8] Wang S, Li J, Wang W,et al. A study on the displacements of the clips in surgical cavity for external-beam partial breast irradiation after breast-conserving surgery based on 4DCT[J]. J Radiat Res,2012,53:433-438. [9] 王玮,李建彬,王素贞,等. 基于4DCT测定的保乳术后全乳调强放疗靶区位移的相关性研究[J].中华放射医学与防护杂志,2011,31:664-667. [10] Penninkhof J,Quint S,Boer Hd,et al. Surgical clips for position verification and correction of non-rigid breast tissue in simultaneously integrated boost (SIB) treatments[J]. Radiother Oncol,2009,90:110-115. [11] Topolnjak R,de Ruiter P,Remeijer P,et al. Image-guided radiotherapy for breast cancer patients:surgical clips as surrogate for breast excision cavity[J]. Int J Radiat Oncol Biol Phys,2011,81:e187-e195. [12] 李建彬,张秋实,马志芳.适度深吸气呼吸控制下部分乳腺外照射时不同参照物配准对银夹构成几何体位移的影响[J].中华肿瘤杂志,2013,35:921-924.
2014, Vol. 23 
