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EVALUATION STUDIES
JOURNAL ARTICLE
Evaluation of tissue computed tomography number changes and dosimetric shifts after conventional whole-breast irradiation in patients undergoing breast-conserving surgery.
Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine 2018 August
The aim of this study was to assess tissue computed tomography (CT) number changes and corresponding dosimetric shifts in repeatedly performed simulation CT (re-sim CT) scans after conventionally fractionated irradiation in breast cancer patients. A total of 28 breast cancer patients who underwent breast-conserving surgery were enrolled in this study. All the patients had received 50.4 Gy of conventional whole-breast irradiation (WBI) and underwent re-sim CT scans for tumor bed boost. For evaluation of dosimetric shifts between initial and re-sim CT scans, electron boost plans in the same field size with the same monitor unit with source-to-skin distance of 100 cm were conducted. Dosimetric parameters (V105% , V103% , V100% , V98% , V95% , V90% : Vx% indicates volumes which receive X% of prescribed doses) between initial and re-sim CT scans were compared. The CT number data (CTmean , CTmax , CTmin ) of the original and irradiated CT (re-sim CT) scans from each representative structure (lung, rib bone, soft tissue, muscle, etc.) were examined and recruited. CT numbers showed highly variable changes. Soft tissue CTmean and muscle CTmax /CTmin showed statistically and significantly increased values in the CT (re-sim CT) compared to the original CT scans. Rib bone CTmean /CTmin showed statistically and significantly decreased values in the re-sim CT compared to the original CT scans. Other CT number values showed no statistically significant changes. Among the dosimetric parameters, only V105% (p = 0.015, mean = 3.07 cc versus 1.63 cc) and V103% (p = 0.017, mean = 13.8 cc versus 11.9 cc) exhibited statistically increased values in the re-sim CT compared to the original CT scans. CT number changes after conventional WBI were different according to tissue component. For electron boost plans, the implementation of a re-sim CT might be helpfully considered because significant dosimetric factor changes were observed especially in the high-dose areas (hot spots: V105% and V103% ).
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