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    Reproducibility of a novel, vacuum-assisted immobilization for breast stereotactic radiotherapy

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    Author
    Snider, J.W.
    Nichols, E.M.
    Mutaf, Y.D.
    Chen, S.
    Molitoris, J.
    Diwanji, T.
    Becker, S.J.
    Feigenberg, S.J.
    Date
    2021-03-03
    Journal
    Journal of Applied Clinical Medical Physics
    Publisher
    John Wiley and Sons Ltd
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1002/acm2.13127
    Abstract
    A novel, breast-specific stereotactic radiotherapy device has been developed for delivery of highly conformal, accelerated partial breast irradiation. This device employs a unique, vacuum-assisted, breast cup immobilization system that applies a gentle, negative pressure to the target breast with the patient in the prone position. A device-specific patient loader is utilized for simulation scanning and device docking. Prior to clinical activation, a prospective protocol enrolled 25 patients who had been or were to be treated with breast conservation surgery and adjuvant radiotherapy for localized breast cancer. The patients underwent breast cup placement and two separate CT simulation scans. Surgical clips within the breast were mapped and positions measured against the device's integrated stereotactic fiducial/coordinate system to confirm reproducible and durable immobilization during the simulation, treatment planning, and delivery process for the device. Of the enrolled 25 patients, 16 were deemed eligible for analysis. Seventy-three clips (median, 4; mean, 4.6; range, 1-8 per patient) were mapped in these selected patients on both the first and second CT scans. X, Y, and Z coordinates were determined for the center point of each clip. Length of vector change in position was determined for each clip between the two scans. The mean displacement of implanted clips was 1.90 mm (median, 1.47 mm; range, 0.44-6.52 mm) (95% CI, 1.6-2.20 mm). Additional analyses stratified clips by position within the breast and depth into the immobilization cup. Overall, this effort validated the clinically utilized 3-mm planning target volume margin for accurate, reliable, and precise employment of the device. Copyright 2021 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine
    Keyword
    breast cancer
    stereotactic radiotherapy
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15207
    ae974a485f413a2113503eed53cd6c53
    10.1002/acm2.13127
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