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Sample records for breast irradiation techniques

  1. Irradiation techniques for the breast cancer treatment

    International Nuclear Information System (INIS)

    Varon T, C.F.; Rojas C, E.L.

    2007-01-01

    The radiotherapy is a cancer treatment way based on the radiation employment. It acts on the tumor, destroying the wicked cells and impeding that this it grows and reproduce. With the radiotherapy the probability of cure of some types of cancer; among them the one of breast, it increases. The investigations in oncology have allowed to develop new technologies with which is possible, for example, to locate the tumors accurately and to adapt the irradiation fields to their form. This has allowed to improve the treatments since it can destroy the tumor applying an intense radiation dose without producing irreversible damages to other organs and healthy tissues of the body. In the underdeveloped countries or in development as Mexico, and almost all those of Latin America, it is not still possible to have several of these technologies in the main oncological centers of the country by their high cost. It is expected that their cost go lowering and that its going to develop technologies more cheap so that they can be applied in more general way to the population that suffers of this suffering. (Author)

  2. Dosimetric comparison between techniques for irradiation of breast plastron

    International Nuclear Information System (INIS)

    Trinca, W.C.; Bruning, F.F.; Caldeira, F A.M.; Silveira, T.B da; Batista, D.V.S.; Andrade, R.R.

    2009-01-01

    Patients with breast cancer undergoing radical mastectomy has as an indication of adjuvancy the irradiation of the breast plastron. This paper makes a comparison between different techniques for treatment of breast plastron routinely used in the National Cancer Institute of Brazil (INCA): The irradiation with tangential fields of photons at 6 MV linear accelerator and irradiation with direct angled fields of electron beams of 6 and 9 MeV. We performed dosimetric comparisons in a tissue-equivalent phantom with the use of radiochromic films for verification of coverage and homogeneity of dose for all technical requirements. Tangential fields in the coverage and homogeneity were satisfactory and well cover the clinical aspects as well as beam 9 MeV, despite a small loss at the edge of the external field. Already in 6 MeV beam, there was significant loss in the end, with significant subdoses of 3 cm in the last field. (author)

  3. Development of breast cancer irradiation technique for BNCT at JRR-4

    International Nuclear Information System (INIS)

    Nakamura, Takemi; Horiguchi, Hironori; Arai, Masaji; Yanagie, Hironobu

    2014-06-01

    In the Department of Research Reactor and Tandem Accelerator, developments of irradiation technique with application enlargement for breast cancer on BNCT have been performed in the second medium term plans. We compiled this report about the technological development to solve several problems with the irradiation of breast cancer in the medical irradiation facility of JRR-4. In the present study, design fabrication of a collimator for breast cancer, dose evaluation analysis by clinical model, investigation of dose enhancement at deeper region and investigation of fixing method for breast cancer irradiation were studied. By these evaluation results, we verified that the developed breast cancer irradiation technique can be applied to BNCT medical irradiation of JRR-4. These results are expected to be able to contribute to breast cancer irradiation techniques of other reactor-based BNCT and future accelerator-based BNCT. (author)

  4. An improved technique for breast cancer irradiation including the locoregional lymph nodes

    NARCIS (Netherlands)

    Hurkmans, C. W.; Saarnak, A. E.; Pieters, B. R.; Borger, J. H.; Bruinvis, I. A.

    2000-01-01

    PURPOSE: To find an irradiation technique for locoregional irradiation of breast cancer patients which, compared with a standard technique, improves the dose distribution to the internal mammary-medial supraclavicular (IM-MS) lymph nodes. The improved technique is intended to minimize the lung dose

  5. Breast radiotherapy in the lateral decubitus position: A technique to prevent lung and heart irradiation

    International Nuclear Information System (INIS)

    Campana, Francois; Kirova, Youlia M.; Rosenwald, Jean-Claude; Dendale, Remi; Vilcoq, Jacques R.; Dreyfus, Helene; Fourquet, Alain

    2005-01-01

    Purpose: To present an original technique for breast radiotherapy, with the aim of limiting lung and heart irradiation, satisfying quality assurance criteria. Methods and Material: An original radiotherapy technique for breast irradiation has been developed at the Institute Curie in January 1996. It consists of isocentric breast irradiation in the lateral decubitus position (isocentric lateral decubitus [ILD]). This technique is indicated for voluminous or pendulous breasts needing breast irradiation only. Thin carbon fiber supports and special patient positioning devices have been developed especially for this technique. In vivo measurements were performed to check the dose distribution before the routine use of the technique. Results: ILD has been successfully implemented in routine practice, and 500 patients have been already treated. Breast radiotherapy is performed using a dose of 50 Gy at ICRU point in 25 fractions. ILD shows good homogeneity of the dose in breast treatment volume, treatment fields are perpendicular to the skin ensuring its protection, and extremely low dose is delivered to the underlying lung and heart. Conclusion: In cases of voluminous breasts or patients with a history of lung and heart disease, our technique provides several advantages over the conventional technique with opposing tangential fields. This technique improves the dose homogeneity according to the ICRU recommendations

  6. Accelerated partial breast irradiation utilizing balloon brachytherapy techniques

    International Nuclear Information System (INIS)

    Strauss, Jonathan B.; Dickler, Adam

    2009-01-01

    To overcome the barriers to BCT, methods of PBI in the setting of breast conservation have been explored. The method of PBI with the longest published follow-up is multi-catheter interstitial brachytherapy. Balloon-based brachytherapy with the MammoSite brachytherapy applicator was designed to simplify the brachytherapy procedure for PBI, enhance the reproducibility of the dosimetry, and improve patient comfort. The rates of local recurrence following PBI with the MammoSite applicator have been low, but there are few published reports and follow-up has been relatively short. The cosmetic outcomes and toxicity of MammoSite PBI are comparable to those seen after multicatheter-based PBI. Additional methods of balloon brachytherapy, including Xoft and SenoRx Contura have been developed. Finally, long-term follow-up after PBI is important for the welfare of individual patients and in order to establish the efficacy, late toxicity and cosmetic outcomes of this technique.

  7. Which techniques for an additional irradiation of the tumour bed in a breast cancer?

    International Nuclear Information System (INIS)

    Chenna, H.; Iraqi, M.; Ahmedou, M.M.; Berhil, H.; El Kacemi, H.; Hassouni, K.; Kebdani, T.; Benjaafar, N.; El Gueddari, B.K.

    2010-01-01

    The authors report a comparison of different techniques for an additional irradiation of the tumour bed, in terms of local control and aesthetic result in the case of a breast cancer. This additional irradiation has been delivered by electron beam in five fractions, high dose rate curie-therapy in two fractions, photon beam in five or six fractions, and low dose rate curie-therapy. The dose increase in the tumour bed allows the local control rate to be increased without compromising aesthetic results. However, the comparison of the different boost techniques does not reveal significant differences. Short communication

  8. Comparison of two sus clavicular irradiation techniques in the breast cancer

    International Nuclear Information System (INIS)

    Boukhelif, W.; Henni, M.; Abrous-Anane, S.; Maisonobe, J.A.; Klotz, S.; Leignel, D.; Dessard-Diana, B.; Giraud, P.; Durdux, C.; Housset, M.

    2009-01-01

    Purpose: to compare the irradiation of the sub clavicular area by a non coplanar beam with the irradiation by a classical beam in the breast cancer. Conclusion: In the breast cancer, the non coplanar irradiation of sub clavicular ganglions allows to better protect the lungs comparatively to the classical irradiation and that without modifying the coverage of the sub clavicular target volume. (N.C.)

  9. Implementation of the technique of partial irradiation accelerated the breast with high doses (HDR) brachytherapy

    International Nuclear Information System (INIS)

    Molina Lopez, M. Y.; Pardo Perez, E.; Castro Novais, J.; Martinez Ortega, J.; Ruiz Maqueda, S.; Cerro Penalver, E. del

    2013-01-01

    The objective of this work is presents procedure carried out in our Centre for the implementation of the accelerated partial breast irradiation (APBI, accelerated partial-breast irradiation) with high-rate brachytherapy (HDR), using plastic tubes as applicators. Carried out measures, the evaluation of the dosimetric parameters analyzing and presenting the results. (Author)

  10. A simple isocentric technique for irradiation of the breast, chest wall and peripheral lymphatics

    International Nuclear Information System (INIS)

    Podgorsak, E.B.; Gosselin, M.; Pla, M.; Kim, T.H.; Freeman, C.R.

    1984-01-01

    The major problem with the standard technique for irradiation of the breast or chest wall and peripheral lymphatics is field matching at the junction between the supraclavicular and tangential fields. Overdosing or underdosing across the junctions is unavoidable because of beam divergence. Various techniques using a half-blocked supraclavicular field in conjunction with special tangential fields have been introduced recently to eliminate the junction problem; they are, however, complicated, involving couch motions and machine isocentre repositioning when changing from the supraclavicular to the tangential fields. The breast treatment technique used by the authors over the past twelve months utilises a supraclavicular half-blocked field, two tangential half-blocked fields and an optional posterior axillary field. The technique is simple and easy to set up since the same machine isocentre is used for all treatment fields and no couch movement or patient repositioning is required. The same half-block collimator used to define the caudad border of the supraclavicular field is used to define the cephalad edges of the two tangential fields. The margin of error of treatment is reduced and the dose measurements demonstrate excellent dose homogeneity through the entire treatment volume with no overdose or underdose at the field junction. (author)

  11. Advantages of the technique with segmented fields for tangential breast irradiation

    International Nuclear Information System (INIS)

    Stefanovski, Zoran; Smichkoska, Snezhana; Petrova, Deva; Lazarova, Emilija

    2013-01-01

    In the case of breast cancer, the prominent role of radiation therapy is an established fact. Depending on the stage of the disease, the breast is most often irradiated with two tangential fields and a direct supraclavicular field. Planning target volume is defined through the recommendations in ICRU Reports 50 and 62. The basic ‘dogma’ of radiotherapy requires the dose in the target volume to be homogenous. The favorable situation would be if the dose width was between 95% and 107%; this, however, is often not possible to be fulfilled. A technique for enhancement of homogeneity of isodose distribution would be using one or more additional fields, which will increase the dose in the volume where it is too low. These fields are called segmented fields (a technique also known as ‘field in field’) because they occupy only part of the primary fields. In this study we will show the influence of this technique on the dose homogeneity improvement in the PTV region. The mean dose in the target volume was increased from 49.51 Gy to 50.79 Gy in favor of the plans with segmented fields; and the dose homogeneity (measured in standard deviations) was also improved - 1.69 vs. 1.30. The increase in the target volume, encompassed by 95% isodose, was chosen as a parameter to characterize overall planning improvement. Thus, in our case, the improvement of dose coverage was from 93.19% to 97.06%. (Author)

  12. Measurement of mean cardiac dose for various breast irradiation techniques and corresponding risk of major cardiovascular event.

    Directory of Open Access Journals (Sweden)

    Tomas Rodrigo Merino Lara

    2014-10-01

    Full Text Available After breast conserving surgery, early stage breast cancer patients are currently treated with a wide range of radiation techniques including whole breast irradiation (WBI, accelerated partial breast irradiation (APBI using high dose rate (HDR brachytherapy, or 3D conformal radiotherapy (3D-CRT. This study compares the mean heart’s doses for a left breast irradiated with different breast techniques.An anthropomorphic Rando phantom was modified with gelatin-based breast of different sizes and tumors located medially or laterally. The breasts were treated with WBI, 3D-CRT or HDR APBI. The heart’s mean doses were measured with Gafchromic films and controlled with optically stimulated luminescent dosimeters (OSLDs. Following the model reported by Darby (16, major cardiac were estimated assuming a linear risk increase with the mean dose to the heart of 7.4% per gray.Whole breast irradiation lead to the highest mean heart dose (2.99 Gy compared to 3D-CRT APBI, (0.51 Gy, multicatheter (1.58 Gy and balloon HDR (2.17 Gy for a medially located tumor. This translated into long-term coronary event increases of 22%, 3.8%, 11.7%, and 16% respectively. The sensitivity analysis showed that the tumor location had almost no effect on the mean heart dose for 3D-CRT APBI and a minimal impact for HDR APBI. For WBI large breast size and set-up errors lead to sharp increases of the mean heart dose. Its value reached 10.79 Gy for women with large breast and a set-up error of 1.5 cm. Such a high value could increase the risk of having long-term coronary events by 80%.Comparison among different irradiation techniques demonstrates that 3D-CRT APBI appears the safest one with less probability of having cardiovascular events in the future. A sensitivity analysis showed that WBI is the most challenging technique for patients with large breasts or when significant set-up errors are anticipated. In those cases additional heart shielding techniques are required.

  13. Comparison of normal tissue dose with three-dimensional conformal techniques for breast cancer irradiation including the internal mammary nodes

    NARCIS (Netherlands)

    van der Laan, Hans Paul; Dolsma, Willemtje; van t Veld, Aart; Bijl, HP; Langendijk, JA

    2005-01-01

    PURPOSE: To compare the Para Mixed technique for irradiation of the internal mammary nodes (IMN) with three commonly used strategies, by analyzing the dose to the heart and other organs at risk. METHODS AND MATERIALS: Four different three-dimensional conformal dose plans were created for 30 breast

  14. Impact of Volumetric Modulated Arc Therapy Technique on Treatment With Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Qiu Jianjian; Chang Zheng; Wu, Q. Jackie; Yoo, Sua; Horton, Janet; Yin Fangfang

    2010-01-01

    Purpose: To investigate the technical feasibility of volumetric modulated arc therapy (V-MAT) in the delivery of partial breast irradiation (PBI). Methods and Materials: V-MAT and the standard, three-dimensional conformal radiotherapy (3D-CRT), were compared retrospectively in 8 patients previously treated with PBI. These patients' plans were replanned with a single partial arc using V-MAT that included partial blocking to minimize normal tissue dose. Dosimetric parameters were calculated to evaluate plan quality. Quality assurance studies included verifying both the point and the multiple planar doses. Total monitor units and delivery time were also evaluated, and collision clearance was analyzed. Results: Volumes of ipsilateral lung irradiated to 10 Gy (V10) and 20 Gy (V20) by V-MAT were significantly less than those of 3D-CRT (p = 0.03 for V10 and p = 0.025 for V20). The volume of ipsilateral breast irradiated to 5 Gy was significantly less by using V-MAT than with 3D-CRT (p = 0.02), with a ratio of integrated dose of <1.00. The total mean monitor units (489 ± 38) for V-MAT were significantly less than those for 3D-CRT (634 ± 123) (p = 0.017), with a 23% reduction. The average machine delivery time was 1.21 ± 0.10 min for the V-MAT plans and 6.28 ± 1.40 min for the 3D-CRT plans, resulting in a reduction factor of 80.1%. The conformity indexes were 1.3 in the V-MAT plans and 1.5 in the 3D-CRT plans (p = 0.102). Conclusions: V-MAT technology is feasible for PBI patients. Compared to a conventional 3D-CRT technique, it is more efficient, offers equivalent or better dose conformity, delivers lower doses to the ipsilateral lung and breast, and may potentially reduce intrafractional motion.

  15. Three dimensional conformal radiotherapy for synchronous bilateral breast irradiation using a mono iso-center technique

    Science.gov (United States)

    Mani, Karthick Raj; Basu, Saumen; Bhuiyan, Md Anisuzzaman; Ahmed, Sharif; Sumon, Mostafa Aziz; Haque, Kh Anamul; Sengupta, Ashim Kumar; Un Nabi, Md Rashid; Das, K. J. Maria

    2017-06-01

    Objective: The purpose of this study is to demonstrate the synchronous bilateral breast irradiation radiotherapy technique using a single isocenter. Materials and Methods: Six patients of synchronous bilateral breast were treated with single isocenter technique from February 2011 to June 2016. All the patients underwent a CT-simulation using appropriate positioning device. Target volumes and critical structures like heart, lung, esophagus, thyroid, etc., were delineated slice by slice in the CT data. An isocenter was placed above the sternum on the skin and both medial tangential and lateral tangential of the breast / chest wall were created using asymmetrical jaws to avoid the beam divergence through the lung and heart. The field weighting were adjusted manually to obtain a homogenous dose distribution. The planning objectives were to deliver uniform doses around the target and keep the doses to the organ at risk within the permissible limit. The beam energy of 6 MV or combination of 6 MV and 15 MV photons were used in the tangential fields according to the tangential separation. Boluses were used for all the mastectomy patients to increase the doses on the chest wall. In addition to that enhanced dynamic wedge and field in field technique were also used to obtain a homogenous distribution around the target volume and reduce the hot spots. The isocenter was just kept on the skin, such that the beam junctions will be overlapped only on the air just above the sternum. Acute toxicity during the treatment and late toxicity were recorded during the patient's follow-up. Results: During the radiotherapy treatment follow-up there were no acute skin reactions in the field junctions, but one patient had grade 1 esophagitis and two patients had grade 2 skin reactions in the chest wall. With a median follow-up of 38.5 months (range: 8 - 49 months), no patients had a local recurrence, but one patients with triple negative disease had a distant metastases in brain and died

  16. Dosimetric comparison of proton and photon three-dimensional, conformal, external beam accelerated partial breast irradiation techniques

    International Nuclear Information System (INIS)

    Kozak, Kevin R.; Katz, Angela; Adams, Judith C.; Crowley, Elizabeth M.; Nyamwanda, Jacqueline A.C.; Feng, Jennifer K.C.; Doppke, Karen P.; DeLaney, Thomas F.; Taghian, Alphonse G.

    2006-01-01

    Purpose: To compare the dosimetry of proton and photon-electron three-dimensional, conformal, external beam accelerated partial breast irradiation (3D-CPBI). Methods and Materials: Twenty-four patients with fully excised, Stage I breast cancer treated with adjuvant proton 3D-CPBI had treatment plans generated using the mixed-modality, photon-electron 3D-CPBI technique. To facilitate dosimetric comparisons, planning target volumes (PTVs; lumpectomy site plus 1.5-2.0 cm margin) and prescribed dose (32 Gy) were held constant. Plans were optimized for PTV coverage and normal tissue sparing. Results: Proton and mixed-modality plans both provided acceptable PTV coverage with 95% of the PTV receiving 90% of the prescribed dose in all cases. Both techniques also provided excellent dose homogeneity with a dose maximum exceeding 110% of the prescribed dose in only one case. Proton 3D-CPBI reduced the volume of nontarget breast tissue receiving 50% of the prescribed dose by an average of 36%. Statistically significant reductions in the volume of total ipsilateral breast receiving 100%, 75%, 50%, and 25% of the prescribed dose were also observed. The use of protons resulted in small, but statistically significant, reductions in the radiation dose delivered to 5%, 10%, and 20% of ipsilateral and contralateral lung and heart. The nontarget breast tissue dosimetric advantages of proton 3D-CPBI were not dependent on tumor location, breast size, PTV size, or the ratio of PTV to breast volume. Conclusions: Compared to photon-electron 3D-CPBI, proton 3D-CPBI significantly reduces the volume of irradiated nontarget breast tissue. Both approaches to accelerated partial breast irradiation offer exceptional lung and heart sparing

  17. Dosimetric comparison between intra-cavitary breast brachytherapy techniques for accelerated partial breast irradiation and a novel stereotactic radiotherapy device for breast cancer: GammaPod™

    Science.gov (United States)

    Ödén, Jakob; Toma-Dasu, Iuliana; Yu, Cedric X.; Feigenberg, Steven J.; Regine, William F.; Mutaf, Yildirim D.

    2013-07-01

    The GammaPod™ device, manufactured by Xcision Medical Systems, is a novel stereotactic breast irradiation device. It consists of a hemispherical source carrier containing 36 Cobalt-60 sources, a tungsten collimator with two built-in collimation sizes, a dynamically controlled patient support table and a breast immobilization cup also functioning as the stereotactic frame for the patient. The dosimetric output of the GammaPod™ was modelled using a Monte Carlo based treatment planning system. For the comparison, three-dimensional (3D) models of commonly used intra-cavitary breast brachytherapy techniques utilizing single lumen and multi-lumen balloon as well as peripheral catheter multi-lumen implant devices were created and corresponding 3D dose calculations were performed using the American Association of Physicists in Medicine Task Group-43 formalism. Dose distributions for clinically relevant target volumes were optimized using dosimetric goals set forth in the National Surgical Adjuvant Breast and Bowel Project Protocol B-39. For clinical scenarios assuming similar target sizes and proximity to critical organs, dose coverage, dose fall-off profiles beyond the target and skin doses at given distances beyond the target were calculated for GammaPod™ and compared with the doses achievable by the brachytherapy techniques. The dosimetric goals within the protocol guidelines were fulfilled for all target sizes and irradiation techniques. For central targets, at small distances from the target edge (up to approximately 1 cm) the brachytherapy techniques generally have a steeper dose fall-off gradient compared to GammaPod™ and at longer distances (more than about 1 cm) the relation is generally observed to be opposite. For targets close to the skin, the relative skin doses were considerably lower for GammaPod™ than for any of the brachytherapy techniques. In conclusion, GammaPod™ allows adequate and more uniform dose coverage to centrally and peripherally

  18. Design and implementation of a rotational radiotherapy technique for breast cancer treatment and their comparison with 3-D-Crt irradiation technique

    International Nuclear Information System (INIS)

    Gutierrez M, J. G.; Lopez V, A.; Rivera M, T.; Velazquez T, J. J.; Adame G, C. S.; Rubio N, O.; Chagoya G, A.; Hernandez G, J. C.

    2015-10-01

    Breast cancer is one of oncological diseases worldwide, as well in Mexico, which causes even more deaths than cervical cancer; this condition is the second death cause in women aged 30-54 years and threatens all socio-economic groups. The treatment is highly dependent on the stage which is detected and based on protocols that include a combination of surgery, chemotherapy and radiotherapy. This paper studies the main irradiation technique for patients with mastectomy, breast full cycle (irradiation of the chest well and supraclavicular nodes) in their mode Three Dimensional - Conformal Radiation Therapy (3-D-Crt), and compared with the Volumetric Modulated Arc Therapy (VMAT) technique proposed in this paper. In both techniques the prescription was 50 Gy divided into 25 fractions. The techniques were applied in three female patients (being an initial study) with disease of the left side, the target volume and organs at risk were delineated by the medical treating radiation oncologist, the planning system used was Eclipse version 10; for quantitative comparison of both plans indexes of homogeneity were used, con formality, the target volume coverage and normal tissue, sub factors and overdosing, the conformation number and coverage quality. They were evaluated and compared the media, maximum and minimum dose of the organs at risk, based on the fact that the coverage of the target volume, dose gradient and dose at risk organs are acceptable (prescription dose greater that 90% coverage, gradient less that 20% and organs at risk in accordance with the Quantec limitations for both versions). (Author)

  19. Evaluation of set-up deviations during the irradiation of patients suffering from breast cancer treated with two different techniques

    International Nuclear Information System (INIS)

    KukoIowicz, Pawel Franciszek; Debrowski, Andrzej; Gut, Piotr; Chmielewski, Leszek; Wieczorek, Andrzej; Kedzierawski, Piotr

    2005-01-01

    Purpose: To compare reproducibility of set-up for two different treatment techniques for external irradiation of the breast. Methods and materials: In total, the analysis comprised 56 pairs of portal and simulator films for 14 consecutive patients treated following breast conserving therapy and 98 pairs of portal and simulator films for 20 consecutive patients treated after mastectomy. For the first group the tangential field technique (TF technique) was used, for the second the inverse hockey stick technique (IHS technique). Evaluation of the treatment reproducibility was performed in terms of systematic and random error calculated for the whole groups, comparison of set-up accuracy by means of comparison of cumulative distribution of the length of the displacement vector. Results: In the IHS and TF techniques for medial and lateral fields, displacement larger than 5 mm occurred in 28.3, 15.8 and 25.4%, respectively. For the IHS technique, the systematic errors for lateral and cranial-caudal direction were 1.9 and 1.7 mm, respectively (1 SD), the random errors for lateral and cranial-caudal direction were 2.0 and 2.5 mm. For the TF technique, the systematic errors for ventral-dorsal and cranial-caudal direction were 2.6 and 1.3 mm for medial field and 3.7 and 0.7 mm for lateral fields, respectively, the random errors for lateral and cranial-caudal direction were 2.2 and 1.0 mm for medial field and 2.9 and 1.1 for lateral field, respectively. Rotations were negligible in the IHS technique. For the TF technique the systematic and random components amounted to about 2.0 degrees (1 SD). Conclusions: Both the inverse hockey stick and standard tangential techniques showed good reproducibility of patients' set-up with respect to cranial-caudal direction. For the TF technique, the accuracy should be improved for the medial field with respect to the ventral-dorsal direction

  20. Investigation of normal tissue complication probabilities in prostate and partial breast irradiation radiotherapy techniques

    International Nuclear Information System (INIS)

    Bezak, E.; Takam, R.; Bensaleh, S.; Yeoh, E.; Marcu, L.

    2011-01-01

    Full text: Normal- Tissue-Complication Probabilities of rectum, bladder and urethra following various radiation techniques for prostate cancer were evaluated using the relative-seriality and Lyman models. NTCPs of lungs, heart and skin, their dependence on sourceposition, balloon-deformation were also investigated for HDR mammosite brachytherapy. The prostate treatment techniques included external three dimentional conformal-radiotherapy, Low-Dose-Rate brachytherapy (1-125), High-Dose-Rate brachytherapy (Ir-I92). Dose- Volume-Histograms of critical structures for prostate and breast radiotherapy, retrieved from corresponding treatment planning systems, were converted to Biological Effective Dose (BEffD)-based and Equivalent Dose(Deq)-based DVHs to account for differences in radiation delivery and fractionation schedule. Literature-based model parameters were used to calculate NTCPs. Hypofractionated 3D-CRT (2.75 Gy/fraction, total dose 55 Gy) NTCPs of rectum, bladder and urethra were less than those for standard fractionated 4-field 3D-CRT (2-Gy/fraction, 64 Gy) and dose-escalated 4- and 5-field 3D-CRT (74 Gy). Rectal and bladder NTCPs (5.2% and 6.6%) following the dose-escalated 4-field 3D-CRT (74 Gy) were the highest among analyzed techniques. The average NTCP for rectum and urethra were 0.6% and 24.7% for LDRBT and 0.5% and 11.2% for HDR-BT. For Mammosite, NTCP was estimated to be 0.1 %, 0.1 %, 1.2% and 3.5% for skin desquamation, erythema, telangiectasia and fibrosis respectively (the source positioned at the balloon centre). A 4 mm Mammosite-balloon deformation leads to overdosing of PTV regions by ∼40%, resulting in excessive skin dose and increased NTCP. Conclusions Prostate brachytherapy resulted in NTCPs lower compared to external beam techniques. Mammosite-brachytherapy resulted in no heart/lung complications regardless of balloon deformation. However, 4 mm deformation caused 0.6% increase in tissue fibrosis NTCP.

  1. Accelerated partial breast irradiation using intensity-modulated radiotherapy technique compared to whole breast irradiation for patients aged 70 years or older: subgroup analysis from a randomized phase 3 trial.

    Science.gov (United States)

    Meattini, Icro; Saieva, Calogero; Marrazzo, Livia; Di Brina, Lucia; Pallotta, Stefania; Mangoni, Monica; Meacci, Fiammetta; Bendinelli, Benedetta; Francolini, Giulio; Desideri, Isacco; De Luca Cardillo, Carla; Scotti, Vieri; Furfaro, Ilaria Francesca; Rossi, Francesca; Greto, Daniela; Bonomo, Pierluigi; Casella, Donato; Bernini, Marco; Sanchez, Luis; Orzalesi, Lorenzo; Simoncini, Roberta; Nori, Jacopo; Bianchi, Simonetta; Livi, Lorenzo

    2015-10-01

    The purpose of this study was to report the efficacy and the safety profile on the subset of selected early breast cancer (BC) patients aged 70 years or older from a single-center phase 3 trial comparing whole breast irradiation (WBI) to accelerated partial breast irradiation (APBI) using intensity-modulated radiation therapy technique. Between 2005 and 2013, 520 patients aged more than 40 years old were enrolled and randomly assigned to receive either WBI or APBI in a 1:1 ratio. Eligible patients were women with early BC (maximum diameter 2.5 cm) suitable for breast conserving surgery. This study is registered with ClinicalTrials.gov, NCT02104895. A total of 117 patients aged 70 years or more were analyzed (58 in the WBI arm, 59 in the APBI arm). At a median follow-up of 5-years (range 3.4-7.0), the ipsilateral breast tumor recurrence (IBTR) rate was 1.9 % in both groups. No significant difference between the two groups was identified (log-rank test p = 0.96). The 5-year disease-free survival (DFS) rates in the WBI group and APBI group were 6.1 and 1.9 %, respectively (p = 0.33). The APBI group presented significantly better results in terms of acute skin toxicity, considering both any grade (p = 0.0001) and grade 2 or higher (p = 0.0001). Our subgroup analyses showed a very low rate and no significant difference in terms of IBTR, using both WBI and APBI. A significant impact on patients compliance in terms of acute and early late toxicity was shown, which could translate in a consistent improvement of overall quality of life.

  2. Special irradiation techniques

    International Nuclear Information System (INIS)

    Colomez, Gerard; Veyrat, J.F.

    1981-01-01

    Irradiation trials conducted on materials-testing reactors should provide a better understanding of the phenomena which characterize the working and evolution in time of electricity-generating nuclear reactors. The authors begin by outlining the objectives behind experimental irradiation (applied to the various nuclear chains) and then describe the special techniques deployed to achieve these objectives [fr

  3. Microwave Breast Imaging Techniques

    DEFF Research Database (Denmark)

    Zhurbenko, Vitaliy; Rubæk, Tonny

    2010-01-01

    This paper outlines the applicability of microwave radiation for breast cancer detection. Microwave imaging systems are categorized based on their hardware architecture. The advantages and disadvantages of various imaging techniques are discussed. The fundamental tradeoffs are indicated between...... various requirements to be fulfilled in the design of an imaging system for breast cancer detection and some strategies to overcome these limitations....

  4. Accelerated partial breast irradiation

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Whole breast radiotherapy afier tumor lumpectomy is based on the premise that that the breast cancer recurrence rate is reduced through the elimination of residual cancer foci in the remaining tissue immediately adjacent to the lumpectomy site and occult multicentric areas of in situ or infiltrating cancer in remote areas of the breast. The relevance of remote foci to ipsilateral breast failure rates after breast conserving treatment is debatable, because 65%~100% of recurrences develop in the same quadrant as the initial tumor. This has led several investigators to question whether radiotherapy must be administered to the entire breast.

  5. Craniospinal irradiation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Scarlatescu, Ioana, E-mail: scarlatescuioana@gmail.com; Avram, Calin N. [Faculty of Physics, West University of Timisoara, Bd. V. Parvan 4, 300223 Timisoara (Romania); Virag, Vasile [County Hospital “Gavril Curteanu” - Oradea (Romania)

    2015-12-07

    In this paper we present one treatment plan for irradiation cases which involve a complex technique with multiple beams, using the 3D conformational technique. As the main purpose of radiotherapy is to administrate a precise dose into the tumor volume and protect as much as possible all the healthy tissues around it, for a case diagnosed with a primitive neuro ectoderm tumor, we have developed a new treatment plan, by controlling one of the two adjacent fields used at spinal field, in a way that avoids the fields superposition. Therefore, the risk of overdose is reduced by eliminating the field divergence.

  6. A Dosimetric Comparison of Accelerated Partial Breast Irradiation Techniques: Multicatheter Interstitial Brachytherapy, Three-Dimensional Conformal Radiotherapy, and Supine Versus Prone Helical Tomotherapy

    International Nuclear Information System (INIS)

    Patel, Rakesh R.; Becker, Stewart J.; Das, Rupak K.; Mackie, Thomas R.

    2007-01-01

    Purpose: To compare dosimetrically four different techniques of accelerated partial breast irradiation (APBI) in the same patient. Methods and Materials: Thirteen post-lumpectomy interstitial brachytherapy (IB) patients underwent imaging with preimplant computed tomography (CT) in the prone and supine position. These CT scans were then used to generate three-dimensional conformal radiotherapy (3D-CRT) and prone and supine helical tomotherapy (PT and ST, respectively) APBI plans and compared with the treated IB plans. Dose-volume histogram analysis and the mean dose (NTD mean ) values were compared. Results: Planning target volume coverage was excellent for all methods. Statistical significance was considered to be a p value mean dose of 1.3 Gy 3 and 1.2 Gy 3 , respectively. Both of these methods were statistically significantly lower than the supine external beam techniques. Overall, all four methods yielded similar low doses to the heart. Conclusions: The use of IB and PT resulted in greater normal tissue sparing (especially ipsilateral breast and lung) than the use of supine external beam techniques of 3D-CRT or ST. However, the choice of APBI technique must be tailored to the patient's anatomy, lumpectomy cavity location, and overall treatment goals

  7. Irradiation techniques for the breast cancer treatment; Tecnicas de irradiacion para el tratamiento de cancer de mama

    Energy Technology Data Exchange (ETDEWEB)

    Varon T, C F; Rojas C, E L [ININ, 52750 La Marquesa, Estado de Mexico (Mexico)

    2007-07-01

    The radiotherapy is a cancer treatment way based on the radiation employment. It acts on the tumor, destroying the wicked cells and impeding that this it grows and reproduce. With the radiotherapy the probability of cure of some types of cancer; among them the one of breast, it increases. The investigations in oncology have allowed to develop new technologies with which is possible, for example, to locate the tumors accurately and to adapt the irradiation fields to their form. This has allowed to improve the treatments since it can destroy the tumor applying an intense radiation dose without producing irreversible damages to other organs and healthy tissues of the body. In the underdeveloped countries or in development as Mexico, and almost all those of Latin America, it is not still possible to have several of these technologies in the main oncological centers of the country by their high cost. It is expected that their cost go lowering and that its going to develop technologies more cheap so that they can be applied in more general way to the population that suffers of this suffering. (Author)

  8. SU-F-T-418: Evaluation of Organs at Risk (OAR) Sparing in Left Breast Irradiation Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Saini, A [Oviedo, FL (United States); Hwang, C [FLHOSP, Altamonte Springs, Florida (United States); Das, I [Indiana University- School of Medicine, Indianapolis, IN (United States)

    2016-06-15

    Purpose: To compare dose to organs at risk (OAR) for left sided breast radiation therapy with comparable planning target volume (PTV) coverage in three techniques; free breathing in supine position (FB), deep inspirational breath hold in supine (DIBH) and free breathing in prone position (PP). Methods: Ten left sided breast cancer patients suitable for this study underwent a CT scan in three techniques e.g. supine, FB and DIBH and prone position (PP). One radiation oncologist contoured the PTV and OAR (cardiac components) based on RTOG guidelines. Treatment plans were optimized using field-in-field technique with AAA algorithm. Each plan was optimized to provide identical coverage to PTV such that a reasonable comparison in OAR dosimetry can be evaluated. The prescribed dose to PTV were 42.56 Gy; 2.66 Gy in 16 fractions. Results: Average lung dose parameters; Dmean, V10, V20 and V30 were 0.5 Gy, 0.6%, 0.2%, and 0.1% respectively in PP which is significantly lower than FB (5.9 Gy, 14.2%, 10.7 %, and 8.4%) and DIBH (5.8 Gy, 14.3%, 10.2%, 7.8%). Similarly average heart Dmean, V2.5, V5, V10, and V20 were much lower in PP (1.2Gy, 9.1%, 2.1%, 0.8%, and 0.4%), and in DIBH (1.2 Gy, 10.6%, 1.7%, 0.5%, and 0.1%) compared to FB (2.6 Gy, 21%, 7.2%, 4.4% and 3.3%) respectively. Similar findings were also noted in the heart component left anterior descending artery (LAD) and Left ventricle (LV) which are correlated to radiation related toxicity. Conclusion: Based on the calculated dose, FB technique provides highest heart and lung dose. Prone has lowest lung dose, and DIBH has lowest LAD dose. It is found that PP is always superior for heart, LV, LAD and lung as compared to FB. This conclusion is in contrast to some published study concluding that prone position has no benefit for heart sparing.

  9. Recent advances in radiotherapy: Partial Breast Irradiation (PBI) in breast cancer patients after breast conserving surgery

    International Nuclear Information System (INIS)

    Niwinska, A.

    2003-01-01

    The interest in accelerated partial breast irradiation (PBI) after conservative surgery has increased over the past decade as a result of many factors, including clinical and pathological data questioning the efficacy of whole breast irradiation in highly selected patients, as well as factors related to patient's convenience. High dose rate and low dose rate brachytherapy, brachytherapy MammoSite, Electron Intraoperative Therapy - ELIOT and Targeted Intraoperative Radiotherapy - TARGIT are the subject of investigation. The tolerability and efficacy of the treatment are of special interest. In this review article, methods of accelerated PBI, eligibility criteria, techniques of radiotherapy, early results and side effects are reviewed. (author)

  10. Geometric and Dosimetric Approach to Determine Probability of Late Cardiac Mortality in Left Tangential Breast Irradiation: Comparison Between Wedged Beams and Field-in-Field Technique

    International Nuclear Information System (INIS)

    Pili, Giorgio; Grimaldi, Luca; Fidanza, Christian; Florio, Elena T.; Petruzzelli, Maria F.; D'Errico, Maria P.; De Tommaso, Cristina; Tramacere, Francesco; Musaio, Francesca; Castagna, Roberta; Francavilla, Maria C.; Gianicolo, Emilio A.L.; Portaluri, Maurizio

    2011-01-01

    Purpose: To evaluate the probability of late cardiac mortality resulting from left breast irradiation planned with tangential fields and to compare this probability between the wedged beam and field-in-field (FIF) techniques and to investigate whether some geometric/dosimetric indicators can be determined to estimate the cardiac mortality probability before treatment begins. Methods and Materials: For 30 patients, differential dose-volume histograms were calculated for the wedged beam and FIF plans, and the corresponding cardiac mortality probabilities were determined using the relative seriality model. As a comparative index of the dose distribution uniformity, the planning target volume (PTV) percentages involved in 97-103% of prescribed dose were determined for the two techniques. Three geometric parameters were measured for each patient: the maximal length, indicates how much the heart contours were displaced toward the PTV, the angle subtended at the center of the computed tomography slice by the PTV contour, and the thorax width/thickness ratio. Results: Evaluating the differential dose-volume histograms showed that the gain in uniformity between the two techniques was about 1.5. With the FIF technique, the mean dose sparing for the heart, the left anterior descending coronary artery, and the lung was 15% (2.5 Gy vs. 2.2 Gy), 21% (11.3 Gy vs. 9.0 Gy), and 42% (8.0 Gy vs. 4.6 Gy) respectively, compared with the wedged beam technique. Also, the cardiac mortality probability decreased by 40% (from 0.9% to 0.5%). Three geometric parameters, the maximal length, angle subtended at the center of the computed tomography slice by the PTV contour, and thorax width/thickness ratio, were the determining factors (p = .06 for FIF, and p = .10 for wedged beam) for evaluating the cardiac mortality probability. Conclusion: The FIF technique seemed to yield a lower cardiac mortality probability than the conventional wedged beam technique. However, although our study

  11. Radiation osteitis following irradiation for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Langlands, A O; Souter, W A; Samuel, E; Redpath, A T [Royal Infirmary, Edinburgh (UK)

    1977-01-01

    Radiographs of the shoulder girdle were examined in 180 women who attended the breast follow-up clinic at the Department of Radiotherapy, Edinburgh. These comprised 52 controls who had been treated by radical mastectomy alone and 128 patients who had received post-operative X-ray therapy. The significance of osteoporosis as a sequel to irradiation is doubtful as it occurred in a substantial proportion of the control cases. Osteitis of severe degree occurred in 13.3% of patients who had been irradiated and was present in a mild form in a further 8.6%. The development of severe osteitis requires an NSD of 1650 rets or more. Estimates of the frequency of radiation osteitis are of no value unless detailed information is also provided about the techniques and quality of radiation.

  12. First symposium accelerated partial breast irradiation

    International Nuclear Information System (INIS)

    2012-01-01

    The First symposium accelerated partial breast irradiation, was organized by the Marie Curie Foundation, between the 14 to 16 june 2012, in the Cordoba city of Argentina. In this event were presented some papers on the following topics: radiotherapy in breast cancer; interaction between systemic treatments and radiotherapy; interstitial brachytherapy.

  13. Assessment of cardiac exposure in left-tangential breast irradiation

    International Nuclear Information System (INIS)

    Vees, H.; Bigler, R.; Gruber, G.; Bieri, S.

    2011-01-01

    Purpose. - To assess the value of treatment-planning related parameters namely, the breast volume; the distance of the inferior field border to diaphragm; and the cardio-thoracic ratio for left-tangential breast irradiation. Patients and methods. - Treatment plans of 27 consecutively left-sided breast cancer patients after breast conserving surgery were evaluated for several parameters concerning heart-irradiation. We measured the heart distance respective to the cardio-thoracic ratio and the distance of the inferior field border to diaphragm, as well as the breast volume in correlation with the irradiated heart volume. Results. - The mean heart and left breast volumes were 504 cm 3 and 672.8 cm 3 , respectively. The mean heart diameter was 13.4 cm; the mean cardio-thoracic ratio 0.51 and the mean distance of the inferior field border to diaphragm was 1.4 cm. Cardio-thoracic ratio (p = 0.01), breast volume (p = 0.0002), distance of the inferior field border to diaphragm (p = 0.02) and central lung distance (p = 0.02) were significantly correlated with the measured heart distance. A significant correlation was also found between cardio-thoracic ratio, breast volume and distance of the inferior field border to diaphragm with the irradiated heart volume measured by V10, V20 and V40. Conclusion. - The verification of parameters like cardio-thoracic ratio, distance of the inferior field border to diaphragm and breast volume in left-sided breast cancer patients may help in determining which patients could benefit from more complex planning techniques such as intensity-modulated radiotherapy to reduced risk of late cardiac injury. (authors)

  14. Dosimetric investigation depending on tumor location in patient breast in partial breast irradiation

    International Nuclear Information System (INIS)

    Kim, Min Joo; Park, So Hyun; Jung, Joo Young; Woong, Cho; Suh, Tae Suk

    2012-01-01

    The Partial Breast Irradiation (PBI) technique, which involves radiation beam delivery techniques that use a limited range of treatment volumes, has been a challenging approach that is worthy of consideration compared to whole-breast radiation therapy (WBRT). Because of a small target volumes used in the PBI technique, the radiation dose can be safely delivered to the targeted tissue without the unwanted delivery of radiation to normal breast tissues and organ at risk (OAR), such as contralateral breast, lung and heart.Through PBI technique, better cosmetic outcomes and minimizing damages to OARs could be expected and also the daily dose can be increased with smaller number of fractionation in radiation therapy. The purpose of this study was to evaluate the dosimetric effects according to tumor locations in patient's breast for Partial Breast Irradiation (PBI) technique using three Dimensional Conformal Radiation Therapy (3DCRT), Electron Beam Radiation therapy (EBRT) and Helical-tomotherapy (H-TOMO). Dosimetric comparisons of PBI technique for 3DCRT, EBRT, and H-TOMO depending on the classified tumor locations were performed. H-TOMO delivered the low dose to lager volume to surrounding normal tissue, such as the heart and lungs compared to 3DCRT and EBRT although it had the same degree of target coverage as the other methods (3DCRT, EBRT). EBRT had a curative effect for early-stage breast cancers located in the lower and inner sections (LIQ-S, LIQ-D)

  15. Significance of postoperative irradiation for breast cancer

    International Nuclear Information System (INIS)

    Murai, Nobuko; Ogami, Koji; Nishikawa, Kiyoshi; Koga, Kenji; Waki, Norio; Higashi, Hidefumi; Hayashi, Asami; Shibata, Koichiro; Watanabe, Katsuji

    1986-01-01

    From 1978 through 1983, 27 patients were treated with surgery followed by irradiation (irradiated group) and 29 with surery alone (non-irradiated group). In the irradiated group, 10 had stage II and 17 stage III; in the non-irradiated group, 25 had stage II and 4 stage III. The most common histology was medullary tubular carcinoma (MTC). There was no significant difference in survivals at 3 years and 5 years between the groups. Similarly, no significant difference was seen among stage II patients. Patients with MTC tended to have worse survivals in the irradiated group than in the non-irradiated group, with no statistically significant difference. Among stage II patients, no major differences in local recurrence were seen between the groups; the incidence of distant metastases tended to be high in the irradiated group. The incidence of both local recurrence and distant metastases for stage III patients showed a tendency to be higher in the irradiated group than in the non-irradiated group. The results indicated no apparent benifit of postoperative irradiation for breast cancer. A randomized clinical trial is needed for the evaluation of postoperative irradiation for breast cancer. (Namekawa, K.)

  16. A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

    International Nuclear Information System (INIS)

    Probst, Heidi; Bragg, Christopher; Dodwell, David; Green, David; Hart, John

    2014-01-01

    Greater use of 3D conformal, Intensity Modulated Radiotherapy (IMRT) and external beam partial breast irradiation following local excision (LE) for breast cancer has necessitated a review of the effectiveness of immobilisation methods to stabilise breast tissue. To identify the suitability of currently available breast (rather than thorax) immobilisation techniques an appraisal of the literature was undertaken. The aim was to identify and evaluate the benefit of additional or novel immobilisation approaches (beyond the standard supine, single arm abducted and angled breast board technique adopted in most radiotherapy departments). A database search was supplemented with an individual search of key radiotherapy peer-reviewed journals, author searching, and searching of the grey literature. A total of 27 articles met the inclusion criteria. The review identified good reproducibility of the thorax using the standard supine arm-pole technique. Reproducibility with the prone technique appears inferior to supine methods (based on data from existing randomised controlled trials). Assessing the effectiveness of additional breast support devices (such as rings or thermoplastic material) is hampered by small sample sizes and a lack of randomised data for comparison. Attention to breast immobilisation is recommended, as well as agreement on how breast stability should be measured using volumetric imaging

  17. Development of three-dimensional radiotherapy techniques in breast cancer

    Science.gov (United States)

    Coles, Charlotte E.

    Radiotherapy following conservation surgery decreases local relapse and death from breast cancer. Currently, the challenge is to minimise the morbidity caused by this treatment without losing efficacy. Despite many advances in radiation techniques in other sites of the body, the majority of breast cancer patients are still planned and treated using 2-dimensional simple radiotherapy techniques. In addition, breast irradiation currently consumes 30% of the UK's radiotherapy workload. Therefore, any change to more complex treatment should be of proven benefit. The primary objective of this research is to develop and evaluate novel radiotherapy techniques to decrease irradiation of normal structures and improve localisation of the tumour bed. I have developed a forward-planned intensity modulated (IMRT) breast radiotherapy technique, which has shown improved dosimetry results compared to standard breast radiotherapy. Subsequently, I have developed and implemented a phase III randomised controlled breast IMRT trial. This National Cancer Research Network adopted trial will answer an important question regarding the clinical benefit of breast IMRT. It will provide DNA samples linked with high quality clinical outcome data, for a national translational radiogenomics study investigating variation in normal tissue toxicity. Thus, patients with significant late normal tissue side effects despite good dose homogeneity will provide the best model for finding differences due to underlying genetics. I evaluated a novel technique using high definition free-hand 3-dimensional (3D) ultrasound in a phantom study, and the results suggested that this is an accurate and reproducible method for tumour bed localisation. I then compared recognised methods of tumour bed localisation with the 3D ultrasound method in a clinical study. The 3D ultrasound technique appeared to accurately represent the shape and spatial position of the tumour cavity. This tumour bed localisation research

  18. Comparison study of the partial-breast irradiation techniques: Dosimetric analysis of three-dimensional conformal radiation therapy, electron beam therapy, and helical tomotherapy depending on various tumor locations

    International Nuclear Information System (INIS)

    Kim, Min-Joo; Park, So-Hyun; Son, Seok-Hyun; Cheon, Keum-Seong; Choi, Byung-Ock; Suh, Tae-Suk

    2013-01-01

    The partial-breast irradiation (PBI) technique, an alternative to whole-breast irradiation, is a beam delivery method that uses a limited range of treatment volume. The present study was designed to determine the optimal PBI treatment modalities for 8 different tumor locations. Treatment planning was performed on computed tomography (CT) data sets of 6 patients who had received lumpectomy treatments. Tumor locations were classified into 8 subsections according to breast quadrant and depth. Three-dimensional conformal radiation therapy (3D-CRT), electron beam therapy (ET), and helical tomotherapy (H-TOMO) were utilized to evaluate the dosimetric effect for each tumor location. Conformation number (CN), radical dose homogeneity index (rDHI), and dose delivered to healthy tissue were estimated. The Kruskal-Wallis, Mann-Whitney U, and Bonferroni tests were used for statistical analysis. The ET approach showed good sparing effects and acceptable target coverage for the lower inner quadrant—superficial (LIQ-S) and lower inner quadrant—deep (LIQ-D) locations. The H-TOMO method was the least effective technique as no evaluation index achieved superiority for all tumor locations except CN. The ET method is advisable for treating LIQ-S and LIQ-D tumors, as opposed to 3D-CRT or H-TOMO, because of acceptable target coverage and much lower dose applied to surrounding tissue

  19. SU-F-SPS-04: Dosimetric Evaluation of the Dose Calculation Accuracy of Different Algorithms for Two Different Treatment Techniques During Whole Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Pacaci, P; Cebe, M; Mabhouti, H; Codel, G; Serin, E; Sanli, E; Kucukmorkoc, E; Doyuran, M; Kucuk, N; Canoglu, D; Altinok, A; Acar, H; Caglar Ozkok, H [Medipol University, Istanbul, Istanbul (Turkey)

    2016-06-15

    Purpose: In this study, dosimetric comparison of field in field (FIF) and intensity modulated radiation therapy (IMRT) techniques used for treatment of whole breast radiotherapy (WBRT) were made. The dosimetric accuracy of treatment planning system (TPS) for Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) algorithms in predicting PTV and OAR doses was also investigated. Methods: Two different treatment planning techniques of left-sided breast cancer were generated for rando phantom. FIF and IMRT plans were compared for doses in PTV and OAR volumes including ipsilateral lung, heart, left ascending coronary artery, contralateral lung and the contralateral breast. PTV and OARs doses and homogeneity and conformality indexes were compared between two techniques. The accuracy of TPS dose calculation algorithms was tested by comparing PTV and OAR doses measured by thermoluminescent dosimetry with the dose calculated by the TPS using AAA and AXB for both techniques. Results: IMRT plans had better conformality and homogeneity indexes than FIF technique and it spared OARs better than FIF. While both algorithms overestimated PTV doses they underestimated all OAR doses. For IMRT plan, PTV doses, overestimation up to 2.5 % was seen with AAA algorithm but it decreased to 1.8 % when AXB algorithm was used. Based on the results of the anthropomorphic measurements for OAR doses, underestimation greater than 7 % is possible by the AAA. The results from the AXB are much better than the AAA algorithm. However, underestimations of 4.8 % were found in some of the points even for AXB. For FIF plan, similar trend was seen for PTV and OARs doses in both algorithm. Conclusion: When using the Eclipse TPS for breast cancer, AXB the should be used instead of the AAA algorithm, bearing in mind that the AXB may still underestimate all OAR doses.

  20. Implementation of the technique of partial irradiation accelerated the breast with high doses (HDR) brachytherapy; Puesta en marcha de la tecnica de irradiacion parcial acelerada de la mama con braquterapia de alta tasa de dosis (HDR)

    Energy Technology Data Exchange (ETDEWEB)

    Molina Lopez, M. Y.; Pardo Perez, E.; Castro Novais, J.; Martinez Ortega, J.; Ruiz Maqueda, S.; Cerro Penalver, E. del

    2013-07-01

    The objective of this work is presents procedure carried out in our Centre for the implementation of the accelerated partial breast irradiation (APBI, accelerated partial-breast irradiation) with high-rate brachytherapy (HDR), using plastic tubes as applicators. Carried out measures, the evaluation of the dosimetric parameters analyzing and presenting the results. (Author)

  1. Partial-Breast Irradiation Versus Whole-Breast Irradiation for Early-Stage Breast Cancer: A Cost-Effectiveness Analysis

    International Nuclear Information System (INIS)

    Sher, David J.; Wittenberg, Eve; Suh, W. Warren; Taghian, Alphonse G.; Punglia, Rinaa S.

    2009-01-01

    Purpose: Accelerated partial-breast irradiation (PBI) is a new treatment paradigm for patients with early-stage breast cancer. Although PBI may lead to greater local recurrence rates, it may be cost-effective because of better tolerability and lower cost. We aim to determine the incremental cost-effectiveness of PBI compared with whole-breast radiation therapy (WBRT) for estrogen receptor-positive postmenopausal women treated for early-stage breast cancer. Methods and Materials: We developed a Markov model to describe health states in the 15 years after radiotherapy for early-stage breast cancer. External beam (EB) and MammoSite (MS) PBI were considered and assumed to be equally effective, but carried different costs. Patients received tamoxifen, but not chemotherapy. Utilities, recurrence risks, and costs were adapted from the literature; the baseline utility for no disease after radiotherapy was set at 0.92. Probabilistic sensitivity analyses were performed to model uncertainty in the PBI hazard ratio, recurrence pattern, and patient utilities. Costs (in 2004 US dollars) and quality-adjusted life-years were discounted at 3%/y. Results: The incremental cost-effectiveness ratio for WBRT compared with EB-PBI was $630,000/quality-adjusted life-year; WBRT strongly dominated MS-PBI. One-way sensitivity analysis found that results were sensitive to PBI hazard ratio, recurrence pattern, baseline recurrence risk, and no evidence of disease PBI utility values. Probabilistic sensitivity showed that EB-PBI was the most cost-effective technique over a wide range of assumptions and societal willingness-to-pay values. Conclusions: EB-PBI was the most cost-effective strategy for postmenopausal women with early-stage breast cancer. Unless the quality of life after MS-PBI proves to be superior, it is unlikely to be cost-effective.

  2. A new three-dimensional conformal radiotherapy (3DCRT) technique for large breast and/or high body mass index patients: evaluation of a novel fields assessment aimed to reduce extra–target-tissue irradiation

    Science.gov (United States)

    Stimato, Gerardina; Ippolito, Edy; Silipigni, Sonia; Venanzio, Cristina Di; Gaudino, Diego; Fiore, Michele; Trodella, Lucio; D'Angelillo, Rolando Maria; Ramella, Sara

    2016-01-01

    Objective: To develop an alternative three-dimensional treatment plan with standardized fields class solution for whole-breast radiotherapy in patients with large/pendulous breast and/or high body mass index (BMI). Methods: Two treatment plans [tangential fields and standardized five-fields technique (S5F)] for a total dose of 50 Gy/25 fractions were generated for patients with large breasts [planning target volume (PTV) >1000 cm3 and/or BMI >25 kg m−2], supine positioned. S5F plans consist of two wedged tangential beams, anteroposterior: 20° for the right breast and 340° for the left breast, and posteroanterior: 181° for the right breast and 179° for the left breast. A field in field in medial–lateral beam and additional fields were added to reduce hot spot areas and extra–target-tissue irradiation and to improve dose distribution. The percentage of PTV receiving 95% of the prescribed dose (PTV V95%), percentage of PTV receiving 105% of the prescribed dose (PTV V105%), maximal dose to PTV (PTV Dmax), homogeneity index (HI) and conformity index were recorded. V10%, V20%, V105% and V107% of a “proper” normal tissue structure (body-PTV healthy tissue) were recorded. Statistical analyses were performed using SYSTAT v.12.0 (SPSS, Chicago, IL). Results: In 38 patients included, S5F improved HI (8.4 vs 10.1; p ≤ 0.001) and significantly reduced PTV Dmax and PTV V105%. The extra–target-tissue irradiation was significantly reduced using S5F for V105% (cm3) and V107% (cm3) with a very high difference in tissue irradiation (46.6 vs 3.0 cm3, p ≤ 0.001 for V105% and 12.2 vs 0.0 cm3, p ≤ 0.001 for V107% for tangential field and S5F plans, respectively). Only a slight increase in low-dose extra–target-tissue irradiation (V10%) was observed (2.2719 vs 1.8261 cm3, p = 0.002). Conclusion: The S5F technique in patients with large breast or high BMI increases HI and decreases hot spots in extra-target-tissues and can therefore be

  3. Radioisotope techniques used in breast cancer

    International Nuclear Information System (INIS)

    Au-Yong Ting Kun

    2001-01-01

    Breast cancer is one of the commonest cancer in women. Treatment and prognosis of breast cancer depend very much on accurate diagnosis, staging and follow-up of patients. Recently, there are several radioisotope techniques developed and have great impact on management of breast cancer. These include scintimammography, sentinel lymph node detection and positron emission tomography. This article is to review these important techniques

  4. The Techniques Of Food Irradiation

    International Nuclear Information System (INIS)

    Olorunda, A.O. Department Of Food Technology, University Of Ibadan, Nigeria.

    1996-01-01

    Food irradiation is a technique which is increasingly being recognised as an effective method for reducing post-harvest food losses, ensuring hygienic quality of food and facilitating wider trade of certain food items. Irradiation of food may be used to achieve a variety of desirable objectives including the following which are classified according to the average radiation dose requirement: i. Low dose application (up to about 1 kg), for inhibition of sprouting in yams, potatoes, onions, etc. insect disinfestation and delay of ripening in fruits. ii. Medium dose applications (about 1-10kgy), for reduction of micro-organisms and improvement in technological properties of food. iii. High dose application (about 10-50kgy) which is used for sterilization for commercial purposes and elimination of viruses. From the point of view of food safety the energy level of the radiation applied to food is the most important characteristics that has to be regulated in order to prevent the possible formation of induced radio activity. Fortunately, the most commonly used isotopic sources 60Co and 137Cs; and machine sources such as the electron beam generators, induced radio activity is negligible, short lived and lower than that causing radio activity. This and other scientific and technical aspects of the commercial application irradiation technology with respect Nigeria have been examined in this paper along side with those of its politics and social policy

  5. Tangential breast irradiation - rationale and methods for improving dosimetry

    International Nuclear Information System (INIS)

    Neal, A.J.; Mayles, W.P.M.; Yarnold, J.R.

    1994-01-01

    In recent years there have been great advances and innovations in all technical aspects of radiotherapy, including three dimensional (3D) computer planning, patient immobilization, radiation delivery and treatment verification. Despite this progress, the technique of tangential breast irradiation has changed little over this period and has not exploited these advances. There is increasing evidence that dose inhomogeneity within the breast is greater than at other anatomical sites, especially in women with large breasts. This paper is a review of the factors contributing to poor dosimetry in the breast, the clinical consequences of an inhomogeneous dose distribution, and how breast dosimetry could be improved by considering each of the stages from planning to accurate treatment delivery. It also highlights the particular problem of women with large breasts who may be more likely to have a poorer outcome after a fractionated course of radiotherapy than women with small/medium-sized breasts, and supports the clinical impression that such women are also more likely to have greater inhomogenicity when 3D treatment plans are examined. Preliminary data from our current computed tomography (CT) planning study are presented to support these observations. (author)

  6. Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  7. Blood irradiation: Rationale and technique

    International Nuclear Information System (INIS)

    Lewis, M.C.

    1990-01-01

    Upon request by the local American Red Cross, the Savannah Regional Center for Cancer Care irradiates whole blood or blood components to prevent post-transfusion graft-versus-host reaction in patients who have severely depressed immune systems. The rationale for blood irradiation, the total absorbed dose, the type of patients who require irradiated blood, and the regulations that apply to irradiated blood are presented. A method of irradiating blood using a linear accelerator is described

  8. In vivo dosimetry during breast irradiation

    International Nuclear Information System (INIS)

    Ebert, M.A.; Herbert, C.E.; Joseph, D.J.

    2001-01-01

    Full text: In vivo dosimetry during breast irradiation can be difficult due to frequent use of wedged fields, and the contour of the breast. In vivo measurements of central-axis entrance dose were made on 62 breast patients for two consecutive fractions. Discrepancies from expected doses of up to 13.4 % were found for lateral tangential fields (mean 4.31 %). It was proposed that large discrepancies were due to i) dosimetric I and setup errors, and ii) diode misplacement errors. An investigation of the effect of diode misplacement error was undertaken by reviewing possible measurement errors for 20 randomly selected breast treatments. A Monte Carlo study was used to examine the expected measurement error as a function of the standard deviation (SD) in diode placement error (see figure). A strong relationship was found between breast contour and wedge angle. Diode misplacement in the presence of a large wedge angle was identified as a major possible source of measurement error. For the sample of treatments considered, the Monte Carlo study showed that, ignoring general dosimetric errors, mean errors of 4 % are feasible for setup errors of the order of 1 cm (the width of the diode). This study has shown that accurate in vivo dosimetry requires separating measurements errors out from diode readings in order not to overestimate the actual dosimetric errors occurring at treatment time. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  9. Cardiac dose sparing and avoidance techniques in breast cancer radiotherapy

    International Nuclear Information System (INIS)

    Shah, Chirag; Badiyan, Shahed; Berry, Sameer; Khan, Atif J.; Goyal, Sharad; Schulte, Kevin; Nanavati, Anish; Lynch, Melanie; Vicini, Frank A.

    2014-01-01

    Breast cancer radiotherapy represents an essential component in the overall management of both early stage and locally advanced breast cancer. As the number of breast cancer survivors has increased, chronic sequelae of breast cancer radiotherapy become more important. While recently published data suggest a potential for an increase in cardiac events with radiotherapy, these studies do not consider the impact of newer radiotherapy techniques commonly utilized. Therefore, the purpose of this review is to evaluate cardiac dose sparing techniques in breast cancer radiotherapy. Current options for cardiac protection/avoidance include (1) maneuvers that displace the heart from the field such as coordinating the breathing cycle or through prone patient positioning, (2) technological advances such as intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT), and (3) techniques that treat a smaller volume around the lumpectomy cavity such as accelerated partial breast irradiation (APBI), or intraoperative radiotherapy (IORT). While these techniques have shown promise dosimetrically, limited data on late cardiac events exist due to the difficulties of long-term follow up. Future studies are required to validate the efficacy of cardiac dose sparing techniques and may use surrogates for cardiac events such as biomarkers or perfusion imaging

  10. Early-stage bilateral breast cancer treated with breast-conserving surgery and definitive irradiation: the university of Pennsylvania experience

    International Nuclear Information System (INIS)

    Fung, Man C.; Schultz, Delray J.; Solin, Lawrence J.

    1997-01-01

    Purpose: To determine whether patients with early-stage bilateral breast cancer can be treated with definitive irradiation following breast-conserving surgery with acceptable survival, local control, complications, and cosmesis. Methods and Materials: During the period 1977-1992, 55 women with Stage 0, I, or II concurrent (n = 12) or sequential (n = 43) bilateral breast cancer were treated with definitive irradiation following breast-conserving surgery. The records of these 55 patients with 110 treated breasts were reviewed for tumor size, histology, pathologic axillary lymph node status, first and overall site(s) of failure, and adjuvant chemotherapy or hormonal therapy. Curves for survival, local control, and regional control were determined. Cosmetic outcome, complication rates, and matching technique were analyzed. The median total radiation dose delivered was 64 Gy (range 42-72) using tangential whole-breast irradiation followed by an electron or iridium implant boost. The tangential fields were matched with no overlap in 40 patients (73%); there was overlap on skin of up to 4 cm in 14 patients (25%); and the matching technique was unknown in 1 patient (2%). The median follow-up for the 12 women with concurrent bilateral breast cancer was 4.0 years. The median follow-up for the other 43 women with sequential cancer was 9.3 and 4.9 years, respectively, after the first and second cancers. Results: For the overall group of 55 patients, the 5- and 10-year overall survival rates were 96% and 94%, respectively, after treatment of the first cancer, and 96% and 92%, respectively, after treatment of the second cancer. The 5- and 10-year actuarial relapse-free survival rates were 90% and 75%, respectively, after treatment of the first cancer, and 83% and 72%, respectively, after treatment of the second cancer. For the 110 treated breast cancers, the 5- and 10-year actuarial local failure rates were 5% and 15%, respectively. Complication rates were: 28% breast edema, 8

  11. Technical consideration of intact breast irradiation

    International Nuclear Information System (INIS)

    Buck, B.A.

    1980-01-01

    Alternatives to mastectomy in the treatment of breast cancer have been discussed in the medical literature since 1937. The advent of megavoltage equipment has enabled radiation therapy to become an increasingly accepted alternative. The modified treatment technique developed at the Joint Center for Radiation Therapy is discussed

  12. Biologic comparison of partial breast irradiation protocols

    International Nuclear Information System (INIS)

    Rosenstein, Barry S.; Lymberis, Stella C.; Formenti, Silvia C.

    2004-01-01

    Purpose: To analyze the dose/fractionation schedules currently used in ongoing clinical trials of partial breast irradiation (PBI) by comparing their biologically effective dose (BED) values to those of three standard whole breast protocols commonly used after segmental mastectomy in the treatment of breast cancer. Methods and materials: The BED equation derived from the linear-quadratic model for radiation-induced cell killing was used to calculate the BEDs for three commonly used whole breast radiotherapy regimens, in addition to a variety of external beam radiotherapy, as well as high-dose-rate and low-dose-rate brachytherapy, PBI protocols. Results: The BED values of most PBI protocols resulted in tumor control BEDs roughly equivalent to a 50-Gy standard treatment, but consistently lower than the BEDs for regimens in which the tumor bed receives a total dose of either 60 Gy or 66 Gy. The BED values calculated for the acute radiation responses of erythema and desquamation were nearly all lower for the PBI schedules, and the late-response BEDs for most PBI regimens were in a similar range to the BEDs for the standard treatments. Conclusion: Biologically effective dose modeling raises the concern that inadequate doses might be delivered by PBI to ensure optimal in-field tumor control

  13. Cancer of the breast -- primary irradiation

    International Nuclear Information System (INIS)

    Recht, Abram

    1995-01-01

    Purpose/Objective: The combination of breast-conserving surgery (CS) and radiotherapy (RT) is now accepted as a standard treatment option for most women with clinical Stage I or II invasive breast cancer. However, numerous controversies remain concerning the optimal means of selecting patients for such treatment and the details of treatment technique. These include: 1) Whether some patients can be treated by CS without RT with a low risk of local recurrence. 2) The meaning and use of patient-related and histologic factors, such as patient age, the status of the microscopic resection margins, and the presence of an extensive intraductal component (EIC). 3) Techniques of RT of the breast (e.g., is a boost dose needed, and how to give it). 4) The role of treatment of the regional lymph nodes, both by surgery and RT. 5) The integration of adjuvant systemic therapy with RT and surgery. 6) The management of patients with noninvasive ductal carcinoma. 7) The detection, prognosis, and management of breast recurrences after breast-conserving therapy. In this refresher course we will examine several of these issues

  14. Bilateral breast cancer treated with breast-conserving surgery and definitive irradiation

    International Nuclear Information System (INIS)

    Man, C. Fung; Schultz, Delray; Solin, Lawrence J.

    1996-01-01

    Objective: To assess whether patients with early stage bilateral breast cancer can be treated with definitive irradiation following breast-conserving surgery with acceptable survival, local control, complication rates, and cosmetic outcomes. Material and Methods: We reviewed 55 cases of patients with synchronous or sequential bilateral breast cancer treated with definitive irradiation following breast-conserving surgery at our institution from 1977 to 1992. Analysis of cases was limited to women who were AJCC clinical Stage 0, I, and II. The records of these 55 patients with 110 treated breasts were reviewed for tumor size, histology, AJCC stage, pathologic axillary lymph nodes status, first and overall site(s) of failure, and adjuvant chemotherapy or hormonal therapy. Analysis regarding matching technique, cosmetic outcome, and complication rate was also performed. The 5- and 10-year overall survival (OS), no evidence of disease (NED) survival, relapse-free survival (RFS), and local control rates were evaluated. Twelve women (22%) presented with synchronous bilateral carcinoma, and 43 women (78%) had sequential bilateral carcinoma. Of the 12 patients with synchronous cancer, 5 received adjuvant chemotherapy, 2 received Tamoxifen, and 1 received both adjuvant therapies. Of the 43 patients with sequential cancer, 6 received chemotherapy, 1 received Tamoxifen, and 1 received both adjuvant therapies for the first cancer treatment; seven received chemotherapy and 6 received Tamoxifen for the second cancer treatment. Results: The median age at the time of treatment of the first cancer was 56 years (range 26-86 years). For the 12 patients with synchronous cancer, the median follow-up was 48 months (range 9-164). For the 43 patients with sequential cancer, the median follow-up was 112 months (range 52-188 months) after the first cancer, and 59 months (range 11-153 months) after the second. The median dose delivered was 64 Gy (range 42-72 Gy) using a combination of

  15. Interfractional Target Variations for Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Ahunbay, Ergun E.; Robbins, Jared; Christian, Robert; Godley, Andrew; White, Julia; Li, X. Allen

    2012-01-01

    Purpose: In this work, we quantify the interfractional variations in the shape of the clinical target volume (CTV) by analyzing the daily CT data acquired during CT-guided partial breast irradiation (PBI) and compare the effectiveness of various repositioning alignment strategies considered to account for the variations. Methods and Materials: The daily CT data for 13 breast cancer patients treated with PBI in either prone (10 patients) or supine (3 patients) with daily kV CT guidance using CT on Rails (CTVision, Siemens, Malvern, PA) were analyzed. For approximately 25 points on the surface of the CTV, deformation vectors were calculated by means of deformable image registration and verified by visual inspection. These were used to calculate the distances along surface normals (DSN), which directly related to the required margin expansions for each point. The DSN values were determined for seven alignment methods based on volumetric imaging and also two-dimensional projections (portal imaging). Results: The margin expansion necessary to cover 99% of all points for all days was 2.7 mm when utilizing the alignment method based on deformation field data (the best alignment method). The center-of-mass based alignment yielded slightly worse results (a margin of 4.0 mm), and shifts obtained by operator placement (7.9 mm), two-dimensional-based methods (7.0–10.1 mm), and skin marks (13.9 mm) required even larger margin expansions. Target shrinkage was evident for most days by the negative values of DSN. Even with the best alignment, the range of DSN values could be as high as 7 mm, resulting in a large amount of normal tissue irradiation, unless adaptive replanning is employed. Conclusion: The appropriate alignment method is important to minimize the margin requirement to cover the significant interfractional target deformations observed during PBI. The amount of normal tissue unnecessarily irradiated is still not insignificant, and can be minimized if adaptive

  16. Novel techniques for 7 tesla breast MRI

    NARCIS (Netherlands)

    van der Velden, T.A.

    2017-01-01

    This thesis introduced several new techniques to the field of 7 tesla breast MRI, enabling high field multi-parametric MR imaging and, potentially, patient specific treatment planning. Chapter 2 described the development of a RF coil setup for bilateral breast MR imaging and 31P spectroscopy. This

  17. Intensity modulated tangential beam irradiation of the intact breast

    International Nuclear Information System (INIS)

    Hong, L.; Hunt, M.; Chui, C.; Forster, K.; Lee, H.; Lutz, W.; Yahalom, J.; Kutcher, G.J.; McCormick, B.

    1997-01-01

    Purpose/Objective: The purpose of this study was to evaluate the potential benefits of intensity modulated tangential beams in the irradiation of the intact breast. The primary goal was to develop an intensity modulated treatment which would substantially decrease the dose to coronary arteries, lung and contralateral breast while still using a standard tangential beam arrangement. Improved target dose homogeneity, within the limits imposed by opposed fields, was also desired. Since a major goal of the study was the development of a technique which was practical for use on a large population of patients, the design of 'standard' intensity profiles analogous in function to conventional wedges was also investigated. Materials and Methods: Three dimensional treatment planning was performed using both conventional and intensity modulated tangential beams. Plans were developed for both the right and left breast for a range of patient sizes and shapes. For each patient, PTV, lung, heart, origin and peripheral branches of the coronary artery, and contralateral breast were contoured. Optimum tangential beam direction and shape were designed using Beams-Eye-View display and then used for both the conventional and intensity modulated plans. For the conventional plan, the optimum wedge combination and beam weighting were chosen based on the dose distribution in a single transverse plane through the field center. Intensity modulated plans were designed using an algorithm which allows the user to specify the prescribed, maximum and minimum acceptable doses and dose volume constraints for each organ of interest. Plans were compared using multiple dose distributions and DVHs. Results: Significant improvements in the doses to critical structures were achieved using the intensity modulated plan. Coronary artery dose decreased substantially for patients treated to the left breast. Ipsilateral lung and contralateral breast doses decreased for all patients. For one patient treated to

  18. Irradiation techniques at BR2 reactor

    International Nuclear Information System (INIS)

    Hebel, W.

    1978-01-01

    Since 1963 the material testing reactor BR2 at Mol is operated for the realisation of numerous research programs and experiments on the behavior of materials under nuclear radiation and in particular under intensive neutron exposure. During this period special irradiation techniques and experimental devices were developed according to the desiderata of the different experiments and to the irradiation possibilities offered at BR2. The design and the operating characteristics of quite a number of those irradiation rigs of proven reliability may be used or can be made available for new irradiation experiments. A brief description is given of some typical irradiation devices designed and constructed by CEN/SCK, Technology and Energy Dpt. They are compiled according to their main use for the different research and development programs realized at BR2. Their eventual application however for different objectives could be possible. A final chapter summarizes the principal irradiation conditions offered by BR2 reactor. (author)

  19. Design and implementation of a rotational radiotherapy technique for breast cancer treatment and their comparison with 3-D-Crt irradiation technique; Diseno e implementacion de una tecnica de radioterapia rotacional para tratamiento de cancer de mama y su comparacion contra la tecnica 3D-CRT de irradiacion

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez M, J. G.; Lopez V, A.; Rivera M, T. [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Av. Legaria 694, Col. Irrigacion, 11500 Mexico D. F. (Mexico); Velazquez T, J. J.; Adame G, C. S. [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamento de Fisica Medica, Av. Cuauhtemoc No. 330, Col. Doctores, 06720 Mexico D. F. (Mexico); Rubio N, O.; Chagoya G, A.; Hernandez G, J. C., E-mail: jggm25@yahoo.com.mx [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamento de Radioterapia, Av. Cuauhtemoc No. 330, Col. Doctores, 06720 Mexico D. F. (Mexico)

    2015-10-15

    Breast cancer is one of oncological diseases worldwide, as well in Mexico, which causes even more deaths than cervical cancer; this condition is the second death cause in women aged 30-54 years and threatens all socio-economic groups. The treatment is highly dependent on the stage which is detected and based on protocols that include a combination of surgery, chemotherapy and radiotherapy. This paper studies the main irradiation technique for patients with mastectomy, breast full cycle (irradiation of the chest well and supraclavicular nodes) in their mode Three Dimensional - Conformal Radiation Therapy (3-D-Crt), and compared with the Volumetric Modulated Arc Therapy (VMAT) technique proposed in this paper. In both techniques the prescription was 50 Gy divided into 25 fractions. The techniques were applied in three female patients (being an initial study) with disease of the left side, the target volume and organs at risk were delineated by the medical treating radiation oncologist, the planning system used was Eclipse version 10; for quantitative comparison of both plans indexes of homogeneity were used, con formality, the target volume coverage and normal tissue, sub factors and overdosing, the conformation number and coverage quality. They were evaluated and compared the media, maximum and minimum dose of the organs at risk, based on the fact that the coverage of the target volume, dose gradient and dose at risk organs are acceptable (prescription dose greater that 90% coverage, gradient less that 20% and organs at risk in accordance with the Quantec limitations for both versions). (Author)

  20. Regional Nodal Irradiation in Early-Stage Breast Cancer.

    Science.gov (United States)

    Whelan, Timothy J; Olivotto, Ivo A; Parulekar, Wendy R; Ackerman, Ida; Chua, Boon H; Nabid, Abdenour; Vallis, Katherine A; White, Julia R; Rousseau, Pierre; Fortin, Andre; Pierce, Lori J; Manchul, Lee; Chafe, Susan; Nolan, Maureen C; Craighead, Peter; Bowen, Julie; McCready, David R; Pritchard, Kathleen I; Gelmon, Karen; Murray, Yvonne; Chapman, Judy-Anne W; Chen, Bingshu E; Levine, Mark N

    2015-07-23

    Most women with breast cancer who undergo breast-conserving surgery receive whole-breast irradiation. We examined whether the addition of regional nodal irradiation to whole-breast irradiation improved outcomes. We randomly assigned women with node-positive or high-risk node-negative breast cancer who were treated with breast-conserving surgery and adjuvant systemic therapy to undergo either whole-breast irradiation plus regional nodal irradiation (including internal mammary, supraclavicular, and axillary lymph nodes) (nodal-irradiation group) or whole-breast irradiation alone (control group). The primary outcome was overall survival. Secondary outcomes were disease-free survival, isolated locoregional disease-free survival, and distant disease-free survival. Between March 2000 and February 2007, a total of 1832 women were assigned to the nodal-irradiation group or the control group (916 women in each group). The median follow-up was 9.5 years. At the 10-year follow-up, there was no significant between-group difference in survival, with a rate of 82.8% in the nodal-irradiation group and 81.8% in the control group (hazard ratio, 0.91; 95% confidence interval [CI], 0.72 to 1.13; P=0.38). The rates of disease-free survival were 82.0% in the nodal-irradiation group and 77.0% in the control group (hazard ratio, 0.76; 95% CI, 0.61 to 0.94; P=0.01). Patients in the nodal-irradiation group had higher rates of grade 2 or greater acute pneumonitis (1.2% vs. 0.2%, P=0.01) and lymphedema (8.4% vs. 4.5%, P=0.001). Among women with node-positive or high-risk node-negative breast cancer, the addition of regional nodal irradiation to whole-breast irradiation did not improve overall survival but reduced the rate of breast-cancer recurrence. (Funded by the Canadian Cancer Society Research Institute and others; MA.20 ClinicalTrials.gov number, NCT00005957.).

  1. A treatment planning study comparing whole breast radiation therapy against conformal, IMRT and tomotherapy for accelerated partial breast irradiation

    International Nuclear Information System (INIS)

    Oliver, Mike; Chen, Jeff; Wong, Eugene; Van Dyk, Jake; Perera, Francisco

    2007-01-01

    Purpose and background: Conventional early breast cancer treatment consists of a lumpectomy followed by whole breast radiation therapy. Accelerated partial breast irradiation (APBI) is an investigational approach to post-lumpectomy radiation for early breast cancer. The purpose of this study is to compare four external beam APBI techniques, including tomotherapy, with conventional whole breast irradiation for their radiation conformity index, dose homogeneity index, and dose to organs at risk. Methods and materials: Small-field tangents, three-dimensional conformal radiation therapy, intensity-modulated radiation therapy and helical tomotherapy were compared for each of 15 patients (7 right, 8 left). One radiation conformity and two dose homogeneity indices were used to evaluate the dose to the target. The mean dose to organs at risk was also evaluated. Results: All proposed APBI techniques improved the conformity index significantly over whole breast tangents while maintaining dose homogeneity and without a significant increase in dose to organs at risk. Conclusion: The four-field IMRT plan produced the best dosimetric results; however this technique would require appropriate respiratory motion management. An alternative would be to use a four-field conformal technique that is less sensitive to the effects of respiratory motion

  2. Echography and operated or irradiated breasts

    International Nuclear Information System (INIS)

    Baratte, B.; Neel-Paprocki, V.; Grumbach, Y.

    1995-01-01

    Since 1985, the medical survey of patients operated even for benign or malignant initial breast injury comprises an X-ray mammal examination and a mammal echography. Until 1993, the echography was performed with a CGR scanner device with a 7.5 MHz barrette. Now, a GE RTX 400 device with two MHz barrettes is used, one with a removable interposition equipment and the other for echography controlled punctures. Echographic modifications are dependent on the treatment used: partial or complete surgery and/or irradiation. Early and late normal echographic aspects must be known. Echography is particularly efficient for the diagnosis of post-surgery hematoma, lymphocele and abscess and for the detection of recurrence in the case of dense breast. Its combination with X-ray radiography can solve most diagnosis problems. In any case of doubt, puncture or tru-cut biopsy must be done, and if not sufficient, the use of NMR imaging remains of great help. (J.S.)

  3. Dosimetric comparison of 3DCRT versus IMRT in whole breast irradiation of early stage breast cancer

    Directory of Open Access Journals (Sweden)

    Mudasir Ashraf

    2014-08-01

    Full Text Available Purpose: The counseling regarding the treatment option is an important objective in the management of early stages breast cancer. In this study, we attempt to compare and analyze the dosimetric aspects of 3DRT over IMRT in the whole breast radiotherapy.Methods and Materials:  Both right and left sided computed tomography simulations of 14 women with early stage breast cancer were used for our retrospective study to compare the 3DCRT and IMRT. The dose prescribed was 50 Gy in 25 fractions to the whole breast PTV. The PTV was defined by adding unequal margins to the directional safety margin status of each lumpectomy cavity (i.e., medial, lateral, superior, inferior and deep margins measured from the tumor front after the examination of the surgical specimen: 2, 1.5, and 1 cm for resection margins < 1 cm, 1-2 cm, and > 2cm, respectively. And than modified so that it was no longer closer than 3mm to the skin surface and was no deep than the lung –chest interface. The prescribed dose delivered in 5 fractions per week schedule. Treatment plans were compared for target minimum dose, maximum dose, mean dose, conformity index, heterogeneity index and doses to organs at risk were compared and analysed.Results: The target coverage was achieved with 90% prescription to the 95% of the PTV. Conformity to the PTV was significantly higher with 3DCRT technique than IMRT. 3DCRT technique seems better in sparing critical organs parameters like lung V20 and Mean, heart, V25, Maximum, both lungs V20, Mean and Dose to the Normal Healthy tissue.Conclusion: We conclude from our study that treatment technique selection for whole Breast irradiation is an important factor in sparing the adjacent normal structures and in determining the associated risk. 3DCRT produces better conformity and heterogeneity indices of the target volume, also reduces dose to OARs the 3DCRT reduces the risk of radiation induced heart diseases

  4. Irradiated fuel examination using the Cerenkov technique

    International Nuclear Information System (INIS)

    Nicholson, N.; Dowdy, E.J.

    1981-03-01

    A technique for monitoring irradiated nuclear fuel inventories located in water filled storage ponds has been developed and demonstrated. This technique provides sufficient qualitative information to be useful as a confirmatory technique to International Atomic Energy Agency inspectors. Measurements have been made on the Cerenkov glow light intensity from irradiated fuel that show the intensity of this light to be proportional to the cooling time. Fieldable instruments used in several tests confirm that such measurements can be made easily and rapidly, without fuel assembly movement or the introduction of apparatus into the storage ponds. The Cerenkov technique and instrumentation have been shown to be of potential use to operators of reactor spent fuel facilities and away from reactor storage facilities, and to the International Atomic Energy Agency inspectors who provide surveillance of the irradiated fuel stored in these facilities

  5. Dosimetric comparison of volumetric modulated arc therapy (VMAT), DMlC (Dynamic IMRT), and 3DCRT in left breast cancer after breast conserving surgery receiving left breast irradiation

    International Nuclear Information System (INIS)

    Pratibha, Bauskar; Vibhay, Pareek; Rajendra, Bhalavat; Chandra, Manish

    2016-01-01

    Previous studies have demonstrated that the risk of ischemic heart disease is increased as a result of exposure to ionizing radiation in women treated for breast cancer. Alternative radiation techniques, such as dynamic intensity-modulated radiation therapy (DMLC), volumetric-modulated arc therapy (VMAT), have been shown to improve dosimetric parameters of the heart and substructures. However, these techniques have not been compared with each other to potentially guide treatment decisions. Volumetric modulated arc therapy (VMAT) is a novel extension of conventional intensity-modulated radiotherapy (c-IMRT), in which an optimized three dimensional dose distribution may be delivered in a single gantry rotation. VMAT is the predecessor to Rapid-Arc (Varian Medical System). This study uses VMAT, DMLC and 3DCRT to compare target volume coverage and doses to organs at risk (OARs), especially lung and heart doses, using these three techniques in whole breast irradiation after breast conserving surgery in left breast cancer cases

  6. The use of a standardized positioning support cushion during daily routine of breast irradiation

    International Nuclear Information System (INIS)

    Thilmann, Christoph; Adamietz, Irenaeus A.; Saran, Frank; Mose, Stefan; Kostka, A.; Boettcher, H.D.

    1998-01-01

    Purpose: The use of positioning and immobilization techniques during external beam irradiation of the female breast is time consuming and expensive. The currently available standardized positioning devices are insufficient. For this reason, we designed a new and generally useable hard foam positioning support cushion for the use during breast irradiation, and tested its clinical usefulness in a prospective study. Methods and Materials: Fifty-five female breast cancer patients receiving adjuvant radiotherapy following breast-conservative surgery were irradiated either without immobilization (n = 27) or with the positioning support cushion (n = 28). The time necessary for patient setup, the lying subjective comfort and --comparing portal images with simulator images--the reproducibility of the set up were determined. Results: Irradiation reproducibility was significantly improved (average deviation without positioning support cushion: 8.4 mm, with positioning support cushion: 6.1 mm, p < 0.001). The time required for the positioning of the patient with positioning support cushion was in average 73 s, without cushion it was 55 s. A significantly higher proportion of patients (72%) found the position with the positioning support cushion as pleasant, whereas only 46% of patients were pleased with the position without cushion. Conclusion: The positioning support cushion designed in our department makes a substantial contribution to quality assurance in breast irradiation. It significantly increases the patients' comfort in a supine position. In contrast to conventional positioning and fixation aids it may be quickly and easily applied at low costs. Therefore, its use can be recommended

  7. Three-dimensional conformal breast irradiation in the prone position

    Directory of Open Access Journals (Sweden)

    C. Kurtman

    2003-10-01

    Full Text Available The prone position can be used for the planning of adjuvant radiotherapy after conservative breast surgery in order to deliver less irradiation to lung and cardiac tissue. In the present study, we compared the results of three-dimensional conformal radiotherapy planning for five patients irradiated in the supine and prone position. Tumor stage was T1N0M0 in four patients and T1N1M0 in one. All patients had been previously submitted to conservative breast surgery. Breast size was large in three patients and moderate in the other two. Irradiation in the prone position was performed using an immobilization foam pad with a hole cut into it to accommodate the breast so that it would hang down away from the chest wall. Dose-volume histograms showed that mean irradiation doses reaching the ipsilateral lung were 8.3 ± 3.6 Gy with the patient in the supine position and 1.4 ± 1.0 Gy with the patient in the prone position (P = 0.043. The values for the contralateral lung were 1.3 ± 0.7 and 0.3 ± 0.1 Gy (P = 0.043 and the values for cardiac tissue were 4.6 ± 1.6 and 3.0 ± 1.7 Gy (P = 0.079, respectively. Thus, the dose-volume histograms demonstrated that lung tissue irradiation was significantly lower with the patient in the prone position than in the supine position. Large-breasted women appeared to benefit most from irradiation in the prone position. Prone position breast irradiation appears to be a simple and effective alternative to the conventional supine position for patients with large breasts, since they are subjected to lower pulmonary doses which may cause less pulmonary side effects in the future.

  8. Whole-body irradiation technique: physical aspects

    International Nuclear Information System (INIS)

    Venencia, D.; Bustos, S.; Zunino, S.

    1998-01-01

    The objective of this work has been to implement a Total body irradiation technique that fulfill the following conditions: simplicity, repeatability, fast and comfortable positioning for the patient, homogeneity of the dose between 10-15 %, short times of treatments and In vivo dosimetric verifications. (Author)

  9. Electron arc therapy: chest wall irradiation of breast cancer patients

    International Nuclear Information System (INIS)

    McNeely, L.K.; Jacobson, G.M.; Leavitt, D.D.; Stewart, J.R.

    1988-01-01

    From 1980 to October 1985 we treated 45 breast cancer patients with electron arc therapy. This technique was used in situations where optimal treatment with fixed photon or electron beams was technically difficult: long scars, recurrent tumor extending across midline or to the posterior thorax, or marked variation in depth of target tissue. Forty-four patients were treated following mastectomy: 35 electively because of high risk of local failure, and 9 following local recurrence. One patient with advanced local regional disease was treated primarily. The target volume boundaries on the chest wall were defined by a foam lined cerrobend cast which rested on the patient during treatment, functioning as a tertiary collimator. A variable width secondary collimator was used to account for changes in the radius of the thorax from superior to inferior border. All patients had computerized tomography performed to determine Internal Mammary Chain depth and chest wall thickness. Electron energies were selected based on these thicknesses and often variable energies over different segments of the arc were used. The chest wall and regional node areas were irradiated to 45 Gy-50 Gy in 5-6 weeks by this technique. The supraclavicular and upper axillary nodes were treated by a direct anterior photon field abutted to the superior edge of the electron arc field. Follow-up is from 10-73 months with a median of 50 months. No major complications were observed. Acute and late effects and local control are comparable to standard chest wall irradiation. The disadvantages of this technique are that the preparation of the tertiary field defining cast and CT treatment planning are labor intensive and expensive. The advantage is that for specific clinical situations large areas of chest wall with marked topographical variation can be optimally, homogeneously irradiated while sparing normal uninvolved tissues

  10. Tumescent mastectomy technique in autologous breast reconstruction.

    Science.gov (United States)

    Vargas, Christina R; Koolen, Pieter G L; Ho, Olivia A; Ricci, Joseph A; Tobias, Adam M; Lin, Samuel J; Lee, Bernard T

    2015-10-01

    Use of the tumescent mastectomy technique has been reported to facilitate development of a hydrodissection plane, reduce blood loss, and provide adjunct analgesia. Previous studies suggest that tumescent dissection may contribute to adverse outcomes after immediate implant reconstruction; however, its effect on autologous microsurgical reconstruction has not been established. A retrospective review was conducted of all immediate microsurgical breast reconstruction procedures at a single academic center between January 2004 and December 2013. Records were queried for age, body mass index, mastectomy weight, diabetes, hypertension, smoking, preoperative radiation, reconstruction flap type, and autologous flap weight. Outcomes of interest were mastectomy skin necrosis, complete and partial flap loss, return to the operating room, breast hematoma, seroma, and infection. There were 730 immediate autologous breast reconstructions performed during the study period; 46% with the tumescent dissection technique. Groups were similar with respect to baseline patient and procedural characteristics. Univariate analysis revealed no significant difference in the incidence of mastectomy skin necrosis, complete or partial flap loss, return to the operating room, operative time, estimated blood loss, recurrence, breast hematoma, seroma, or infection in patients undergoing tumescent mastectomy. Multivariate analysis also demonstrated no significant association between the use of tumescent technique and postoperative breast mastectomy skin necrosis (P = 0.980), hematoma (P = 0.759), or seroma (P = 0.340). Use of the tumescent dissection technique during mastectomy is not significantly associated with adverse outcomes after microsurgical breast reconstruction. Despite concern for its impact on implant reconstruction, our findings suggest that this method can be used safely preceding autologous procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Effects of irradiation for cervical cancer on subsequent breast cancer

    International Nuclear Information System (INIS)

    Harlan, L.C.M.

    1985-01-01

    Previous research suggests that cervical cancer patients have a lower risk of breast cancer than women in the general population. Possible explanations include opposing risk factors for cervical cancer and breast cancer, the effect of irradiation used to treat cervical cancer, or both. The purpose of this study was to explore the relationship between irradiation for cervical cancer and the subsequent development of breast cancer. There was no statistically significant relationship between radiation to the ovarian area and the risk of breast cancer in this study. However, the results were consistent with a 19% reduction in risk for women irradiated for cervical cancer when compared to nonirradiated women. In a dose-response analysis, there was a nonsignificant trend of decreased risk of breast cancer with increased radiation up to 1800 rad. There was no consistent pattern for higher doses. The trend, although nonsignificant, differed by age. Women <60 years of age at irradiation were generally at a lower risk of breast cancer than nonirradiated women. Women over 59 years were at an increased risk. There are some potentially important findings from this study which might influence medical care. These should be examined in the larger International Radiation Study

  12. Contralateral breast dose from chest wall and breast irradiation: local experience

    International Nuclear Information System (INIS)

    Alzoubi, A.; Kandaiya, S.; Shukri, A.; Elsherbieny, E.

    2010-01-01

    Full text: Second cancer induction in the contralateral breast (CB) is an issue of some concern in breast radiotherapy especially for women under the age of 45 years at the time of treatment. The CB dose from 2-field and 3-field techniques in post-mastectomy chest wall irradiations in an anthropomorphic phantom as well as in patients were measured using thermoluminescent dosimeters (TLDs) at the local radiotherapy center. Breast and chest wall radiotherapy treatments were planned conformally (3D-CRT) and delivered using 6-MV photons. The measured CB dose at the surface fell sharply with distance from the field edge. However, the average ratio of the measured to the calculated CB dose using the pencil beam algorithm at the surface was approximately 53%. The mean and median measured internal dose at the posterior border of CB in a phantom was 5.47 ± 0.22 c G y and 5.44 c G y, respectively. The internal CB dose was relatively independent of depth. In the present study the internal CB dose is 2.1-4.1 % of the prescribed dose which is comparable to the values reported by other authors.

  13. Breast Cancer Patients' Preferences for Adjuvant Radiotherapy Post Lumpectomy: Whole Breast Irradiation vs. Partial Breast Irradiation-Single Institutional Study.

    Science.gov (United States)

    Bonin, Katija; McGuffin, Merrylee; Presutti, Roseanna; Harth, Tamara; Mesci, Aruz; Feldman-Stewart, Deb; Chow, Edward; Di Prospero, Lisa; Vesprini, Danny; Rakovitch, Eileen; Lee, Justin; Paszat, Lawrence; Doherty, Mary; Soliman, Hany; Ackerman, Ida; Cao, Xingshan; Kiss, Alex; Szumacher, Ewa

    2018-02-01

    This study was conducted to elucidate patients with early breast cancer preference for standard whole breast irradiation (WBI) or partial breast irradiation (PBI) following lumpectomy, as well as identify important factors for patients when making their treatment decisions. Based on relevant literature and ASTRO consensus statement guidelines, an educational tool and questionnaire were developed. Consenting, eligible women reviewed the educational tool and completed the trade-off questionnaire. Descriptive statistics were calculated, as well as chi-squares and a logistic regression model. Of the 90 patients who completed the study, 62 % preferred WBI, 30 % preferred PBI, 4 % required more information, and 3 % had no preferences. Of the patients who chose WBI, 58 % preferred hypofractionated RT, whereas 25 % preferred the conventional RT regimen. The majority of patients rated recurrence rate [WBI = 55/55 (100 %), PBI = 26/26 (100 %)] and survival [WBI = 54/55 (98 %), PBI = 26/26 (100 %)] as important factors contributing to their choice of treatment preference. Financial factors [WBI = 21/55 (38 %), PBI = 14/26 (53 %)] and convenience [WBI = 36/54 (67 %), PBI = 18/26 (69 %)] were rated as important less frequently. Significantly, more patients who preferred WBI also rated standard method of treatment as important when compared to patients who preferred PBI [WBI = 52/54 (96 %), PBI = 16/26 (61 %), χ 2  = 16.63, p = 0.001]. The majority of patients with early breast cancer who were surveyed for this study preferred WBI as an adjuvant treatment post lumpectomy, yet there was a sizeable minority who preferred PBI. This was associated with the importance patients place on standard treatment. These results will help medical professionals treat patients according to patient values.

  14. Implant breast reconstruction after salvage mastectomy in previously irradiated patients.

    Science.gov (United States)

    Persichetti, Paolo; Cagli, Barbara; Simone, Pierfranco; Cogliandro, Annalisa; Fortunato, Lucio; Altomare, Vittorio; Trodella, Lucio

    2009-04-01

    The most common surgical approach in case of local tumor recurrence after quadrantectomy and radiotherapy is salvage mastectomy. Breast reconstruction is the subsequent phase of the treatment and the plastic surgeon has to operate on previously irradiated and manipulated tissues. The medical literature highlights that breast reconstruction with tissue expanders is not a pursuable option, considering previous radiotherapy a contraindication. The purpose of this retrospective study is to evaluate the influence of previous radiotherapy on 2-stage breast reconstruction (tissue expander/implant). Only patients with analogous timing of radiation therapy and the same demolitive and reconstructive procedures were recruited. The results of this study prove that, after salvage mastectomy in previously irradiated patients, implant reconstruction is still possible. Further comparative studies are, of course, advisable to draw any conclusion on the possibility to perform implant reconstruction in previously irradiated patients.

  15. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Compliance to the Dosimetry Requirements of RTOG-0413

    Energy Technology Data Exchange (ETDEWEB)

    Wen Bixiu [Department of Radiation Oncology, New York University Medical Center, New York, New York (United States); Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080 (China); Hsu, Howard; Formenti-Ujlaki, George F.; Lymberis, Stella; Magnolfi, Chiara; Zhao Xuan; Chang Jenghwa; DeWyngaert, J. Keith; Jozsef, Gabor [Department of Radiation Oncology, New York University Medical Center, New York, New York (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University Medical Center, New York, New York (United States)

    2012-11-15

    Purpose: The dosimetric results from our institution's trials of prone accelerated partial breast irradiation are compared with the dosimetric requirements of RTOG-0413. Methods and Materials: Trial 1 and Trial 2 are 2 consecutive trials of prone-accelerated partial breast irradiation. Eligible for both trials were stage I breast cancer patients with negative margins after breast-conserving surgery. The planning target tumor volume (PTV) was created by extending the surgical cavity 2.0 cm for Trial 1 and 1.5 cm for Trial 2, respectively. Contralateral breast, heart, lungs, and thyroid were contoured. Thirty Gray was delivered in five daily fractions of 6 Gy by a three-dimensional conformal radiation therapy technique in Trial 1 and were by image-guided radiation therapy/intensity-modulated radiation therapy in Trial 2. Dosimetric results from the trials are reported and compared with RTOG 0413 requirements. Results: One hundred forty-six consecutive plans were analyzed: 67 left and 79 right breast cancers. The plans from the trials complied with the required >90% of prescribed dose covering 90% of PTV{sub E}VAL (=generated from the PTV by cropping 0.5 cm from the skin edge and excluding the chest wall): V90% was 98.1 {+-} 3.0% (with V100% and V95%, 89.4 {+-} 12.8%, 96.4 {+-} 5.1%, respectively). No significant difference between laterality was found (Student's t test). The dose constraints criteria of the RTOG-0413 protocol for ipsilateral and contralateral lung (V30 <15% and Dmax <3%), heart (V5 <40%), and thyroid (Dmax <3%) were satisfied because the plans showed an average V5% of 0.6% (range, 0-13.4) for heart, an average V30% of 0.6% (range, 0-9.1%) for ipsilateral lung, and <2% maximum dose to the thyroid. However, our partial breast irradiation plans demonstrated a higher dose to contralateral breast than that defined by RTOG constraints, with a median value of maximum doses of 4.1% (1.2 Gy), possibly as a result of contouring differences

  16. Partial Breast Irradiation Versus Whole Breast Radiotherapy for Early-Stage Breast Cancer: A Decision Analysis

    International Nuclear Information System (INIS)

    Sher, David J.; Wittenberg, Eve; Taghian, Alphonse G.; Bellon, Jennifer R.; Punglia, Rinaa S.

    2008-01-01

    Purpose: To compare the quality-adjusted life expectancy between women treated with partial breast irradiation (PBI) vs. whole breast radiotherapy (WBRT) for estrogen receptor-positive early-stage breast cancer. Methods and Materials: We developed a Markov model to describe health states in the 15 years after radiotherapy for estrogen receptor-positive early-stage breast cancer. Breast cancer recurrences were separated into local recurrences and elsewhere failures. Ipsilateral breast tumor recurrence (IBTR) risk was extracted from the Oxford overview, and rates and utilities were adapted from the literature. We studied two cohorts of women (aged 40 and 55 years), both of whom received adjuvant tamoxifen. Results: Assuming a no evidence of disease (NED)-PBI utility of 0.93, quality-adusted life expectancy after PBI (and WBRT) was 12.61 (12.57) and 12.10 (12.06) years for 40-year-old and 55-year-old women, respectively. The NED-PBI utility thresholds for preferring PBI over WBRT were 0.923 and 0.921 for 40-year-old and 55-year-old women, respectively, both slightly greater than the NED-WBRT utility. Outcomes were sensitive to the utility of NED-PBI, the PBI hazard ratio for local recurrence, the baseline IBTR risk, and the percentage of IBTRs that were local. Overall the degree of superiority of PBI over WBRT was greater for 55-year-old women than for 40-year-old women. Conclusions: For most utility values of the NED-PBI health state, PBI was the preferred treatment modality. This result was highly sensitive to patient preferences and was also dependent on patient age, PBI efficacy, IBTR risk, and the fraction of IBTRs that were local

  17. Hypofractionated whole breast irradiation: New standard in early breast cancer after breast-conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Su; Shin, Kyung Hwan; Choi, Noorie; Lee, Sea Won [Dept. of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

  18. Evaluation of dose to cardiac structures during breast irradiation

    DEFF Research Database (Denmark)

    Aznar, M C; Korreman, S-S; Pedersen, A N

    2011-01-01

    delivered to the heart and the LAD in respiration-adapted radiotherapy of patients with left-sided breast cancer. METHODS: 24 patients referred for adjuvant radiotherapy after breast-conserving surgery for left-sided lymph node positive breast cancer were evaluated. The whole heart, the arch of the LAD...... and the whole LAD were contoured. The radiation doses to all three cardiac structures were evaluated. RESULTS: For 13 patients, the plans were acceptable based on the criteria set for all 3 contours. For seven patients, the volume of heart irradiated was well below the set clinical threshold whereas a high dose...

  19. Shielding of the contralateral breast during tangential irradiation.

    Science.gov (United States)

    Goffman, Thomas E; Miller, Michael; Laronga, Christine; Oliver, Shelly; Wong, Ping

    2004-08-01

    The purpose of this study was to investigate both optimal and practical contralateral breast shielding during tangential irradiation in young patients. A shaped sheet of variable thickness of lead was tested on a phantom with rubber breasts, and an optimized shield was created. Testing on 18 consecutive patients 50 years or younger showed shielding consistently reduced contralateral breast dose to at least half, with small additional reduction after removal of the medial wedge. For younger patients in whom radiation exposure is of considerable concern, a simple shield of 2 mm lead thickness proved practical and effective.

  20. SU-G-JeP3-02: Comparison of Magnitude and Frequency of Patient Positioning Errors in Breast Irradiation Using AlignRT 3D Optical Surface Imaging and Skin Mark Techniques

    International Nuclear Information System (INIS)

    Yao, R; Chisela, W; Dorbu, G

    2016-01-01

    Purpose: To evaluate clinical usefulness of AlignRT (Vision RT Ltd., London, UK) in reducing patient positioning errors in breast irradiation. Methods: 60 patients undergoing whole breast irradiation were selected for this study. Patients were treated to the left or right breast lying on Qfix Access breast board (Qfix, Avondale, PA) in supine position for 28 fractions using tangential fields. 30 patients were aligned using AlignRT by aligning a breast surface region of interest (ROI) to the same area from a reference surface image extracted from planning CT. When the patient’s surface image deviated from the reference by more than 3mm on one or more translational and rotational directions, a new reference was acquired using AlignRT in-room cameras. The other 30 patients were aligned to the skin marks with room lasers. On-Board MV portal images of medial field were taken daily and matched to the DRRs. The magnitude and frequency of positioning errors were determined from measured translational shifts. Kolmogorov-Smirnov test was used to evaluate statistical differences of positional accuracy and precision between AlignRT and non-AlignRT patients. Results: The percentage of port images with no shift required was 46.5% and 27.0% in vertical, 49.8% and 25.8% in longitudinal, 47.6% and 28.5% in lateral for AlignRT and non-AlignRT patients, respectively. The percentage of port images requiring more than 3mm shifts was 18.1% and 35.1% in vertical, 28.6% and 50.8% in longitudinal, 11.3% and 24.2% in lateral for AlignRT and non-AlignRT patients, respectively. Kolmogorov-Smirnov test showed that there were significant differences between the frequency distributions of AlignRT and non-AlignRT in vertical, longitudinal, and lateral shifts. Conclusion: As confirmed by port images, AlignRT-assisted patient positioning can significantly reduce the frequency and magnitude of patient setup errors in breast irradiation compared to the use of lasers and skin marks.

  1. Postmastectomy irradiation in high-risk breast cancer patients

    International Nuclear Information System (INIS)

    Overgaard, M.; Juul Christensen, J.; Johansen, H.; Nybo-Rasmussen, A.; Brincker, H.; Kooy, P. van der; Frederiksen, P.L.; Laursen, F.; Panduro, J.; Soerensen, N.E.; Gadeberg, C.C.; Hjelm-Hansen, M.; Overgaard, J.; West Andersen, K.; Zedeler, K.

    1988-01-01

    All pre- and postmenopausal high-risk breast cancer patients in the protocols DBCG 77 of the Danish Breast Cancer Cooperative Group received postmastectomy irradiation before randomization to either adjuvant systemic therapy or no such treatment. The actuarial loco-regional recurrence rate at 9 years was 6-17%, with the lowest rate in patients who also received additional adjuvant chemotherapy or tamoxifen. In a subsequent study (DBCG 82) the role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients. Pre- and menopausal patients were randomized to postmastectomy irradiation+CMF (cyclophosphamide, methotrexate, 5-fluorouracil), CMF alone or CMF+TAM (tamoxifen). Postmenopausal patients were randomized to postmastectomy irradiation+TAM, TAM or CMF+TAM. At 4 years the loco-regional recurrence rate was significantly lower in the irradiated patients (5-7% vs. 23-33%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment. At present, there are no significant differences between survival in the treatment groups. Thus, adjuvant systemic treatment alone (chemotherapy and/or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumour control in high-risk breast cancer patients with respect to survival. (orig.)

  2. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT

    International Nuclear Information System (INIS)

    Velazquez T, J. J.; Gutierrez M, J. G.; Ortiz A, C. S.; Chagoya G, A.; Gutierrez C, J. G.

    2015-10-01

    Partial breast irradiation is a new type of external radiation therapy to treat breast cancer in early clinical stages. Consist of administering to the channel surgical high doses of radiation in few treatment sessions. In this paper the dose calculations of the planning system Eclipse version 10 for a treatment of partial breast irradiation with X-rays beams (6 MV) intensity modulated were compared against the measurements made with OSL dosimeters and radio-chromic dye film. An anthropomorphic mannequin was used in which OSL dosimeters were collocated near the surface, an inside the radio-chromic dye film one plate; with this latest one dimensional dose distribution was measured. Previously dosimeters were calibrated irradiating them with a beam of X-rays 6 MV under the conditions specified in the IAEA-398 protocol. The OSL dosimeters were read in the Micro star Landauer equipment, the radio-chromic dye films were read with a scanner Epson 10000-Xl and analyzed with FilmCal and PTW Verisoft programs. The differences between measured and calculated dose were as follows: 3.6±1% for the OSL dosimeter and 96.3±1% of the analyzed points approved the gamma index criterion (3%, 3m m) when comparing the matrices of calculated dose and measured with the radio-chromic dye film. These results confirm the good dosimetric performance of planning system used under specific conditions used in the partial breast irradiation technique. (Author)

  3. Long-term observations of operated and irradiated breast carcinoma

    International Nuclear Information System (INIS)

    Decker-Mroz, G.; Schroeder, R.

    1983-01-01

    498 patients with histologically established and surgically removed breast carcinomas received post-operative irradiation treatment at Moabit hospital, Berlin, between 1965 and 1975. The long-term results of this largely standardized therapy have been compiled and evaluated. (orig./MG) [de

  4. Studies On Quality Criteria For Irradiated Breaded Chicken Breast Fillets

    International Nuclear Information System (INIS)

    HASSAN, I.M.; IBRAHIM, M.T.; MAHMOUD, A.A.; SHAMS EL DIN, N.M.M.; MOHAMMAD, M.K.

    2010-01-01

    Quality criteria of irradiated breaded chicken breast fillets were studied. Fresh boneless and skinless breaded chicken breast meats samples were divided into four separate batches and packed in plastic bags and sealed by an impulse sealer. Samples in plastic bags were exposed to different doses of gamma irradiation (2.5, 5 and 7 kGy) at ambient temperature. Just after irradiation, the samples were stored at 4 ±1 0 C. All samples were evaluated for microbiological, chemical and sensorial properties after irradiation and throughout the storage periods. During storage, the total bacterial count was significantly increased (P<0.05) in all samples with higher rates of increase in non-irradiated samples. In all irradiated samples, Staphylococcus aureus did not detected up to 6 days then detected after 22 days in samples treated with 2.5 kGy as well as 31 days in samples treated with 5 kGy. On the other hand, Staphylococcus aureus was detected after 45 days in samples treated with 7 kGy. Salmonella sp., Listeria monocytogenes and Campylobacter jejuni could not detected in untreated and treated samples. The protein content showed significant decrease immediately after irradiation and during the refrigerated storage. The TVN values for non-irradiated samples were significantly higher (P<0.05) than irradiated samples. The present data showed significant decrease (P<0.05) in protein solubility percentages of irradiated samples at day 0 and 6 of refrigerated storage. The observed decrease was related to the increase of radiation dose. At the end of storage period (62 days), 2.5 kGy samples were significantly higher in TBA values than other irradiated samples. On the other hand, irradiation was significantly reduced (P<0.05) the amount of major mono unsaturated and poly unsaturated fatty acids. Sensory attributes of breaded chicken breast fillets did not affected by irradiation. It could be concluded that irradiation dose of 5 kGy can be used in chicken samples stored in

  5. Irradiation technique useful in food preservation

    International Nuclear Information System (INIS)

    Jayaprakas, C.A.; Palaniswarmi, M.S.

    2001-01-01

    Application of innovative technologies to promote the production of food is indispensable to meet the demand of emerging populations. It is equally important to protect the stored products from the invasion of pests and diseases. Indiscriminate use of insecticides has now been highly discouraged, as it causes health and environmental hazards. In causes health and environmental hazards. In this juncture, an alternate method to curb the menace of pests and diseases is imperative. Irradiation technique, a gift of nuclear physics, which has been identified as an eco-friendly method to preserve food materials for long term, is now been getting wider acceptance

  6. Conservation irradiation in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Faria, S.L.; Chiminazzo Junior, H.

    1985-01-01

    Techniques of treatment and cosmetic results of 130 patients with breast cancer are presented. All patients received conservative treatment, with lumpectomy and radiotherapy at Centro de Oncologia Campinas. (M.A.C.) [pt

  7. [Partial breast irradiation (PBI): the therapy of the future?].

    Science.gov (United States)

    Koning, Caro C E; Bijker, Nina; van Tienhoven, Geertjan

    2010-01-01

    Breast-conserving therapy with radiation therapy of 50 Gy over 5 weeks to the entire breast plus a tumour bed boost is the standard treatment for patients with early stage breast cancer. Several attempts have been made to lower the treatment burden, such as omitting either all radiotherapy or the tumour bed boost, without success. Phase III trials are now being carried out to evaluate the treatment of the primary tumour area only (PBI). Various methods for selection of patient groups and of delivering the radiation dose have been employed. Vaidya et al. report the same favourable local recurrence rates following PBI with single dose intraoperative radiotherapy as with whole-breast irradiation. As the follow-up period so far has been short, long-time results should be awaited.

  8. American Brachytherapy Society consensus report for accelerated partial breast irradiation using interstitial multicatheter brachytherapy.

    Science.gov (United States)

    Hepel, Jaroslaw T; Arthur, Douglas; Shaitelman, Simona; Polgár, Csaba; Todor, Dorin; Zoberi, Imran; Kamrava, Mitchell; Major, Tibor; Yashar, Catheryn; Wazer, David E

    To develop a consensus report for the quality practice of accelerated partial breast irradiation (APBI) using interstitial multicatheter brachytherapy (IMB). The American Brachytherapy Society Board appointed an expert panel with clinical and research experience with breast brachytherapy to provide guidance for the current practice of IMB. This report is based on a comprehensive literature review with emphasis on randomized data and expertise of the panel. Randomized trials have demonstrated equivalent efficacy of APBI using IMB compared with whole breast irradiation for select patients with early-stage breast cancer. Several techniques for placement of interstitial catheters are described, and importance of three-dimensional planning with appropriate optimization is reviewed. Optimal target definition is outlined. Commonly used dosing schemas include 50 Gy delivered in pulses of 0.6-0.8 Gy/h using pulsed-dose-rate technique and 34 Gy in 10 fractions, 32 Gy in eight fractions, or 30 Gy in seven fractions using high-dose-rate technique. Potential toxicities and strategies for toxicity avoidance are described in detail. Dosimetric constraints include limiting whole breast volume that receives ≥50% of prescription dose to 0.75 (>0.85 preferred), V 150  < 45 cc, and V 200  < 14 cc. Using an optimal implant technique coupled with optimal planning and appropriate dose constraints, a low rate of toxicity and a good-to-excellent cosmetic outcome of ≥90% is expected. IMB is an effective technique to deliver APBI for appropriately selected women with early-stage breast cancer. This consensus report has been created to assist clinicians in the appropriate practice of APBI using IMB. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  9. Three-Dimensional Volumetric Analysis of Irradiated Lung With Adjuvant Breast Irradiation

    International Nuclear Information System (INIS)

    Teh, Amy Yuen Meei; Park, Eileen J.H.; Shen Liang; Chung, Hans T.

    2009-01-01

    Purpose: To retrospectively evaluate the dose-volume histogram data of irradiated lung in adjuvant breast radiotherapy (ABR) using a three-dimensional computed tomography (3D-CT)-guided planning technique; and to investigate the relationship between lung dose-volume data and traditionally used two-dimensional (2D) parameters, as well as their correlation with the incidence of steroid-requiring radiation pneumonitis (SRRP). Methods and Materials: Patients beginning ABR between January 2005 and February 2006 were retrospectively reviewed. Patients included were women aged ≥18 years with ductal carcinoma in situ or Stage I-III invasive carcinoma, who received radiotherapy using a 3D-CT technique to the breast or chest wall (two-field radiotherapy [2FRT]) with or without supraclavicular irradiation (three-field radiotherapy [3FRT]), to 50 Gy in 25 fractions. A 10-Gy tumor-bed boost was allowed. Lung dose-volume histogram parameters (V 10 , V 20 , V 30 , V 40 ), 2D parameters (central lung depth [CLD], maximum lung depth [MLD], and lung length [LL]), and incidence of SRRP were reported. Results: A total of 89 patients met the inclusion criteria: 51 had 2FRT, and 38 had 3FRT. With 2FRT, mean ipsilateral V 10 , V 20 , V 30 , V 40 and CLD, MLD, LL were 20%, 14%, 11%, and 8% and 2.0 cm, 2.1 cm, and 14.6 cm, respectively, with strong correlation between CLD and ipsilateral V 10-V40 (R 2 = 0.73-0.83, p 10 , V 20 , V 30 , and V 40 were 30%, 22%, 17%, and 11%, but its correlation with 2D parameters was poor. With a median follow-up of 14.5 months, 1 case of SRRP was identified. Conclusions: With only 1 case of SRRP observed, our study is limited in its ability to provide definitive guidance, but it does provide a starting point for acceptable lung irradiation during ABR. Further prospective studies are warranted.

  10. A Simple Technique of Supine Craniospinal Irradiation

    International Nuclear Information System (INIS)

    Munshi, Anusheel; Jalali, Rakesh

    2008-01-01

    We describe a simple procedure of craniospinal irradiation in supine position. The procedure was carried out with a 100-cm isocenter linear accelerator and compatible simulator. Treatment was with a 1 or 2 posteroanterior (PA)-directed spinal fields abutting lateral-directed cranial fields. Abutment of the fields was established by placement of markers on the neck of the patient, which provided a measure of the divergence of the spinal field. The precision and reproducibility of this technique, including the placement of junctions, appeared to be as good as for treatment in the prone position. The same could be verified with port films. We conclude that this new technique of supine craniospinal treatment is a simple and convenient alternative to traditional treatment in the prone position

  11. Performance evaluation of breast image compression techniques

    Energy Technology Data Exchange (ETDEWEB)

    Anastassopoulos, G; Lymberopoulos, D [Wire Communications Laboratory, Electrical Engineering Department, University of Patras, Greece (Greece); Panayiotakis, G; Bezerianos, A [Medical Physics Department, School of Medicine, University of Patras, Greece (Greece)

    1994-12-31

    Novel diagnosis orienting tele working systems manipulate, store, and process medical data through real time communication - conferencing schemes. One of the most important factors affecting the performance of these systems is image handling. Compression algorithms can be applied to the medical images, in order to minimize : a) the volume of data to be stored in the database, b) the demanded bandwidth from the network, c) the transmission costs, and to minimize the speed of the transmitted data. In this paper an estimation of all the factors of the process that affect the presentation of breast images is made, from the time the images are produced from a modality, till the compressed images are stored, or transmitted in a Broadband network (e.g. B-ISDN). The images used were scanned images of the TOR(MAX) Leeds breast phantom, as well as typical breast images. A comparison of seven compression techniques has been done, based on objective criteria such as Mean Square Error (MSE), resolution, contrast, etc. The user can choose the appropriate compression ratio in order to achieve the desired image quality. (authors). 12 refs, 4 figs.

  12. Performance evaluation of breast image compression techniques

    International Nuclear Information System (INIS)

    Anastassopoulos, G.; Lymberopoulos, D.; Panayiotakis, G.; Bezerianos, A.

    1994-01-01

    Novel diagnosis orienting tele working systems manipulate, store, and process medical data through real time communication - conferencing schemes. One of the most important factors affecting the performance of these systems is image handling. Compression algorithms can be applied to the medical images, in order to minimize : a) the volume of data to be stored in the database, b) the demanded bandwidth from the network, c) the transmission costs, and to minimize the speed of the transmitted data. In this paper an estimation of all the factors of the process that affect the presentation of breast images is made, from the time the images are produced from a modality, till the compressed images are stored, or transmitted in a Broadband network (e.g. B-ISDN). The images used were scanned images of the TOR(MAX) Leeds breast phantom, as well as typical breast images. A comparison of seven compression techniques has been done, based on objective criteria such as Mean Square Error (MSE), resolution, contrast, etc. The user can choose the appropriate compression ratio in order to achieve the desired image quality. (authors)

  13. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, Lloyd M, E-mail: lloyd.smyth@epworth.org.au [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia); Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Knight, Kellie A [Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Aarons, Yolanda K; Wasiak, Jason [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia)

    2015-03-15

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

  14. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    International Nuclear Information System (INIS)

    Smyth, Lloyd M; Knight, Kellie A; Aarons, Yolanda K; Wasiak, Jason

    2015-01-01

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy

  15. External beam radiotherapy (EBRT) techniques used in breast cancer treatment to reduce cardiac exposure

    International Nuclear Information System (INIS)

    Fung, Esther; Hendry, Julie

    2013-01-01

    Radiotherapy in breast cancer treatment has been shown to reduce local recurrence and improve survival rates. However, there is a concern that breast radiotherapy can cause an increase in cardiac mortality, particularly in patients being treated for left-sided breast cancer. This review aims to investigate how cardiac exposure is minimised in breast radiotherapy and determine an optimal method for reducing cardiac dose, using literature from ScienceDirect, Medline and CINAHL. IMRT and breathing-adapted radiotherapy both reduce cardiac exposure but IMRT also increases the irradiated volume at low dose. Several issues were reported with regards to the clinical implementation of these techniques. It is suggested that inspiration breath-hold radiotherapy, is the preferred solution to minimising cardiac exposure but more research is warranted to confirm this. Long-term follow-up is required to determine dose–response relationships. Research needs to focus on breast cancer treatment as a whole in order to effectively reduce cardiac mortality.

  16. Irradiation doses on thyroid gland during the postoperative irradiation for breast cancer.

    Science.gov (United States)

    Akın, Mustafa; Ergen, Arzu; Unal, Aysegul; Bese, Nuran

    2014-01-01

    Thyroid gland is one of the radiosensitive endocrine organs in the body. It has been shown that direct irradiation of thyroid with total doses of 26 to 30 Gy can lead to functional abnormalities. In this study, irradiation doses on thyroid gland of the patients who received postoperative chest-wall/breast and regional nodal irradiation were assessed. Retrospective analyses of treatment plans from 122 breast cancer patients who were treated with 3D conformal radiotherapy (3D CRT) planning was performed. All patients received irradiation to supraclavicular/level III lymph nodes in addition to chest-wall/breast. A total dose of 46 Gy was delivered in 25 days to supraclavicular/level III lymph node region while a total dose of 50 Gy was delivered to whole breast/chest-wall. Thyroid gland was contoured on 2-5 mm thickness of computed tomography scans. Absolute thyroid volume, mean thyroid doses were calculated. The mean thyroid volume of all patients was 16.7 cc (min: 1.9 cc, max: 41.6 cc). The mean irradiation dose on was 22.5 Gy (0.32 Gy-46.5 Gy). The level of dose was higher than 26 Gy in 44% of the patients. In majority of the node-positive breast cancer patients treated with 3D CRT, the thyroid gland was exposed to considerable doses. On the other hand, for 44% of the patients are at risk for developing thyroid function abnormalities which should be considered during the routine follow-up.

  17. Is current clinical practice modified about intraoperative breast irradiation?

    Science.gov (United States)

    Massa, Michela; Franchelli, Simonetta; Panizza, Renzo; Massa, Tiberio

    2016-04-01

    After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

  18. Influence of locoregional irradiation on local control and survival in breast cancer

    International Nuclear Information System (INIS)

    Cutuli, B.

    1998-01-01

    Locoregional control is a crucial step in the achievement of breast cancer cure. In ductal carcinoma in situ, breast irradiation significantly reduces the rates of local recurrence whatever the histological subtypes, as demonstrated by the NSABP-B17 trial (25.8 % of local recurrences without radiotherapy vs. 11.4 % with radiotherapy). In infiltrating breast carcinomas, complementary breast irradiation has been shown to significantly improve the local control and slightly the overall survival in five randomized trials. Following mastectomy, locoregional irradiation clearly reduces the chest wall and nodal relapse rates, especially in case of lesions more than 5 cm or with nodal involvement and/or large lymphatic or vascular emboli. Two recent randomized trials confirmed the benefit of well-adapted locoregional irradiation in all subgroups, especially in patients with one to three axillary involves nodes. In the Danish trial (including pre-menopausal high-risk women), radiotherapy reduced locoregional relapses from 32 to 9 % (p<0.001) and increased the 10-year survival rate from 45 to 54% (p<0.001). In the Canadian trial, locoregional relapse rate decreased from 25 to 13 % and the 10-year survival rate increased from 56 to 65 %. The meta-analysis published in 1995 by the EBCTCG showed only a modest benefit due to locoregional irradiation in breast cancer. However, when small or old trials were excluded due to imperfect methodology or inadequate irradiation techniques, the benefit of modern radiotherapy became much more evident in a population of 7,840 patients. Locoregional irradiation appears to be able to reduce the risk of metastatic evolution occurring after local or nodal relapse and must be integrated in a multidisciplinary strategy. Treatment toxicity (especially toxicity due to irradiation of internal mammary nodes) is of special concern, as anthracycline-based chemotherapy is prescribed more often. The use of a direct field, with at least 60 % of the dose

  19. Skin toxicity during hypo fractionated breast irradiation in patient with early breast cancer

    International Nuclear Information System (INIS)

    Petrova, Deva; Smichkoska, Snezhana

    2013-01-01

    Radiotherapy is an important component in the treatment of breast cancer. (1) Many women with an early stage of breast cancer are candidates for a breast conservation therapy, which combines both conservative surgery and radiotherapy. (2) According to the data from some series, an estimated 90% of the patients treated with radiotherapy for breast cancer will develop a degree of radiation-induced dermatitis. (3) The severity of the skin reactions during and following the breast irradiation is influenced by both treatment-related and patient-related factors. The treatment - related factors include the fraction size (the dose delivered with each treatment), the total dose delivered, the volume of tissue treated, the type of radiation (4) and the addition of chemotherapy. (5) The patient-related factors include breast size, smoking, axillary lymphocele drainage before treatment, age, and infection of the surgical wound. (6) A hypo fractionation radiotherapy is alternative for a standard fractionation radiotherapy for women with early stage of breast cancer after conservative surgery. The aim of the study was to analyse the acute skin reactions during a hypo fractionated radiotherapy in patients with early breast cancer at our institution. Materials and methods: Twenty patients with early stage of breast cancer (Stadium I and II) and conservative surgery (quadrantectomy of breast with ipsilateral axillary dissection) were analysed. The patients were treated with 6MV x rays on LINAC, using tangential fields with 2.65Gy per fraction and the total dose prescribed to target volume was 42,4 Gy. These patients were observed for acute skin toxicity during the second week and at the end of the treatment. We evaluated dryness, epilation, pigmentation, changes and eritema, dry desquamation (clinically characterized by scaling and pruritus) and moist desquamation (characterized by serious oozing and exposure of the dermis). By using the radiation therapy oncology group’s (RTOG

  20. Dosimetric comparison of field in field intensity-modulated radiotherapy technique with conformal radiotherapy techniques in breast cancer

    International Nuclear Information System (INIS)

    Ercan, T.; Alco, G.; Zengin, F.; Atilla, S.; Dincer, M.; Igdem, S.; Okkan, S.

    2010-01-01

    The aim of this study was to be able to implement the field-in-field intensity-modulated radiotherapy (FiF) technique in our daily practice for breast radiotherapy. To do this, we performed a dosimetric comparison. Treatment plans were produced for 20 consecutive patients. FiF plans and conformal radiotherapy (CRT) plans were compared for doses in the planning target volume (PTV), the dose homogeneity index (DHI), doses in irradiated soft tissue outside the target volume (SST), ipsilateral lung and heart doses for left breast irradiation, and the monitor unit counts (MU) required for treatment. Averaged values were compared using Student's t-test. With FiF, the DHI is improved 7.0% and 5.7%, respectively (P<0.0001) over the bilateral and lateral wedge CRT techniques. When the targeted volumes received 105% and 110% of the prescribed dose in the PTV were compared, significant decreases are found with the FiF technique. With the 105% dose, the SST, heart, and ipsilateral lung doses and the MU counts were also significantly lower with the FiF technique. The FiF technique, compared to CRT, for breast radiotherapy enables significantly better dose distribution in the PTV. Significant differences are also found for soft tissue volume, the ipsilateral lung dose, and the heart dose. Considering the decreased MUs needed for treatment, the FiF technique is preferred over tangential CRT. (author)

  1. Contribution of the deep-inspiration breath-hold technique in patients treated for a left breast cancer by mono-isocentric conformational irradiation; Apport du blocage inspiratoire profond chez des patientes traitees pour un cancer du sein gauche par irradiation conformationnelle mono-isocentrique

    Energy Technology Data Exchange (ETDEWEB)

    Zioueche, A.; Mege, A.; Bodez, V.; Rauglaudre, G. de [Institut Sainte-Catherine, Avignon (France)

    2011-10-15

    The authors report a study which aimed at assessing the benefit of a deep-inspiration-breath-hold on heart sparing in 31 women treated in the left breast or wall and locoregional ganglionary areas by three-dimensional conformational irradiation with field-in-field optimization. All heart and lung parameters (delivered doses) have been significantly improved by a deep-inspiration-breath-hold. Short communication

  2. Dosimetric comparison of partial and whole breast external beam irradiation in the treatment of early stage breast cancer

    International Nuclear Information System (INIS)

    Kim, Yongbok; Parda, David S.; Trombetta, Mark G.; Colonias, Athanasios; Werts, E. Day; Miller, Linda; Miften, Moyed

    2007-01-01

    A dosimetric comparison was performed on external-beam three-dimensional conformal partial breast irradiation (PBI) and whole breast irradiation (WBI) plans for patients enrolled in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-39/Radiation Therapy Oncology Group (RTOG) 0413 protocol at our institution. Twenty-four consecutive patients were treated with either PBI (12 patients) or WBI (12 patients). In the PBI arm, the lumpectomy cavity was treated to a total dose of 38.5 Gy at 3.85 Gy per fraction twice daily using a four-field noncoplanar beam setup. A minimum 6 h interval was required between fractions. In the WBI arm, the whole breast including the entirety of the lumpectomy cavity was treated to a total dose of 50.4 Gy at 1.8 Gy per fraction daily using opposed tangential beams. The lumpectomy cavity volume, planning target volume for evaluation (PTV E VAL), and critical structure volumes were contoured for both the PBI and WBI patients. Dosimetric parameters, dose volume histograms (DVHs), and generalized equivalent uniform dose (gEUD) for target and critical structures were compared. Dosimetric results show the PBI plans, compared to the WBI plans, have smaller hot spots in the PTV E VAL (maximum dose: 104.2% versus 110.9%) and reduced dose to the ipsilateral breast (V50: 48.6% versus 92.1% and V100: 10.2% versus 50.5%), contralateral breast (V3: 0.16% versus 2.04%), ipsilateral lung (V30: 5.8% versus 12.7%), and thyroid (maximum dose: 0.5% versus 2.0%) with p values ≤0.01. However, similar dose coverage of the PTV E VAL (98% for PBI and 99% for WBI, on average) was observed and the dose difference for other critical structures was clinically insignificant in both arms. The gEUD data analysis showed the reduction of dose to the ipsilateral breast and lung, contralateral breast and thyroid. In addition, preliminary dermatologic adverse event assessment data suggested reduced skin toxicity for patients treated with the PBI technique

  3. Outcomes of breast cancer patients with triple negative receptor status treated with accelerated partial breast irradiation.

    Science.gov (United States)

    Wilkinson, J Ben; Reid, Robert E; Shaitelman, Simona F; Chen, Peter Y; Mitchell, Christine K; Wallace, Michelle F; Marvin, Kimberly S; Grills, Inga S; Margolis, Jeffrey M; Vicini, Frank A

    2011-11-01

    Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Outcomes of Breast Cancer Patients With Triple Negative Receptor Status Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Wilkinson, J. Ben; Reid, Robert E.; Shaitelman, Simona F.; Chen, Peter Y.; Mitchell, Christine K.; Wallace, Michelle F.; Marvin, Kimberly S.; Grills, Inga S.; Margolis, Jeffrey M.; Vicini, Frank A.

    2011-01-01

    Purpose: Triple negative receptor status (TNRS) of patients undergoing breast-conserving therapy treated with whole-breast irradiation has been associated with increased distant metastasis and decreased disease-free and overall survival. This paper reports the outcomes of TNRS patients treated with accelerated partial breast irradiation (APBI). Methods and Materials: We studied 455 patients who received APBI at our institution, using interstitial, intracavitary, and three-dimensional conformal radiation therapy. TNRS was assigned if a patient tested negative for all three (ER [estrogen receptor], PR [progesterone receptor], and HER2/neu) receptors. Of 202 patients with all receptor results available, 20 patients were designated TNRS, and 182 patients had at least one receptor positive (RP). We analyzed ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), distant metastasis (DM), and overall survival (OS). Results: Mean follow-up was 4.1 years for the TNRS group and 5.1 years for the RP cohort (p = 0.11). TNRS patients had a higher histologic grade (59% TNRS vs. 13% RP; p 0.52). OS for the RP cohort was 93% at 5 years (p > 0.28). Conclusions: In our patient population, TNRS conferred a clinical outcome similar to that of patients with RP disease treated with APBI. Further investigation with larger patient populations and longer follow-up periods is warranted to confirm that APBI is a safe and effective treatment for patients with localized TNRS breast cancer.

  5. Change in volume of lumpectomy cavity during external-beam irradiation of the intact breast

    International Nuclear Information System (INIS)

    Jacobson, Geraldine; Betts, Vicki; Smith, Brian

    2006-01-01

    Purpose: Definition of the lumpectomy cavity is an important component of irradiation of the breast. We use computed tomography (CT)-based planning and contour the lumpectomy volume on the planning CT. We obtained a second CT in the 4th or 5th week of treatment for boost planning and compared the volume change with the first planning-CT scan. Methods and Materials: This retrospective study reviewed the planning-CT data for 20 patients. In the first CT, images were obtained from the mandible to 2 cm below the breast in 3-mm slices. In the second CT, for the boost, images were obtained from the top to the bottom of the clinically defined breast, in 3-mm slices. Lumpectomy cavities were contoured on both CT scans and volumes compared. Results: Sixteen of the 20 patients (80%) had more than a 20% decrease from the first to the second volume, with a corresponding 95% confidence interval. The mean decrease was 16.13 cc, with a standard deviation of 14.05. The Spearman correlation coefficient of 0.18 did not show a significant correlation between the initial volume and the percent change. Conclusions: During external breast irradiation, many patients will have significant volume reduction in the lumpectomy cavity. Because CT-based definition of the lumpectomy cavity can influence the planning of a boost technique, further study appears warranted

  6. Tumor bed delineation for external beam accelerated partial breast irradiation: A systematic review

    International Nuclear Information System (INIS)

    Yang, T. Jonathan; Tao, Randa; Elkhuizen, Paula H.M.; Vliet-Vroegindeweij, Corine van; Li, Guang; Powell, Simon N.

    2013-01-01

    In recent years, accelerated partial breast irradiation (APBI) has been considered an alternative to whole breast irradiation for patients undergoing breast-conserving therapy. APBI delivers higher doses of radiation in fewer fractions to the post-lumpectomy tumor bed with a 1–2 cm margin, targeting the area at the highest risk of local recurrence while sparing normal breast tissue. However, there are inherent challenges in defining accurate target volumes for APBI. Studies have shown that significant interobserver variation exists among radiation oncologists defining the lumpectomy cavity, which raises the question of how to improve the accuracy and consistency in the delineation of tumor bed volumes. The combination of standardized guidelines and surgical clips significantly improves an observer’s ability in delineation, and it is the standard in multiple ongoing external-beam APBI trials. However, questions about the accuracy of the clips to mark the lumpectomy cavity remain, as clips only define a few points at the margin of the cavity. This paper reviews the techniques that have been developed so far to improve target delineation in APBI delivered by conformal external beam radiation therapy, including the use of standardized guidelines, surgical clips or fiducial markers, pre-operative computed tomography imaging, and additional imaging modalities, including magnetic resonance imaging, ultrasound imaging, and positron emission tomography/computed tomography. Alternatives to post-operative APBI, future directions, and clinical recommendations were also discussed

  7. Complex immunological monitoring of breast cancer patients treated postoperatively by electron beam irradiation

    International Nuclear Information System (INIS)

    Horvath, M.; Horvath, A.; Fekete, B.; Toth, J.

    1986-01-01

    To monitor the electron beam therapy some immunological parameters of breast cancer patients previously undergone surgery were tested before, during and after irradiation. Immune complex levels measured by complement consumption technique were not altered by irradiation. Killer cell activity tested in so-called antibody dependent cellular cytotoxicity (ADCC) capacity assay showed a marked decrease in some cases. Based on the phagocytic capacity of the granulocytes the patients could be divided into two groups: one with declining activity and another with rising activity: The majority of the patients (22/45) were humoral leukocyte adherence inhibition (H-LAI) negative before and during irradiation. Those showed positive H-LAI indices before electron therapy had unchanged (7/45) or decreasing (9/45) tendencies during the observation period. Further study is needed to establish the clinical relevance of these in vitro assays used by us. (orig.) [de

  8. Effect of irradiation dose and irradiation temperature on the thiamin content of raw and cooked chicken breast meat

    International Nuclear Information System (INIS)

    Graham, W.D.; Stevenson, M.H.; Stewart, E.M.

    1998-01-01

    The usefulness of ionising radiation for the elimination of pathogenic bacteria in poultry meat has been well documented as have the effects of this processing treatment on the nutritional status of the food, in particular, the vitamins. Unfortunately, much of the earlier research carried out on the effect of irradiation on vitamins was carried out in solution or in model systems at doses much greater than those used commercially thereby resulting in considerable destruction of these compounds. Thus, those opposed to the process of food irradiation labelled the treated food as nutritionally poor. However, in reality, due to the complexity of food systems the effects of irradiation on vitamins are generally not as marked and many processes, for example cooking, cause the same degree of change to the vitamins. Thiamin (vitamin B1) is the most radiation sensitive of the water-soluble vitamins and is therefore a good indicator of the effect of irradiation treatment. In this study the effects of irradiation at either 4°C or −20°C followed by cooking on the thiamin content of chicken breast meat was determined. Results showed that whilst both irradiation and cooking resulted in a decrease in thiamin concentration, the losses incurred were unlikely to be of nutritional significance and could be further minimised by irradiating the chicken meat at a low temperature. Thiamin analyses were carried out using high-performance liquid chromatography since this technique is faster and more selective than the chemical or microbiological methods more commonly employed. Total thiamin, both free and combined form, was determined following acid and enzyme hydrolysis. © 1998 Society of Chemical Industry

  9. Three-Dimensional Conformal Simultaneously Integrated Boost Technique for Breast-Conserving Radiotherapy

    International Nuclear Information System (INIS)

    Laan, Hans Paul van der; Dolsma, Wil V.; Maduro, John H.; Korevaar, Erik W.; Hollander, Miranda; Langendijk, Johannes A.

    2007-01-01

    Purpose: To compare the target coverage and normal tissue dose with the simultaneously integrated boost (SIB) and the sequential boost technique in breast cancer, and to evaluate the incidence of acute skin toxicity in patients treated with the SIB technique. Methods and Materials: Thirty patients with early-stage left-sided breast cancer underwent breast-conserving radiotherapy using the SIB technique. The breast and boost planning target volumes (PTVs) were treated simultaneously (i.e., for each fraction, the breast and boost PTVs received 1.81 Gy and 2.3 Gy, respectively). Three-dimensional conformal beams with wedges were shaped and weighted using forward planning. Dose-volume histograms of the PTVs and organs at risk with the SIB technique, 28 x (1.81 + 0.49 Gy), were compared with those for the sequential boost technique, 25 x 2 Gy + 8 x 2 Gy. Acute skin toxicity was evaluated for 90 patients treated with the SIB technique according to Common Terminology Criteria for Adverse Events, version 3.0. Results: PTV coverage was adequate with both techniques. With SIB, more efficiently shaped boost beams resulted in smaller irradiated volumes. The mean volume receiving ≥107% of the breast dose was reduced by 20%, the mean volume outside the boost PTV receiving ≥95% of the boost dose was reduced by 54%, and the mean heart and lung dose were reduced by 10%. Of the evaluated patients, 32.2% had Grade 2 or worse toxicity. Conclusion: The SIB technique is proposed for standard use in breast-conserving radiotherapy because of its dose-limiting capabilities, easy implementation, reduced number of treatment fractions, and relatively low incidence of acute skin toxicity

  10. A case report on bilateral partial breast irradiation using SAVI

    Energy Technology Data Exchange (ETDEWEB)

    Gloi, Aime M., E-mail: agloi@stvgb.org [Radiation Oncology, St. Vincent Hospital, Green Bay, WI (United States); Buchanan, Robert [Southeast Alabama Medical Center, Radiation Oncology Department, Dothan, AL 36301 (United States); Nuskind, Jeff; Zuge, Corrie; Goettler, Anndrea [Radiation Oncology, St. Vincent Hospital, Green Bay, WI (United States)

    2012-07-01

    To assess dosimetric parameters in a case study where bilateral accelerated partial breast irradiation (APBI) is delivered using a strut-adjusted volume implant (SAVI) device. A 59-year-old female received APBI in both breasts over 5 days, with fractions of 3.4 Gy twice daily. A Vac-lok system was used for immobilization, and a C-arm was used for daily imaging. We generated dose-volume histograms (DVHs) for the brachytherapy plans to derive several important biologic factors. We calculated the normal tissue complication probability (NTCP), equivalent uniform dose (EUD), and tumor control probability (TCP) using the Lyman-Kutcher-Burman model parameters {alpha} = 0.3 Gy{sup -1}, {alpha}/{beta} = 4 Gy, n = 0.1, and m = 0.3. In addition, we assessed the dose homogeneity index (DHI), overdose index, and dose nonuniformity ratio. D95 was >95% and V150 was <50 mL for both breasts. The DHIs were 0.469 and 0.512 for the left and right breasts, respectively. The EUDs (normalized to 3.4 Gy b.i.d.) were 33.53 and 29.10 Gy. The TCPs were estimated at 99.2% and 99.9%, whereas the NTCP values were 4.2% and 2.57%. In this clinical case, we were able to quantify the dosimetric parameters of an APBI treatment performed with a SAVI device.

  11. Accelerated partial breast irradiation for elderly women with early breast cancer: A compromise between whole breast irradiation and omission of radiotherapy.

    Science.gov (United States)

    Sumodhee, Shakeel; Levy, Johan; Chamorey, Emmanuel; Lam Cham Kee, Daniel; Chand, Marie-Eve; Gautier, Mathieu; Peyrottes, Isabelle; Barranger, Emmanuel; Hannoun-Levi, Jean-Michel

    Regarding adjuvant radiation therapy making decision for elderly women, Albert (2013) published a nomogram predicting the mastectomy-free survival (MFS) rate with or without adjuvant irradiation. Based on this approach, we proposed to investigate the use of accelerated partial breast irradiation (APBI) vs. whole breast irradiation (WBI) or endocrine therapy alone in elderly low-risk breast cancer patients. For each elderly woman treated by conserving surgery and APBI (multicatheter interstitial high-dose-rate brachytherapy), 5- and 10-year MFS rates were calculated. For each treated patient, using the Albert nomogram, we calculated the estimated MFS rates at 5 and 10 years, with and without WBI. Then, we compared the estimated MFS rates after no irradiation and WBI vs. observed MFS rates after APBI. From 2005 to 2016, 79 patients were treated. Median followup was 96.8 months [68.6-104.9], median age was 77 years [66-89]. Expected 5- and 10-year mastectomy rates calculated with the Albert nomogram without WBI were 2.95% and 7.25%, respectively, leading to a 10-year MFS rate of 92.7%. Expected 5- and 10-year mastectomy rates after WBI were 1.41% and 3.66%, respectively, leading to a 10-year MFS rate of 96.3%. Regarding observed MFS rate, 1 pt (1.3%) experienced a salvage mastectomy. The 10-year MFS rate after APBI was 97.4% vs. 96.3% after WBI (p = 1) and 92.7% after no irradiation (p = 0.27). No toxicity Grade 3 or more was observed. APBI seems to be an attractive compromise between WBI and no irradiation for elderly women with early stage breast cancer as far as local control, quality of life and cost benefit is concerned. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. The method of estimating the irradiated lung volume in primary breast irradiation

    International Nuclear Information System (INIS)

    Leite, Miguel Torres Teixeira; Marques, Iara Silva; Geraldo, Jony Marques

    1999-01-01

    Tangential breast fields irradiation usually includes some volume of lung and it is occasionally associated with pneumonitis. The estimation of the amount of lung irradiated can be determined measuring the central lung distance (CLD) by the port films, and it must be inferior to 2.5 cm. The purpose of this study was to determine through a linear regression analysis the relationship between CLD and the geometrical parameters of the treatment, and to develop an equation to predict this volume. The studied population consisted of 100 patients who received definitive radiation for clinical stage I and II breast cancer between January, 1996 and June, 1997. According to the contour of the breast and thorax was determined the angle of the tangential fields. In 71% of the patients the CLD measured by the portal films were superior to 2.5 cm, requiring a new beam arrangement. We develop a simple and convenient quantitative model to predict the irradiated lung volume based on portal films. We need further analysis in order to include variables and antomical variations. (author)

  13. A spreadsheet to determine the volume ratio for target and breast in partial breast irradiation

    International Nuclear Information System (INIS)

    Kron, T.; Willis, D.; Miller, J.; Hubbard, P.; Oliver, M.; Chua, B.

    2009-01-01

    Full text: The technical feasibility of Partial Breast Irradiation (PBI) using external beam radiotherapy depends on the ratio between the evaluation planning target volume (PTV e val) and the whole breast volume (PBI volume ratio = PVR). We aimed to develop a simple method to determine PVR using measurements performed at the time of the planning CT scan. A PVR calculation tool was developed using a Microsoft Excel spreadsheet to determine the PTV from three orthogonal dimensions of the seroma cavity and a given margin on the CT scans. The breast volume is estimated from the separation and breast height in five equally spaced CT slices. The PTV e val and whole breast volume were determined for 29 patients from two centres using the spreadsheet calculation tool and compared to volumes delineated on computerised treatment planning systems. Both the PTV e val and whole breast volumes were underestimated by approximately 25% using the spreadsheet. The resulting PVRs were 1.05 +/- 0.35 (mean +/- 1 S D) times larger than the ones determined from planning. Estimations of the PVR using the calculation tool were achievable in around 5 minutes at the time of CT scanning and allow a prompt decision on the suitability of the patients for PBI.

  14. Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomised controlled trial.

    Science.gov (United States)

    Livi, Lorenzo; Meattini, Icro; Marrazzo, Livia; Simontacchi, Gabriele; Pallotta, Stefania; Saieva, Calogero; Paiar, Fabiola; Scotti, Vieri; De Luca Cardillo, Carla; Bastiani, Paolo; Orzalesi, Lorenzo; Casella, Donato; Sanchez, Luis; Nori, Jacopo; Fambrini, Massimiliano; Bianchi, Simonetta

    2015-03-01

    Accelerated partial breast irradiation (APBI) has been introduced as an alternative treatment method for selected patients with early stage breast cancer (BC). Intensity-modulated radiotherapy (IMRT) has the theoretical advantage of a further increase in dose conformity compared with three-dimensional techniques, with more normal tissue sparing. The aim of this randomised trial is to compare the local recurrence and survival of APBI using the IMRT technique after breast-conserving surgery to conventional whole-breast irradiation (WBI) in early stage BC. This study was performed at the University of Florence (Florence, Italy). Women aged more than 40years affected by early BC, with a maximum pathological tumour size of 25mm, were randomly assigned in a 1:1 ratio to receive either WBI or APBI using IMRT. Patients in the APBI arm received a total dose of 30 Gy to the tumour bed in five daily fractions. The WBI arm received 50Gy in 25 fractions, followed by a boost on the tumour bed of 10Gy in five fractions. The primary end-point was occurrence of ipsilateral breast tumour recurrences (IBTRs); the main analysis was by intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT02104895. A total of 520 patients were randomised (260 to external WBI and 260 to APBI with IMRT) between March 2005 and June 2013. At a median follow-up of 5.0 years (Interquartile Range (IQR) 3.4-7.0), the IBTR rate was 1.5% (three cases) in the APBI group (95% confidence interval (CI) 0.1-3.0) and in the WBI group (three cases; 95% CI 0.0-2.8). No significant difference emerged between the two groups (log rank test p=0.86). We identified seven deaths in the WBI group and only one in the APBI group (p=0.057). The 5-year overall survival was 96.6% for the WBI group and 99.4% for the APBI group. The APBI group presented significantly better results considering acute (p=0.0001), late (p=0.004), and cosmetic outcome (p=0.045). To our knowledge, this is the first randomised

  15. Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

    Science.gov (United States)

    Farace, P; Deidda, M A; Amichetti, M

    2015-10-01

    The recent EORTC 10981-22023 AMAROS trial showed that axillary radiotherapy and axillary lymph node dissection provide comparable local control and reduced lymphoedema in the irradiated group. However, no significant differences between the two groups in range of motion and quality of life were reported. It has been acknowledged that axillary irradiation could have induced some toxicity, particularly shoulder function impairment. In fact, conventional breast irradiation by tangential beams has to be modified to achieve full-dose coverage of the axillary nodes, including in the treatment field a larger portion of the shoulder structures. In this scenario, alternative irradiation techniques were discussed. Compared with modern photon techniques, axillary irradiation by proton therapy has the potential for sparing the shoulder without detrimental increase of the medium-to-low doses to the other normal tissues.

  16. Doses to internal organs for various breast radiation techniques - implications on the risk of secondary cancers and cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Keller Brian M

    2011-01-01

    Full Text Available Abstract Background Breast cancers are more frequently diagnosed at an early stage and currently have improved long term outcomes. Late normal tissue complications induced by adjuvant radiotherapy like secondary cancers or cardiomyopathy must now be avoided at all cost. Several new breast radiotherapy techniques have been developed and this work aims at comparing the scatter doses of internal organs for those techniques. Methods A CT-scan of a typical early stage left breast cancer patient was used to describe a realistic anthropomorphic phantom in the MCNP Monte Carlo code. Dose tally detectors were placed in breasts, the heart, the ipsilateral lung, and the spleen. Five irradiation techniques were simulated: whole breast radiotherapy 50 Gy in 25 fractions using physical wedge or breast IMRT, 3D-CRT partial breast radiotherapy 38.5 Gy in 10 fractions, HDR brachytherapy delivering 34 Gy in 10 treatments, or Permanent Breast 103Pd Seed Implant delivering 90 Gy. Results For external beam radiotherapy the wedge compensation technique yielded the largest doses to internal organs like the spleen or the heart, respectively 2,300 mSv and 2.7 Gy. Smaller scatter dose are induced using breast IMRT, respectively 810 mSv and 1.1 Gy, or 3D-CRT partial breast irradiation, respectively 130 mSv and 0.7 Gy. Dose to the lung is also smaller for IMRT and 3D-CRT compared to the wedge technique. For multicatheter HDR brachytherapy a large dose is delivered to the heart, 3.6 Gy, the spleen receives 1,171 mSv and the lung receives 2,471 mSv. These values are 44% higher in case of a balloon catheter. In contrast, breast seeds implant is associated with low dose to most internal organs. Conclusions The present data support the use of breast IMRT or virtual wedge technique instead of physical wedges for whole breast radiotherapy. Regarding partial breast irradiation techniques, low energy source brachytherapy and external beam 3D-CRT appear safer than 192Ir HDR

  17. Advanced disassembling technique of irradiated driver fuel assembly for continuous irradiation of fuel pins

    International Nuclear Information System (INIS)

    Ichikawa, Shoichi; Haga, Hiroyuki; Katsuyama, Kozo; Maeda, Koji; Nishinoiri, Kenji

    2012-01-01

    It was necessary to carry out continuous irradiation tests in order to obtain the irradiation data of high burn-up fuel and high neutron dose material for FaCT (Fast Reactor Cycle Technology Development) project. There, the disassembling technique of an irradiated fuel assembly was advanced in order to realize further continuous irradiation tests. Although the conventional disassembling technique had been cutting a lower end-plug of a fuel pin needed to fix fuel pins to an irradiation vehicle, the advanced disassembling technique did not need cutting a lower end-plug. As a result, it was possible to supply many irradiated fuel pins to various continuous irradiation tests for FaCT project. (author)

  18. Intensity-modulated tangential beam irradiation of the intact breast

    International Nuclear Information System (INIS)

    Hong, L.; Hunt, M.; Chui, C.; Spirou, S.; Forster, K.; Lee, H.; Yahalom, J.; Kutcher, G.J.; McCormick, B.

    1999-01-01

    Purpose: To evaluate the potential benefits of intensity modulated tangential beams in the irradiation of the intact breast. Methods and Materials: Three-dimensional treatment planning was performed on five left and five right breasts using standard wedged and intensity modulated (IM) tangential beams. Optimal beam parameters were chosen using beams-eye-view display. For the standard plans, the optimal wedge angles were chosen based on dose distributions in the central plane calculated without inhomogeneity corrections, according to our standard protocol. Intensity-modulated plans were generated using an inverse planning algorithm and a standard set of target and critical structure optimization criteria. Plans were compared using multiple dose distributions and dose volume histograms for the planning target volume (PTV), ipsilateral lung, coronary arteries, and contralateral breast. Results: Significant improvements in the doses to critical structures were achieved using intensity modulation. Compared with a standard-wedged plan prescribed to 46 Gy, the dose from the IM plan encompassing 20% of the coronary artery region decreased by 25% (from 36 to 27 Gy) for patients treated to the left breast; the mean dose to the contralateral breast decreased by 42% (from 1.2 to 0.7 Gy); the ipsilateral lung volume receiving more than 46 Gy decreased by 30% (from 10% to 7%); the volume of surrounding soft tissue receiving more than 46 Gy decreased by 31% (from 48% to 33%). Dose homogeneity within the target volume improved greatest in the superior and inferior regions of the breast (approximately 8%), although some decrease in the medial and lateral high-dose regions (approximately 4%) was also observed. Conclusion: Intensity modulation with a standard tangential beam arrangement significantly reduces the dose to the coronary arteries, ipsilateral lung, contralateral breast, and surrounding soft tissues. Improvements in dose homogeneity throughout the target volume can also be

  19. SU-F-T-314: Estimation of Dose Distributions with Different Types of Breast Implants in Various Radiation Treatment Techniques for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M; Lee, S; Suh, T [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, J [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Department of Radiation Oncology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kim, S; Cho, Y; Lee, I [Department of Radiation Oncology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2016-06-15

    Purpose: This study investigates the effects of different kinds and designs of commercialized breast implants on the dose distributions in breast cancer radiotherapy under a variety of conditions. Methods: The dose for the clinical conventional tangential irradiation, Intensity Modulated Radiation Therapy (IMRT), volumetric modulated arc therapy (VMAT) breast plans was measured using radiochromic films and stimulated luminescence dosimeter (OSLD). The radiochromic film was used as an integrating dosimeter, while the OSLDs were used for real-time dosimetry to isolate the contribution of dose from individual segment. The films were placed at various slices in the Rando phantom and between the body and breast surface OSLDs were used to measure skin dose at 18 positions spaced on the two (right/left) breast. The implant breast was placed on the left side and the phantom breast was remained on the right side. Each treatment technique was performed on different size of the breasts and different shape of the breast implant. The PTV dose was prescribed 50.4 Gy and V47.88≥95%. Results: In different shapes of the breast implant, because of the shadow formed extensive around the breast implant, dose variation was relatively higher that of prescribed dose. As the PTV was delineated on the whole breast, maximum 5% dose error and average 3% difference was observed averagely. VMAT techniques largely decrease the contiguous hot spot in the skin by an average of 25% compared with IMRT. The both IMRT and VMAT techniques resulted in lower doses to normal critical structures than tangential plans for nearly all dose analyzation. Conclusion: Compared to the other technique, IMRT reduced radiation dose exposure to normal tissues and maintained reasonable target homogeneity and for the same target coverage, VMAT can reduce the skin dose in all the regions of the body.

  20. SU-F-T-314: Estimation of Dose Distributions with Different Types of Breast Implants in Various Radiation Treatment Techniques for Breast Cancer

    International Nuclear Information System (INIS)

    Lee, M; Lee, S; Suh, T; Jung, J; Kim, S; Cho, Y; Lee, I

    2016-01-01

    Purpose: This study investigates the effects of different kinds and designs of commercialized breast implants on the dose distributions in breast cancer radiotherapy under a variety of conditions. Methods: The dose for the clinical conventional tangential irradiation, Intensity Modulated Radiation Therapy (IMRT), volumetric modulated arc therapy (VMAT) breast plans was measured using radiochromic films and stimulated luminescence dosimeter (OSLD). The radiochromic film was used as an integrating dosimeter, while the OSLDs were used for real-time dosimetry to isolate the contribution of dose from individual segment. The films were placed at various slices in the Rando phantom and between the body and breast surface OSLDs were used to measure skin dose at 18 positions spaced on the two (right/left) breast. The implant breast was placed on the left side and the phantom breast was remained on the right side. Each treatment technique was performed on different size of the breasts and different shape of the breast implant. The PTV dose was prescribed 50.4 Gy and V47.88≥95%. Results: In different shapes of the breast implant, because of the shadow formed extensive around the breast implant, dose variation was relatively higher that of prescribed dose. As the PTV was delineated on the whole breast, maximum 5% dose error and average 3% difference was observed averagely. VMAT techniques largely decrease the contiguous hot spot in the skin by an average of 25% compared with IMRT. The both IMRT and VMAT techniques resulted in lower doses to normal critical structures than tangential plans for nearly all dose analyzation. Conclusion: Compared to the other technique, IMRT reduced radiation dose exposure to normal tissues and maintained reasonable target homogeneity and for the same target coverage, VMAT can reduce the skin dose in all the regions of the body.

  1. An Optimized Online Verification Imaging Procedure for External Beam Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Willis, David J.; Kron, Tomas; Chua, Boon

    2011-01-01

    The purpose of this study was to evaluate the capabilities of a kilovoltage (kV) on-board imager (OBI)-equipped linear accelerator in the setting of on-line verification imaging for external-beam partial breast irradiation. Available imaging techniques were optimized and assessed for image quality using a modified anthropomorphic phantom. Imaging dose was also assessed. Imaging techniques were assessed for physical clearance between patient and treatment machine using a volunteer. Nonorthogonal kV image pairs were identified as optimal in terms of image quality, clearance, and dose. After institutional review board approval, this approach was used for 17 patients receiving accelerated partial breast irradiation. Imaging was performed before every fraction verification with online correction of setup deviations >5 mm (total image sessions = 170). Treatment staff rated risk of collision and visibility of tumor bed surgical clips where present. Image session duration and detected setup deviations were recorded. For all cases, both image projections (n = 34) had low collision risk. Surgical clips were rated as well as visualized in all cases where they were present (n = 5). The average imaging session time was 6 min, 16 sec, and a reduction in duration was observed as staff became familiar with the technique. Setup deviations of up to 1.3 cm were detected before treatment and subsequently confirmed offline. Nonorthogonal kV image pairs allowed effective and efficient online verification for partial breast irradiation. It has yet to be tested in a multicenter study to determine whether it is dependent on skilled treatment staff.

  2. Respiration Induced Heart Motion and Indications of Gated Delivery for Left-Sided Breast Irradiation

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Hu, Angela; Wang Kai; Newman, Francis; Crosby, Marcus; Hu Bin; White, Julia; Li, X. Allen

    2012-01-01

    Purpose: To investigate respiration-induced heart motion for left-sided breast irradiation using a four-dimensional computed tomography (4DCT) technique and to determine novel indications to assess heart motion and identify breast patients who may benefit from a gated treatment. Methods and Materials: Images of 4DCT acquired during free breathing for 20 left-sided breast cancer patients, who underwent whole breast irradiation with or without regional nodal irradiation, were analyzed retrospectively. Dose distributions were reconstructed in the phases of 0%, 20%, and 50%. The intrafractional heart displacement was measured in three selected transverse CT slices using D LAD (the distance from left ascending aorta to a fixed line [connecting middle point of sternum and the body] drawn on each slice) and maximum heart depth (MHD, the distance of the forefront of the heart to the line). Linear regression analysis was used to correlate these indices with mean heart dose and heart dose volume at different breathing phases. Results: Respiration-induced heart displacement resulted in observable variations in dose delivered to the heart. During a normal free-breathing cycle, heart-induced motion D LAD and MHD changed up to 9 and 11 mm respectively, resulting in up to 38% and 39% increases of mean doses and V 25.2 for the heart. MHD and D LAD were positively correlated with mean heart dose and heart dose volume. Respiratory-adapted gated treatment may better spare heart and ipsilateral-lung compared with the conventional non-gated plan in a subset of patients with large D LAD or MHD variations. Conclusion: Proposed indices offer novel assessment of heart displacement based on 4DCT images. MHD and D LAD can be used independently or jointly as selection criteria for respiratory gating procedure before treatment planning. Patients with great intrafractional MHD variations or tumor(s) close to the diaphragm may particularly benefit from the gated treatment.

  3. Development of irradiation technique on controlling food contamination residue

    International Nuclear Information System (INIS)

    Liu Bin; Xiong Shanbai; Xiong Guangquan; Cheng Wei; Chen Yuxia; Liao Tao; Li Xin; Lin Ruotai

    2010-01-01

    The current state of the researches of irradiation technology on controlling food mycotoxin, pesticide, veterinary drugs and fishery drugs residue was summarized. And the degradation rate, mechanism, products and toxicities of food contamination were expatiated. The free radical from irradiation attack the site of weaker bond, and the less or more toxic substances were produced, which lead to the degradation of the food contamination. The limitations and future application of irradiation technique on controlling food contamination were also analyzed. (authors)

  4. Phase II trial of proton beam accelerated partial breast irradiation in breast cancer

    International Nuclear Information System (INIS)

    Chang, Ji Hyun; Lee, Nam Kwon; Kim, Ja Young; Kim, Yeon-Joo; Moon, Sung Ho; Kim, Tae Hyun; Kim, Joo-Young; Kim, Dae Yong; Cho, Kwan Ho; Shin, Kyung Hwan

    2013-01-01

    Background and purpose: Here, we report the results of our phase II, prospective study of proton beam accelerated partial breast irradiation (PB-APBI) in patients with breast cancer after breast conserving surgery (BCS). Materials and methods: Thirty patients diagnosed with breast cancer were treated with PB-APBI using a single-field proton beam or two fields after BCS. The treatment dose was 30 cobalt gray equivalent (CGE) in six CGE fractions delivered once daily over five consecutive working days. Results: All patients completed PB-APBI. The median follow-up time was 59 months (range: 43–70 months). Of the 30 patients, none had ipsilateral breast recurrence or regional or distant metastasis, and all were alive at the last follow-up. Physician-evaluated toxicities were mild to moderate, except in one patient who had severe wet desquamation at 2 months that was not observed beyond 6 months. Qualitative physician cosmetic assessments of good or excellent were noted in 83% and 80% of the patients at the end of PB-APBI and at 2 months, respectively, and decreased to 69% at 3 years. A good or excellent cosmetic outcome was noted in all patients treated with a two-field proton beam at any follow-up time point except for one. For all patients, the mean percentage breast retraction assessment (pBRA) value increased significantly during the follow-up period (p = 0.02); however, it did not increase in patients treated with two-field PB-APBI (p = 0.3). Conclusions: PB-APBI consisting of 30 CGE in six CGE fractions once daily for five consecutive days can be delivered with excellent disease control and tolerable skin toxicity to properly selected patients with early-stage breast cancer. Multiple-field PB-APBI may achieve a high rate of good-to-excellent cosmetic outcomes. Additional clinical trials with larger patient groups are needed

  5. Nonintrusive irradiated fuel inventory confirmation technique

    International Nuclear Information System (INIS)

    Dowdy, E.J.; Nicholson, N.; Caldwell, J.T.

    1980-01-01

    Successful tests showing correlation between the intensity of the Cerenkov glow surrounding irradiated fuel assemblies in water-filled spent fuel storage ponds and the exposure and cooling times of assemblies have been concluded. Fieldable instruments used in subsequent tests confirmed that such measurements can be made easily and rapidly, without fuel assembly movement or the introduction of apparatus into the storage ponds

  6. Managing a small recurrence in the previously irradiated breast. Is there a second chance for breast conservation?

    Science.gov (United States)

    Chadha, Manjeet; Trombetta, Mark; Boolbol, Susan; Osborne, Michael P

    2009-10-01

    Over the past 30 years, lumpectomy and radiation therapy (breast-conservation therapy, or BCT) has been the preferred treatment for early-stage breast cancer. With accumulating follow-up, we have an ever-expanding pool of patients with history of an irradiated intact breast. Routine use of every-6-month or annual screening in this population has identified an emerging clinical dilemma with respect to managing a small recurrence or a second primary tumor in the treated breast. Most women diagnosed with a second cancer in a previously irradiated breast are advised to undergo mastectomy. More recently, with an improved understanding of the patterns of in-breast failure, and with advances in the delivery of conformal radiation dose there is an opportunity to reevaluate treatment alternatives for managing a small in-breast recurrence. A limited number of publications have reported on patient outcomes after a second lumpectomy and radiation therapy for this clinical scenario. In this report, we review the controversial subject of a second chance at breast conservation for women with a prior history of breast irradiation.

  7. Breast conserving surgery following primary irradiation in 3-7 cm breast cancer: pathologic response and outcome

    International Nuclear Information System (INIS)

    Saint-Gaudens, Anne Bareille; Vilcoq, Jacques R.; Campana, Francois; Gautier, Chantal; Asselain, Bernard; Rocherfordiere, Anne de la; Clough, Krishna B.; Fourquet, Alain

    1997-01-01

    Purpose: To retrospectively evaluate histologic response and outcome of patients treated by primary irradiation followed by conservative surgery. Materials and Methods: Between 1981 and 1993, 1742 patients (pts.) with large 3-7 cm invasive breast cancer were treated by primary breast and nodes irradiation in our institution. Of these, 311 pts. (18%) further underwent a wide excision of the residual tumor. Median age was 55 years (yrs.) (29 - 79 yrs.). Median breast tumor size was 40 mm (35 - 70mm). 149 pts. (48%) were premenopausal. 142 pts (46%) had clinically palpable axillary nodes. Diagnosis of invasive breast cancer was performed in all patients by drill biopsy. Following diagnosis, all 311 patients were treated by external irradiation to the breast and regional nodes. Median dose to the breast was 55 Gy (50 - 64 Gy) over 5.5 weeks. Following this irradiation, all patients underwent a wide surgical excision with (140 pts; 45%) or without (171 pts; 55%) axillary node dissection. In addition, 70 pts (22.5%) received adjuvant chemotherapy and 70 pts. received hormone therapy after local treatment. All patients were then regularly followed. Results: Median residual breast tumor size after completion of irradiation was 20 mm (0 - 50mm). On pathologic examination, 34 (11%) tumors had no residual malignant cells (complete response), 137 tumors (44%) had residual fibrosis with clusters of viable cells (partial response), and 138 tumors (45%) had residual viable malignant cells (no response). Median follow up was 106 months (10 - 188 months). Actuarial 9-year overall survival rate was 69 % ± 6%. The 9-year metastasis-free interval was 58 % ± 6%. The 9-year breast recurrence rate was 22 % ± 5 %. The 9-year breast preservation rate was 84% ± 5%. Pathologic response was not predictive of outcome, either distant or local. Conclusion: This retrospective study showed that in patients with tumors too large to be treated by upfront breast-conserving surgery, primary breast

  8. Examination of irradiated fuel elements using gamma scanning technique

    International Nuclear Information System (INIS)

    Ichim, O.; Mincu, M.; Man, I.; Stanica, M.

    2016-01-01

    The purpose of this paper is to validate the gamma scanning technique used to calculate the activity of gamma fission products from CANDU/TRIGA irradiated fuel elements. After a short presentation of the equipments used and their characteristics, the paper describes the calibration technique for the devices and how computed tomography reconstruction is done. Following the previously mentioned steps is possible to obtain the axial and radial profiles and the computed tomography reconstruction for calibration sources and for the irradiated fuel elements. The results are used to validate the gamma scanning techniques as a non-destructive examination method. The gamma scanning techniques will be used to: identify the fission products in the irradiated CANDU/TRIGA fuel elements, construct the axial and radial distributions of fission products, get the distribution in cross section through computed tomography reconstruction, and determine the nuclei number and the fission products activity of the irradiated CANDU/TRIGA fuel elements. (authors)

  9. Does Three-Dimensional External Beam Partial Breast Irradiation Spare Lung Tissue Compared With Standard Whole Breast Irradiation?

    International Nuclear Information System (INIS)

    Jain, Anudh K.; Vallow, Laura A.; Gale, Ashley A.; Buskirk, Steven J.

    2009-01-01

    Purpose: To determine whether three-dimensional conformal partial breast irradiation (3D-PBI) spares lung tissue compared with whole breast irradiation (WBI) and to include the biologically equivalent dose (BED) to account for differences in fractionation. Methods and Materials: Radiotherapy treatment plans were devised for WBI and 3D-PBI for 25 consecutive patients randomized on the NSABP B-39/RTOG 0413 protocol at Mayo Clinic in Jacksonville, Florida. WBI plans were for 50 Gy in 25 fractions, and 3D-PBI plans were for 38.5 Gy in 10 fractions. Volume of ipsilateral lung receiving 2.5, 5, 10, and 20 Gy was recorded for each plan. The linear quadratic equation was used to calculate the corresponding dose delivered in 10 fractions and volume of ipsilateral lung receiving these doses was recorded for PBI plans. Ipsilateral mean lung dose was recorded for each plan and converted to BED. Results: There was a significant decrease in volume of lung receiving 20 Gy with PBI (median, 4.4% vs. 7.5%; p 3 vs 4.85 Gy 3 , p = 0.07). PBI plans exposed more lung to 2.5 and 5 Gy. Conclusions: 3D-PBI exposes greater volumes of lung tissue to low doses of radiation and spares the amount of lung receiving higher doses when compared with WBI.

  10. The utilization of irradiation techniques in food industry

    International Nuclear Information System (INIS)

    Szabo, S.A.

    1988-01-01

    Irradiation technical researches and the main areas of nuclear technical applications are surveyed, and the main areas where nuclear techniques are used are reported. Then an overview on radiation techniques including radiostimulation, radiomutation, radurization, radioecology and isotope techniques used in the food industry is presented. (author) 4 refs

  11. Planning Hybrid Intensity Modulated Radiation Therapy for Whole-breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Farace, Paolo [Medical Physics Department, Regional Oncological Hospital, Cagliari (Italy); Zucca, Sergio; Solla, Ignazio; Fadda, Giuseppina; Durzu, Silvia; Porru, Sergio; Meleddu, Gianfranco [Medical Physics Department, Regional Oncological Hospital, Cagliari (Italy); Deidda, Maria Assunta; Possanzini, Marco; Orru, Sivia; Lay, Giancarlo [Radiotherapy Department, Regional Oncological Hospital, Cagliari (Italy)

    2012-09-01

    Purpose: To test tangential and not-tangential hybrid intensity modulated radiation therapy (IMRT) for whole-breast irradiation. Methods and Materials: Seventy-eight (36 right-, 42 left-) breast patients were randomly selected. Hybrid IMRT was performed by direct aperture optimization. A semiautomated method for planning hybrid IMRT was implemented using Pinnacle scripts. A plan optimization volume (POV), defined as the portion of the planning target volume covered by the open beams, was used as the target objective during inverse planning. Treatment goals were to prescribe a minimum dose of 47.5 Gy to greater than 90% of the POV and to minimize the POV and/or normal tissue receiving a dose greater than 107%. When treatment goals were not achieved by using a 4-field technique (2 conventional open plus 2 IMRT tangents), a 6-field technique was applied, adding 2 non tangential (anterior-oblique) IMRT beams. Results: Using scripts, manual procedures were minimized (choice of optimal beam angle, setting monitor units for open tangentials, and POV definition). Treatment goals were achieved by using the 4-field technique in 61 of 78 (78%) patients. The 6-field technique was applied in the remaining 17 of 78 (22%) patients, allowing for significantly better achievement of goals, at the expense of an increase of low-dose ({approx}5 Gy) distribution in the contralateral tissue, heart, and lungs but with no significant increase of higher doses ({approx}20 Gy) in heart and lungs. The mean monitor unit contribution to IMRT beams was significantly greater (18.7% vs 9.9%) in the group of patients who required 6-field procedure. Conclusions: Because hybrid IMRT can be performed semiautomatically, it can be planned for a large number of patients with little impact on human or departmental resources, promoting it as the standard practice for whole-breast irradiation.

  12. Planning hybrid intensity modulated radiation therapy for whole-breast irradiation.

    Science.gov (United States)

    Farace, Paolo; Zucca, Sergio; Solla, Ignazio; Fadda, Giuseppina; Durzu, Silvia; Porru, Sergio; Meleddu, Gianfranco; Deidda, Maria Assunta; Possanzini, Marco; Orrù, Sivia; Lay, Giancarlo

    2012-09-01

    To test tangential and not-tangential hybrid intensity modulated radiation therapy (IMRT) for whole-breast irradiation. Seventy-eight (36 right-, 42 left-) breast patients were randomly selected. Hybrid IMRT was performed by direct aperture optimization. A semiautomated method for planning hybrid IMRT was implemented using Pinnacle scripts. A plan optimization volume (POV), defined as the portion of the planning target volume covered by the open beams, was used as the target objective during inverse planning. Treatment goals were to prescribe a minimum dose of 47.5 Gy to greater than 90% of the POV and to minimize the POV and/or normal tissue receiving a dose greater than 107%. When treatment goals were not achieved by using a 4-field technique (2 conventional open plus 2 IMRT tangents), a 6-field technique was applied, adding 2 non tangential (anterior-oblique) IMRT beams. Using scripts, manual procedures were minimized (choice of optimal beam angle, setting monitor units for open tangentials, and POV definition). Treatment goals were achieved by using the 4-field technique in 61 of 78 (78%) patients. The 6-field technique was applied in the remaining 17 of 78 (22%) patients, allowing for significantly better achievement of goals, at the expense of an increase of low-dose (∼5 Gy) distribution in the contralateral tissue, heart, and lungs but with no significant increase of higher doses (∼20 Gy) in heart and lungs. The mean monitor unit contribution to IMRT beams was significantly greater (18.7% vs 9.9%) in the group of patients who required 6-field procedure. Because hybrid IMRT can be performed semiautomatically, it can be planned for a large number of patients with little impact on human or departmental resources, promoting it as the standard practice for whole-breast irradiation. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Planning Hybrid Intensity Modulated Radiation Therapy for Whole-breast Irradiation

    International Nuclear Information System (INIS)

    Farace, Paolo; Zucca, Sergio; Solla, Ignazio; Fadda, Giuseppina; Durzu, Silvia; Porru, Sergio; Meleddu, Gianfranco; Deidda, Maria Assunta; Possanzini, Marco; Orrù, Sivia; Lay, Giancarlo

    2012-01-01

    Purpose: To test tangential and not-tangential hybrid intensity modulated radiation therapy (IMRT) for whole-breast irradiation. Methods and Materials: Seventy-eight (36 right-, 42 left-) breast patients were randomly selected. Hybrid IMRT was performed by direct aperture optimization. A semiautomated method for planning hybrid IMRT was implemented using Pinnacle scripts. A plan optimization volume (POV), defined as the portion of the planning target volume covered by the open beams, was used as the target objective during inverse planning. Treatment goals were to prescribe a minimum dose of 47.5 Gy to greater than 90% of the POV and to minimize the POV and/or normal tissue receiving a dose greater than 107%. When treatment goals were not achieved by using a 4-field technique (2 conventional open plus 2 IMRT tangents), a 6-field technique was applied, adding 2 non tangential (anterior-oblique) IMRT beams. Results: Using scripts, manual procedures were minimized (choice of optimal beam angle, setting monitor units for open tangentials, and POV definition). Treatment goals were achieved by using the 4-field technique in 61 of 78 (78%) patients. The 6-field technique was applied in the remaining 17 of 78 (22%) patients, allowing for significantly better achievement of goals, at the expense of an increase of low-dose (∼5 Gy) distribution in the contralateral tissue, heart, and lungs but with no significant increase of higher doses (∼20 Gy) in heart and lungs. The mean monitor unit contribution to IMRT beams was significantly greater (18.7% vs 9.9%) in the group of patients who required 6-field procedure. Conclusions: Because hybrid IMRT can be performed semiautomatically, it can be planned for a large number of patients with little impact on human or departmental resources, promoting it as the standard practice for whole-breast irradiation.

  14. CT planning of boost irradiation in radiotherapy of breast cancer after conservative surgery

    International Nuclear Information System (INIS)

    Messer, Peter M.; Kirikuta, Ion C.; Bratengeier, Klaus; Flentje, Michael

    1997-01-01

    Background and purpose: A study was performed to compare the accuracy of clinical treatment set-up and CT planning of boost irradiation in radiotherapy of breast cancer. Material and methods: Between September 1993 and October 1994, 45 women who underwent breast conserving surgery and irradiation containing a boost to the tumour bed were investigated. Prospective evaluation of CT planning of the boost was carried out. The target volume/boost field, electron energy and treatment set-up had been defined on the basis of clinical examination, initial and postsurgical mammograms by one radiotherapist. Next, a planning CT was performed in treatment position and a CT-based treatment plan was calculated according to a target volume defined by another radiotherapist. The clinical treatment set-up was imported into our computer planning system and the resulting isodose plots were compared with those from CT planning and reviewed critically. Results: The clinically defined treatment set-up had to be modified in 80% of the patients. Most discrepancies observed were related to the size of the boost field itself and the chosen electron energy. Minor changes had to be made with respect to angle of table and gantry. Conclusions: Critical review of the isodose plots from both methods showed clear advantages for CT planning. Guidelines for target definition in CT planning of boost irradiation and subgroups of patients benefiting from this technique are described

  15. The incidence of breast cancer following mantle field radiation therapy as a function of dose and technique

    International Nuclear Information System (INIS)

    Tinger, Alfred; Wasserman, Todd H.; Klein, Eric E.; Miller, Elizabeth A.; Roberts, Tracy; Piephoff, James V.; Kucik, Nancy A.

    1997-01-01

    Purpose: There is an increased incidence of breast cancer following mantle field radiation therapy for Hodgkin's disease (HD). We reviewed the experience at the Mallinckrodt Institute of Radiology (MIR) for radiation factors related to the development of breast cancer after mantle field radiation therapy for HD. Methods: The radiation therapy records of 152 women treated with mantle field irradiation for HD at MIR between 1966-1985 were reviewed for the development of breast cancer and treatment-related factors. All patients had a minimum of 5 years of follow-up. The treatment era (1966-1974 vs. 1975-1985), stage of HD, mediastinal dose, axillary dose, maximum dose from the anterior field (anterior d max dose), the anterior-posterior:posterior-anterior (AP:PA) ratio, age at the time of treatment, length of follow-up, and history of splenectomy were analyzed as possible contributing factors for the development of breast cancer. The observed number of breast cancers was compared to the expected number based on age-adjusted incidences from the Connecticut Tumor Registry. Results: Ten breast cancers occurred in the population. Eight involved an upper outer quadrant. In a multivariate analysis, the development of breast cancer was significantly associated with axillary dose. Patients in the early treatment era were at an increased risk for the development of breast cancer due to high anterior d max and breast doses from weighting the fields anteriorly on a low energy linear accelerator. The use of current radiation therapy techniques was not related to an increased risk of breast cancer with a median follow-up of 13 years. Conclusions: A high dose to the axilla and the anterior d max point is significantly associated with the development of breast cancer after mantle field irradiation for HD. Efforts to protect the breast from high doses will likely lessen the increased risk of breast cancer in women treated with radiation therapy for HD

  16. [Accelerated partial breast irradiation with multicatheters during breast conserving surgery for cancer].

    Science.gov (United States)

    Rodríguez-Spiteri Sagredo, Natalia; Martínez Regueira, Fernando; Olartecoechea Linaje, Begoña; Arredondo Chaves, Jorge; Cambeiro Vázquez, Mauricio; Pina Insausti, Luis Javier; Elizalde Pérez, Arlette; y García-Lallana, Amaya; Sola Gallego, Jose Javier

    2013-10-01

    Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123 min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11 mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  17. Stereotactic Accelerated Partial Breast Irradiation (SAPBI for Early Stage Breast Cancer: Rationale, Feasibility and Early Experience using the CyberKnife Radiosurgery Delivery Platform

    Directory of Open Access Journals (Sweden)

    Olusola eOBAYOMI-DAVIES

    2016-05-01

    .Conclusions: CyberKnife stereotactic accelerated partial breast irradiation is an appealing technique for partial breast irradiation offering improvements over existing APBI techniques. Our early findings indicate that CyberKnife SAPBI delivered in 5 daily fractions is feasible, well tolerated and is a reliable platform for delivering APBI.

  18. Cardiac avoidance in breast radiotherapy: a comparison of simple shielding techniques with intensity-modulated radiotherapy

    International Nuclear Information System (INIS)

    Landau, David; Adams, Elizabeth J.; Webb, Steve; Ross, Gillian

    2001-01-01

    Background and purpose: Adjuvant breast radiotherapy (RT) is now part of the routine care of patients with early breast cancer. However, analysis of the Early Breast Cancer Trialists' Collaborative suggests that patients with the lowest risk of dying of breast cancer are at significant risk of cardiac mortality due to longer relapse-free survival. Patients with a significant amount of heart in the high-dose volume have been shown to be at risk of fatal cardiac events. This study was designed to assess whether conformal planning or intensity-modulated radiotherapy (IMRT) techniques allow reduced cardiac irradiation whilst maintaining full target coverage. Material and methods: Ten patients with early breast cancer were available for computed tomography (CT) planning. Each had at least 1 cm maximum heart depth within the posterior border of conventional tangents. For each patient, plans were generated and compared using dose volume histograms for planning target volume (PTV) and organs at risk. The plans included conventional tangents with and without shielding. The shielding was designed to either completely spare the heart or to shield as much heart as possible without compromising PTV coverage. IMRT plans were also prepared using two- and four-field tangential and six-field arc-like beam arrangements. Results: PTV homogeneity was better for the tangential IMRT techniques. For all patients, cardiac irradiation was reduced by the addition of partial cardiac shielding to conventional tangents, without compromise of PTV coverage. The two- and four-field IMRT techniques also reduced heart doses. The average percentage volume of heart receiving >60% of the prescription dose was 4.4% (range 1.0-7.1%) for conventional tangents, 1.5% (0.2-3.9%) for partial shielding, 2.3% (0.5-4.6%) for the two-field IMRT technique and 2.2% (0.4-5.6%) for the four-field IMRT technique. For patients with larger maximum heart depths the four-field IMRT plan achieved greater heart sparing

  19. Realistic respiratory motion margins for external beam partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, Leigh; Quirk, Sarah [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4 (Canada); Smith, Wendy L., E-mail: wendy.smith@albertahealthservices.ca [Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta T2N 4N2 (Canada); Department of Physics and Astronomy, University of Calgary, Calgary, Alberta T2N 1N4 (Canada); Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4 (Canada)

    2015-09-15

    Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dose profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was

  20. Realistic respiratory motion margins for external beam partial breast irradiation

    International Nuclear Information System (INIS)

    Conroy, Leigh; Quirk, Sarah; Smith, Wendy L.

    2015-01-01

    Purpose: Respiratory margins for partial breast irradiation (PBI) have been largely based on geometric observations, which may overestimate the margin required for dosimetric coverage. In this study, dosimetric population-based respiratory margins and margin formulas for external beam partial breast irradiation are determined. Methods: Volunteer respiratory data and anterior–posterior (AP) dose profiles from clinical treatment plans of 28 3D conformal radiotherapy (3DCRT) PBI patient plans were used to determine population-based respiratory margins. The peak-to-peak amplitudes (A) of realistic respiratory motion data from healthy volunteers were scaled from A = 1 to 10 mm to create respiratory motion probability density functions. Dose profiles were convolved with the respiratory probability density functions to produce blurred dose profiles accounting for respiratory motion. The required margins were found by measuring the distance between the simulated treatment and original dose profiles at the 95% isodose level. Results: The symmetric dosimetric respiratory margins to cover 90%, 95%, and 100% of the simulated treatment population were 1.5, 2, and 4 mm, respectively. With patient set up at end exhale, the required margins were larger in the anterior direction than the posterior. For respiratory amplitudes less than 5 mm, the population-based margins can be expressed as a fraction of the extent of respiratory motion. The derived formulas in the anterior/posterior directions for 90%, 95%, and 100% simulated population coverage were 0.45A/0.25A, 0.50A/0.30A, and 0.70A/0.40A. The differences in formulas for different population coverage criteria demonstrate that respiratory trace shape and baseline drift characteristics affect individual respiratory margins even for the same average peak-to-peak amplitude. Conclusions: A methodology for determining population-based respiratory margins using real respiratory motion patterns and dose profiles in the AP direction was

  1. Breast radiotherapy with inclusion of internal mammary nodes: a comparison of techniques with three-dimensional planning

    International Nuclear Information System (INIS)

    Severin, Diane; Connors, Sherry; Thompson, Heather; Rathee, Satyapal; Stavrev, Pavel; Hanson, John

    2003-01-01

    Purpose: To compare the partially wide tangent (PWT) technique of breast and internal mammary chain irradiation with photon/electron (P/E) and standard tangent (ST) techniques in terms of dose homogeneity within breast and the dose to critical structures such as the heart and lung. Methods and Materials: Sixteen left breast cancer patients underwent CT simulation. The breasts, lungs, heart, and internal mammary chain were contoured and treatment plans generated on a three-dimensional planning system (Helax-TMS). Results: The mean dose to the left breast volume with the ST, P/E, and PWT techniques was 94.7%, 98.4%, and 96.5%, respectively (p=0.029). The left lung received the lowest mean dose with the ST technique (13.9%) compared with PWT (22.8%) and P/E (24.3%). The internal mammary chain volume was most consistently treated with the PWT (mean dose 99%) vs. P/E (86%) and ST (38.4%) techniques. The heart received the least dose with ST (mean dose 6.7%) vs. PWT (10.3%) and P/E (19%). The PWT treated the greatest amount of contralateral breast (mean dose 5.8%) vs. ST (3.2%) vs. P/E (2.8%). Conclusion: The PWT technique treats the internal mammary chain with acceptable toxicity to major organs, especially the heart, and with reasonable dose homogeneity in patients with mastectomy or intact breasts

  2. Debate about breast cancer: 'Cons: Intraoperative radiotherapy'; Debats autour du cancer du sein: 'contre' la radiotherapie peroperatoire

    Energy Technology Data Exchange (ETDEWEB)

    Bourgier, C.; Heymann, S.; Verstraet, R.; Biron, B.; Marsiglia, H. [Departement de radiotherapie, institut Gustave-Roussy, 114, rue edouard-Vaillant, 94800 Villejuif (France)

    2011-10-15

    Early breast cancer incidence increases owing to mammography screening. Hypo-fractionated radiotherapy is more and more proposed in women with low local relapse risk breast cancer, especially accelerated partial breast irradiation. Various irradiation modalities have been reported: brachytherapy, intraoperative irradiation, 3D-conformal accelerated partial breast irradiation. We describe limitations of intraoperative irradiation and the advantages of alternative techniques. (authors)

  3. A study of breast composition using radiographic techniques

    International Nuclear Information System (INIS)

    Noriah Jamal

    2005-01-01

    Accurate knowledge of breast composition is fundamental to the diagnosis and treatment of breast diseases. The goal of the research described in this thesis is to develop a system of experimental methods and theoretical models for studying breast composition using radiographic techniques. This research is divided into three parts. In part one, a technique based on the decomposition of breast components was developed and validated under laboratory conditions through the measurement of mastectomy specimen composition. The technique used double-exposure dual energy subtraction microradiography in conjunction with computed radiography in a five steps sequence, namely; a specimen was exposed at low and high energies alternately, followed by image registration, image subtraction and subsequent analysis of the subtracted image. The technique was then applied to quantify composition of mastectomy specimens. In part two, a quantitative assessment technique of breast density developed using MATLAB based image processing of digital mammograms. A comparison of breast density, classified by computer and subjective evaluation based on Tabar's patterns, was carried out. Inter-observer variations were analysed. In part three, a technique to estimate breast glandularity using phantom attenuation was developed and was used to estimate breast density for a large population sample. The difference in breast glandularity between three ethnic groups was tested for significance using the nonparametric Kruskal-Wallis test. This part also included an assessment of mammographic mean glandular dose using phantom-based and patient-based methods. Results from part 1 showed that in the double-exposure dual energy microradiography, the resulting fibroglandular tissue area was in 90.3 % agreement with the corresponding manually delineated areas by radiologists. In part 2 the results of computerised assessment of breast density from digitised mammograms correlated well (r 2 =0.92) with the

  4. Search for the lowest irradiation dose from literatures on radiation-induced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizawa, Y; Kusama, T [Tokyo Univ. (Japan). Faculty of Medicine

    1975-12-01

    A survey of past case reports concerning radiation-induced breast cancer was carried out in order to find the lowest irradiation dose. The search of literature published since 1951 revealed 10 cases of radiation-induced breast cancer. Only 5 cases had precise descriptions of the irradiation dose. The lowest irradiation dose was estimated at 1470 rads in the case of external X-ray irradiation for tuberous angioma. All of cases of radiation-induced breast cancer had received radiation for the treatment of nonmalignant tumors, such as pulmonary tuberculosis, mastitis, and tuberous angioma. There also were three statistical studies. The first concerned atomic bomb survivors, the second, pulmoanry tuberculous patients subjected to frequent fluoroscopies, and the third, patients of acute post partum mastitis. These statistical studies had revealed a significant increase in the incidence of breast cancer in the irradiated group, but there was little information about the lowest irradiation dose. It was noticed that radiation-induced breast cancer was more numerous in the upper inner quadrant of the breast. Most histopathological findings of radiation-induced breast cancer involved duct cell carcinoma. The latent period was about 15 years.

  5. Combining Breast Reduction Techniques to Treat Gigantomastia in Ghana

    Directory of Open Access Journals (Sweden)

    Melody F. Scheefer, MD

    2018-02-01

    Full Text Available Summary:. In this presentation of 2 consecutive cases of symptomatic juvenile breast hypertrophy in Ghana, we review the patient presentation, workup, and discuss outcomes following a combined technique of inferior pedicle stump with free nipple graft reduction mammoplasty. Surgical goals for treatment of gigantomastia were 2-fold: to resect adequate tissue to obtain symptomatic relief with improved quality of life, while avoiding a flat, boxy-appearing breast shape.

  6. Development of photo stimulated luminescence technique for detecting irradiated food

    International Nuclear Information System (INIS)

    Ros Anita Ahmad Ramli; Ahmad Zainuri Mohd Dzomir; Zainon Othman; Wan Saffiey Wan Abdullah

    2012-01-01

    The exposure of food to ionizing radiation is being progressively used in many countries to inactivate food pathogens, to eradicate pests and to extend shelf-life of food. To ensure free consumer choice, irradiated food will be labeled. The availability of a reliable method to detect irradiated food is important to enforce legal controls on labeling requirements, ensure proper distribution and increase consumer confidence. This paper reports on the preliminary application of photo stimulated luminescence technique (PSL) as a potential method to detect irradiated food and perhaps be used for monitoring irradiated food on sale locally in the near future. Thus this study will be beneficial and relevant for application of food irradiation towards improving food safety and security in Malaysia. (author)

  7. Identifying irradiated flours by photo-stimulated luminescence technique

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, Ros Anita Ahmad; Yasir, Muhamad Samudi [Faculty of Science and Technology, National University of Malaysia, Bangi, 43000 Kajang, Selangor (Malaysia); Othman, Zainon; Abdullah, Wan Saffiey Wan [Malaysian Nuclear Agency, Bangi 43000 Kajang, Selangor (Malaysia)

    2014-02-12

    Photo-stimulated luminescence (PSL) technique was used in this study to detect gamma irradiation treatment of five types of flours (corn, rice, tapioca, wheat and glutinous rice) at four different doses 0, 0.2, .05 and 1kGy. The signal level was compared with two threshold values (700 and 5000). With the exception of glutinous rice, all irradiated samples produced a strong signal above the upper threshold (5000 counts/60s). All control samples produced negative result with the signals below the lower threshold (700 counts/60s) suggesting that the samples have not been irradiated. Irradiated glutinous rice samples produced intermediate signals (700 - 5000 counts/60s) which were subsequently confirmed using calibrated PSL. The PSL signals remained stable after 90 days of storage. The findings of this study will be useful to facilitate control of food irradiation application in Malaysia.

  8. Identifying irradiated flours by photo-stimulated luminescence technique

    International Nuclear Information System (INIS)

    Ramli, Ros Anita Ahmad; Yasir, Muhamad Samudi; Othman, Zainon; Abdullah, Wan Saffiey Wan

    2014-01-01

    Photo-stimulated luminescence (PSL) technique was used in this study to detect gamma irradiation treatment of five types of flours (corn, rice, tapioca, wheat and glutinous rice) at four different doses 0, 0.2, .05 and 1kGy. The signal level was compared with two threshold values (700 and 5000). With the exception of glutinous rice, all irradiated samples produced a strong signal above the upper threshold (5000 counts/60s). All control samples produced negative result with the signals below the lower threshold (700 counts/60s) suggesting that the samples have not been irradiated. Irradiated glutinous rice samples produced intermediate signals (700 - 5000 counts/60s) which were subsequently confirmed using calibrated PSL. The PSL signals remained stable after 90 days of storage. The findings of this study will be useful to facilitate control of food irradiation application in Malaysia

  9. Development of Photostimulated Luminescence Technique for Detecting Irradiated Food

    International Nuclear Information System (INIS)

    Ros Anita Ahmad Ramli; Ahmad Zainuri Mohd Dzomir; Zainon Othman; Wan Saffiey Wan Abdullah; Muhamad Samudi Yasir

    2015-01-01

    The exposure of food to ionizing radiation is being progressively used in many countries to inactivate food pathogens, to eradicate pests and to extend shelf-life of food. To ensure free consumer choice, irradiated food will be labeled. The availability of a reliable method to detect irradiated food is important to enforce legal controls on labeling requirements, ensure proper distribution and increase consumer confidence. This paper reports on the preliminary application of photostimulated luminescence technique (PSL) as a potential method to detect irradiated food and perhaps be used for monitoring irradiated food on sale locally in the near future. Thus this study will be beneficial and relevant for application of food irradiation towards improving food safety and security in Malaysia. (author)

  10. The application of irradiation techniques to food and foodstuffs

    International Nuclear Information System (INIS)

    Kwon, Joong Ho; Cho, Han Ok; Byun, Myung Woo; Kim, Suck Won; Yang, Jae Seung

    1993-01-01

    With a view to establishing concrete infrastructures for the enlarged utilization of irradiation techniques in the food industries, the efficacy of gamma irradiation was investigated for both soybeans having problems in water-soaking process before mass-processing and dried-red pepper requiring long-term storage. Irradiation of 5 kGy was found effective for the reduction of soaking and cooking time of soybeans, but negligible changes were induced by irradiation in their nutritional components and processing properties (Tofu,soymilk). Air-tight packaging was suitable for the keeping quality of dried red pepper and irradiation applications were more effective in powdered samples than in whole pepper for preserving and improving their quality. (Author)

  11. Isotope correlation and mass spectrometry techniques for irradiated fuel assay

    International Nuclear Information System (INIS)

    Deron, S.

    1985-01-01

    This paper outlines the methods used to account for fissionable materials in irradiated nuclear fuel elements entering reprocessing plants. Verification is accomplished at three mass balance stations in the plant. Techniques employed fall into two categories: isotopic and isotope dilution analyses by mass spectometry and isotope correlation techniques. These methods are discussed in some detail

  12. Identifying irradiated flour by photo-stimulated luminescence technique

    International Nuclear Information System (INIS)

    Ros Anita Ahmad Ramli; Muhammad Samudi Yasir; Zainon Othman; Wan Saffiey Wan Abdullah

    2013-01-01

    Full-text: The photo-stimulated luminescence technique is recommended by European Committee for standardization for the detection food irradiation (EN 13751:2009). This study shows on luminescence technique to identify gamma irradiated five types of flour (corn flour, tapioca flour, wheat flour, glutinos rice flour and rice flour) at three difference dose levels in the range 0.2 - 1 kGy. The signal level is compare with two thresholds (700 and 5000). The majority of irradiated samples produce a strong signal above the upper threshold (5000 counts/ 60 s). All the control samples gave negative screening result while the signals below the lower threshold (700 counts/ 60s) suggest that the sample has not been irradiated. A few samples show the signal levels between the two thresholds (intermediate signals) suggest that further investigation. Reported procedure was also tested over 60 days, confirming the applicability and feasibility of proposed methods. (author)

  13. The use of tissue culture techniques to detect irradiated vegetables

    International Nuclear Information System (INIS)

    Al-Safadi, B.; Sharabi, N.E.; Nabulsi, I

    2001-01-01

    the ability of two tissue culture methods, callus and vegetable growth induction, to detect irradiated vegetables was evaluated. Potato tubers, carrot roots, garlic cloves and onion bulbs were subjected to various gamma radiation doses (0, 25, 100, 150, 250, 500, 750, and 1000 Gy). Irradiated vegetables were cultured in vitro and in vivo (pots). Gamma irradiation significantly reduced callus-forming ability especially in carrot and potato where no callus was observed in doses higher than 50 Gy. Length of shoots and roots growing from irradiated garlic and onion explants was considerably reduced starting from the 25 Gy dose. No roots were formed on garlic explants at any irradiation dose. Garlic leaves growing from irradiated explants were spotted with purple to brown spots. The intensity of these spots increased as gamma ray dosage increased. In the pot experiment, potato plant appeared in the control only. On the contrary, a complete sprouting of garlic and onion was seen in all irradiation treatments. It was not possible to distinguish between the various irradiation treatments and the control 3 days after planting in pots. The two in vitro techniques, tested in our study, may effectively be used to detect irradiated vegetables and estimate the range of doses used. The callus formation method is more useful for potato and carrot, since regeneration of shoots in vitro from these two plants takes along time, making this method unpractical. The other technique is very useful in the case of onion and garlic since it is rapid. The two techniques can be used with most of the vegetables that can be cultured in vitro. (Author)

  14. Initial dosimetric experience using simple three-dimensional conformal external-beam accelerated partial-breast irradiation

    International Nuclear Information System (INIS)

    Taghian, Alphonse G.; Kozak, Kevin R.; Doppke, Karen P.; Katz, Angela; Smith, Barbara L.; Gadd, Michele; Specht, Michelle; Hughes, Kevin; Braaten, Kristina; Kachnic, Lisa A.; Recht, Abram; Powell, Simon N.

    2006-01-01

    Purpose: Several accelerated partial-breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. We present our initial experience using three-dimensional conformal radiation therapy (3D-CRT). Methods and Materials: Sixty-one patients with tumors of 2 cm or less and negative axillary nodes were treated with 3D-CRT accelerated partial-breast irradiation (APBI) between August 2003 and March 2005. The prescribed radiation dose was 32 Gy in 4-Gy fractions given twice daily. Efforts were made to minimize the number of beams required to achieve adequate planning target volume (PTV) coverage. Results: A combination of photons and electrons was used in 85% of patients. A three-field technique that consisted of opposed, conformal tangential photons and enface electrons was employed in 43 patients (70%). Nine patients (15%) were treated with a four-field arrangement, which consisted of three photon fields and enface electrons. Mean PTV volumes that received 100%, 95%, and 90% of the prescribed dose were 93% ± 7%, 97% ± 4%, and 98% ± 2%, respectively. Dose inhomogeneity exceeded 10% in only 7 patients (11%). Mean doses to the ipsilateral lung and heart were 1.8 Gy and 0.8 Gy, respectively. Conclusions: Simple 3D-CRT techniques of APBI can achieve appropriate PTV coverage while offering significant normal-tissue sparing. Therefore, this noninvasive approach may increase the availability of APBI to patients with early-stage breast cancer

  15. Dosimetric improvements following 3D planning of tangential breast irradiation

    International Nuclear Information System (INIS)

    Aref, Amr; Thornton, Dale; Youssef, Emad; He, Tony; Tekyi-Mensah, Samuel; Denton, Lori; Ezzell, Gary

    2000-01-01

    Purpose: To evaluate the dosimetric difference between a simple radiation therapy plan utilizing a single contour and a more complex three-dimensional (3D) plan utilizing multiple contours, lung inhomogeneity correction, and dose-based compensators. Methods and Materials: This is a study of the radiation therapy (RT) plans of 85 patients with early breast cancer. All patients were considered for breast-conserving management and treated by conventional tangential fields technique. Two plans were generated for each patient. The first RT plan was based on a single contour taken at the central axis and utilized two wedges. The second RT plan was generated by using the 3D planning system to design dose-based compensators after lung inhomogeneity correction had been made. The endpoints of the study were the comparison between the volumes receiving greater than 105% and greater than 110% of the reference dose, as well as the magnitude of the treated volume maximum dose. Dosimetric improvement was defined to be of significant value if the volume receiving > 105% of one plan was reduced by at least 50% with the absolute difference between the volumes being 5% or greater. The dosimetric improvements in 49 3D plans (58%) were considered of significant value. Patients' field separation and breast size did not predict the magnitude of improvement in dosimetry. Conclusion: Dose-based compensator plans significantly reduced the volumes receiving > 105%, >110%, and volume maximum dose.

  16. Effects of smoking and irradiated volume on inflammatory response in the lung of irradiated breast cancer patients evaluated with bronchoalveolar lavage

    International Nuclear Information System (INIS)

    Bjermer, L.; Franzen, L.; Littbrand, B.; Nilsson, K.; Angstroem, T.H.; Henriksson, R.

    1990-01-01

    Quantitative measurements of the effects of irradiation on normal tissues in humans have been hard to obtain because most tissues are inaccessible and/or direct responses are difficult to quantify in a nondestructive manner. Pneumonitis and fibrotic lung disease are adverse effects seen in varying intensity in patients treated with radiotherapy for carcinomas of the thorax, e.g., breast cancer. In the present study the aim was to evaluate the inflammatory reaction in the underlying parenchyma following postoperative irradiation with bronchoalveolar lavage technique. Twenty-one patients with breast cancer stage T1N0M0 received radiotherapy with photons to a target dose of 56 Gy following breast conservative surgery. Nineteen healthy controls were also included. The results showed a clear elevation of neutrophils, mast cells, eosinophils, and lymphocytes in the total irradiated groups, compared to controls. When subclassifying the material according to smoking habit, it was obvious that the smokers displayed a significantly decreased inflammatory reaction, i.e., reduced levels of mast cells and lymphocytes, compared to both nonsmoking controls and patients. Eosinophils were seen in an elevated number in all irradiated patients. Radiological signs of pneumonitis were observed in three patients, all in the nonsmoking group. No correlation was found between the volume of lung irradiated and the inflammatory response. It is concluded that bronchoalveolar lavage is a suitable and sensitive method for investigating radiotherapy-induced reactions in the human lung. Furthermore, ongoing smoking during the treatment depressed the inflammatory response in the lung parenchyma induced by irradiation. The present study as well as earlier observations justify further studies concerning the possibility of interaction of smoking with cancer treatment

  17. Lyoluminescence technique as an identification method for irradiated food stuffs

    International Nuclear Information System (INIS)

    Chazhoor, J.S.

    1988-01-01

    The paper presents the studies made on the suitability of lyoluminescence technique as an analytical method for the identification of irradiated food stuffs. Powder milk, cinnamon, cardamom, clove, red chilly, cocoa, pepper, tea, coffee, turmeric and coriander showed lyoluminescence response when irradiated by a 10 kGy 60 Co and dissolved in luminol solution. Various dosimetric parameters such as effect of storage time, proportionality of the lyoluminescence response to dose etc were studied. (author). 1 tab., 3 figs

  18. Primary hypothyroidism in breast cancer patients with irradiated supraclavicular lymph nodes

    International Nuclear Information System (INIS)

    Bruning, P.; Bonfrer, J.; Jong-Bakker, M. de; Nooyen, W.; Burgers, M.

    1985-01-01

    Since the treatment of postmenopausal breast cancer patients with aminoglutethimide caused hypothyroidism with an unexpectedly high frequency previous treatment was suspected to contribute to hypofunction of the thyroid. Serum thyrotropin, triiodothyronine and free thyroxine index were compared between breast cancer patients who had undergone irradiation of regional lymph nodes and non-irradiated breast cancer patients, as well as patients having endometrial or colorectal carcinoma. Subclinical and clinical primary hypothyroidism was significantly more frequent in breast cancer patients who had previously received irradiation on supraclavicular lymph nodes comprising a minor part of the thyroid. Testing for the presence of autoantibodies against thyroid tissue components gave no evidence for radiation-induced autoimmune thyroiditis. Drugs suppressing thyroid hormone synthesis like aminoglutethimide may frequently cause myxedema in such irradiated women, especially at postmenopausal age. (author)

  19. A case of bullous pemphigoid exacerbated by irradiation after breast conservative radiotherapy

    International Nuclear Information System (INIS)

    Isohashi, Fumiaki; Konishi, Koji; Umegaki, Noriko; Tanei, Tomonori; Koizumi, Masahiko; Yoshioka, Yasuo

    2011-01-01

    We present a case, considered to be a form of the Koebner phenomenon, of bullous pemphigoid that was exacerbated mainly within the irradiated field after breast conservative radiotherapy. In May 2009, a 60-year-old woman was diagnosed with bullous pemphigoid, which was treated with steroid therapy. The following month, she was diagnosed with breast cancer (invasive ductal carcinoma, pT1cN0M0). After breast conservative surgery in December 2009, conservative radiotherapy to the right breast was performed (50 Gy in 25 fractions). Portal skin showed no serious change (up to grade 1 skin erythema) and no bullous neogenesis during conservative radiotherapy. However, 2 months after conservative radiotherapy, new blisters became exacerbated mainly within the irradiated field but also in the area outside the irradiated field. Increasing the dosage of oral steroid and minocycline resulted in relief of bullous pemphigoid, although patchy skin pigmentation remained especially in the irradiated skin. (author)

  20. [Technique of complex mammary irradiation: Mono-isocentric 3D conformational radiotherapy and helical tomotherapy].

    Science.gov (United States)

    Vandendorpe, B; Guilbert, P; Champagne, C; Antoni, T; Nguyen, T D; Gaillot-Petit, N; Servagi Vernat, S

    2017-12-01

    To evaluate the dosimetric contribution of helical tomotherapy for breast cancers compared with conformal radiotherapy in mono-isocentric technique. For 23 patients, the dosimetric results in mono-isocentric 3D conformational radiotherapy did not satisfy the constraints either of target volumes nor organs at risk. A prospective dosimetric comparison between mono-isocentric 3D conformational radiotherapy and helical tomotherapy was therefore carried out. The use of helical tomotherapy showed a benefit in these 23 patients, with either an improvement in the conformity index or homogeneity, but with an increase in low doses. Of the 23 patients, two had pectus excavatum, five had past thoracic irradiation and two required bilateral irradiation. The other 14 patients had a combination of morphology and/or indication of lymph node irradiation. For these patients, helical tomotherapy was therefore preferred to mono-isocentric 3D conformational radiotherapy. Tomotherapy appears to provide better homogeneity and tumour coverage. This technique of irradiation may be justified in the case of morphological situations such as pectus exavatum and in complex clinical situations. In other cases, conformal radiotherapy in mono-isocentric technique remains to be favoured. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  1. Comparison between intensity modulated radiotherapy (IMRT) and 3D tangential beams technique used in patients with early-stage breast cancer who received breast-conserving therapy

    International Nuclear Information System (INIS)

    Sas-Korczynska, B.; Kokoszka, A.; Korzeniowski, S.; Sladowska, A.; Rozwadowska-Bogusz, B.; Lesiak, J.; Dyczek, S.

    2010-01-01

    Background: The most often found complications in patients with breast cancer who received radiotherapy are cardiac and pulmonary function disorders and development of second malignancies. Aim: To compare the intensity modulated radiotherapy with the 3D tangential beams technique in respect of dose distribution in target volume and critical organs they generate in patients with early-stage breast cancer who received breast-conserving therapy. Materials and methods: A dosimetric analysis was performed to assess the three radiotherapy techniques used in each of 10 consecutive patients with early-stage breast cancer treated with breast-conserving therapy. Radiotherapy was planned with the use of all the three techniques: 3D tangential beams with electron boost, IMRT with electron boost, and intensity modulated radiotherapy with simultaneous integrated boost. Results: The use of the IMRT techniques enables more homogenous dose distribution in target volume. The range of mean and median dose to the heart and lung was lower with the IMRT techniques in comparison to the 3D tangential beams technique. The range of mean dose to the heart amounted to 0.3 - 3.5 Gy for the IMRT techniques and 0.4 - 4.3 for the tangential beams technique. The median dose to the lung on the irradiated side amounted to 4.9 - 5 Gy for the IMRT techniques and 5.6 Gy for the 3D tangential beams technique. Conclusion: The application of the IMRT techniques in radiotherapy patients with early-stage breast cancer allows to obtain more homogenous dose distribution in target volume, while permitting to reduce the dose to critical organs. (authors)

  2. A new method of boosting irradiation for breast cancer after conservative surgery

    International Nuclear Information System (INIS)

    Gao Hong; Li Gaofeng; Liu Mingyuan

    2007-01-01

    Objective: Based on the position of postoperative surgical clips and scars, a new boost irradiation technique for breast cancer after conservative surgery is devised. Methods: Tenty-six patients with early breast cancer after conservative surgery, were investigated. The medial, lateral, superior, inferior incisional margin of all tumor beds were marked by surgical clips, but posterior incisional margin was not marked before CT simulation. The postoperative scars were tagged by lead wires. After CT sanning, the nipple, clips and scars were delineated. Vitural simulation was implemented as follows: first, when the gantry was zero, place the center of beam in the center of clips marking the incisional margin, then rotate the gantry toward the medial or lateral tangent direction till more than three clips project lining on the beam eye view, second, rerotate gantry by orthogonal angle, then adjust the fields including the clips and scars. Results: More than 85% (88/103) of clips were placed on the surface of pectoralis major and ribs. The type of lining clips projection on the beam: 14 patients showed three clips lining, in the other's 12 patients revealed four clips lining. The mean depth of tumor bed was 4.37 cm, 95% confidence interal of depth varied from 3.98 to 4.96 cm, the range of depth varied from 2.40-6.20 cm, showing the depth of tumor bed less than 5 cm in 77% (20/26) of patients. Conclusion: The boost irradiation technique suggested in this paper is based on surgical scar's to irradiate the three dimensional tumor bed accurately. The aim of this work is not to miss the tumor three dimensionally including the operative scars. (authors)

  3. Radiation efficacy and biological risk from whole-breast irradiation via intensity modulated radiation therapy (IMRT)

    Science.gov (United States)

    Desantis, David M.

    Radiotherapy is an established modality for women with breast cancer. During the delivery of external beam radiation to the breast, leakage, scattered x-rays from the patient and the linear accelerator also expose healthy tissues and organs outside of the breast, thereby increasing the patient's whole-body dose, which then increases the chance of developing a secondary, radiation-induced cancer. Generally, there are three IntensityModulated Radiotherapy (IMRT) delivery techniques from a conventional linear accelerator; forward planned (FMLC), inverse planned 'sliding window' (DMLC), and inverse planned 'step-and-shoot' (SMLC). The goal of this study was to determine which of these three techniques delivers an optimal dose to the breast with the least chance of causing a fatal, secondary, radiation-induced cancer. A conventional, non-IMRT, 'Wedge' plan also was compared. Computerized Tomography (CT) data sets for both a large and small sized patient were used in this study. With Varian's Eclipse AAA algorithm, the organ doses specified in the revised ICRP 60 publication were used to calculate the whole-body dose. Also, an anthropomorphic phantom was irradiated with thermoluminescent dosimeters (TLD) at each organ site for measured doses. The risk coefficient from the Biological Effects of Ionizing Radiation (BEIR) VII report of 4.69 x 10-2 deaths per Gy was used to convert whole-body dose to risk of a fatal, secondary, radiation-induced cancer. The FMLC IMRT delivered superior tumor coverage over the 3D conventional plan and the inverse DMLC or SMLC treatment plans delivered clinically equivalent tumor coverage. However, the FMLC plan had the least likelihood of inadvertently causing a fatal, secondary, radiation-induced cancer compared to the inverse DMLC, SMLC, and Wedge plans.

  4. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Jay P. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lei, Xiudong [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huang, Sheng-Cheng; Nicklaus, Krista M. [Department of Biomedical Engineering, University of Texas, Austin, Texas (United States); Fingeret, Michelle C. [Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Merchant, Fatima [Department of Engineering Technology, University of Houston, Houston, Texas (United States); Markey, Mia K. [Department of Biomedical Engineering, University of Texas, Austin, Texas (United States); Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2017-04-01

    Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment, HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting.

  5. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation

    International Nuclear Information System (INIS)

    Reddy, Jay P.; Lei, Xiudong; Huang, Sheng-Cheng; Nicklaus, Krista M.; Fingeret, Michelle C.; Shaitelman, Simona F.; Hunt, Kelly K.; Buchholz, Thomas A.; Merchant, Fatima; Markey, Mia K.; Smith, Benjamin D.

    2017-01-01

    Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment, HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting.

  6. Pattern of local recurrence after conservative surgery and whole-breast irradiation

    International Nuclear Information System (INIS)

    Freedman, Gary M.; Anderson, Penny R.; Hanlon, Alexandra L.; Eisenberg, Debra F.; Nicolaou, Nicos

    2005-01-01

    Purpose: Most recurrences in the breast after conservative surgery and whole-breast irradiation have been reported to occur within the same quadrant as the initial primary tumor. We analyzed the long-term risk of recurrence by area of the breast after whole-breast irradiation. Materials and Methods: In all, 1,990 women with Stage 0-II breast cancer were treated with conservative surgery and whole-breast irradiation from 1970-1998. Stage was ductal carcinoma in situ in 237, T1 in 1273, and T2 in 480 patients. Of 120 local recurrences, 71 were classified as true local (confined to the original quadrant) and 49 as elsewhere (involving outside the original quadrant). Kaplan-Meier methodology was used to calculate 5-year, 10-year, and 15-year rates of recurrence (95% confidence intervals in parentheses). The median follow-up is 80 months. Results: There was no apparent difference in the 15-year rate of true local vs. elsewhere recurrence, but the time to recurrence was different. The rate of true local recurrence was 2%, 5%, and 7% (5-9%) at 5, 10, and 15 years, respectively. The recurrences elsewhere in the breast were rare at 5 (1%) and 10 (2%) years, but increased to 6 (3-9%) at 15 years. This 15-year rate of elsewhere recurrence was half the rate of contralateral breast cancers of 13% (10-16%). Conclusions: Recurrence elsewhere in the breast is rare for the first 10 years, but by 15 years is nearly equal to true local recurrence even after whole-breast irradiation. The 15-year rate of elsewhere recurrence was half the rate of contralateral breast cancers. This may indicate a therapeutic effect of whole-breast radiation for other areas of the breast. Very long follow-up will be needed for partial breast irradiation with or without tamoxifen to show that the risk of elsewhere recurrence is not significantly different than after whole-breast irradiation

  7. The application of irradiation techniques to food and foodstuffs

    International Nuclear Information System (INIS)

    Kwon, Joong Ho; Cho, Han Ok; Byun, Myung Woo; Kim, Suc Won; Yang, Jae Seong

    1992-02-01

    To establish concrete infrastructure required for food irradiation commercialization, the project was designed to investigate the efficiency of irradiation techniques, such as preserving boiled-dried anchovy and improving its safety, improving the physical quality of soybeans and microbial-immobilization with radiation-induced polymer. Dried anchovies could be kept in a sanitary quality for over one year at cooling conditions (<10 deg C) instead of freezing by using 5 KGy-irradiation and airtight packaging(NY/PE). Gamma irradiation below 10 KGy was significantly effective for improving the hydration and cooking properties of soybeans. Immobilized microorganisms showed an increased-catalytic activity, producing lactic acid 15 times higher than that of free culture. (Author)

  8. Accelerated partial breast irradiation using intensity modulated radiotherapy versus whole breast irradiation: Health-related quality of life final analysis from the Florence phase 3 trial.

    Science.gov (United States)

    Meattini, Icro; Saieva, Calogero; Miccinesi, Guido; Desideri, Isacco; Francolini, Giulio; Scotti, Vieri; Marrazzo, Livia; Pallotta, Stefania; Meacci, Fiammetta; Muntoni, Cristina; Bendinelli, Benedetta; Sanchez, Luis Jose; Bernini, Marco; Orzalesi, Lorenzo; Nori, Jacopo; Bianchi, Simonetta; Livi, Lorenzo

    2017-05-01

    Accelerated partial breast irradiation (APBI) represents a valid option for selected early breast cancer (BC). We recently published the 5-year results of the APBI-IMRT-Florence phase 3 randomised trial (NCT02104895), showing a very low rate of disease failure, with acute and early-late toxicity in favour of APBI. We present the early and 2-year follow-up health-related quality of life (HRQoL) results. Eligible patients were women aged more than 40 years with early BC suitable for breast-conserving surgery. APBI consisted of 30 Gy in five fractions delivered with IMRT technique. Standard whole breast irradiation (WBI) consisted of 50 Gy in 25 fractions plus a 10 Gy in five fractions boost on tumour bed. A total of 520 patients were enrolled in the phase 3 trial. Overall, 205 patients (105 APBI and 100 WBI) fully completed all the given questionnaires and were therefore included in the present analysis. As HRQoL assessment, patients were asked to complete the European Organisation for Research and Treatment of Cancer QLQ-C30, and the BR23 questionnaires at the beginning (T0), at the end (T1) and after 2 years from radiation (T2). No significant difference between the two arms at QLQ-C30 and BR23 scores emerged at T0. Global health status (p = 0.0001), and most scores of the functional and symptom scales of QLQ-C30 at T1 showed significant differences in favour of the APBI arm. Concerning the BR23 functional and symptom scales, the body image perception, future perspective and breast and arm symptoms were significantly better in the APBI group. Similar significant results emerged at T2: significant differences in favour of APBI emerged for GHS (p = 0.0001), and most functional and symptom QLQ-C30 scales. According to QLQ-BR23 module, among the functional scales, the body image perception and the future perspective were significantly better in the APBI group (p = 0.0001), whereas among the symptom scales significant difference emerged by breast and arm

  9. Respiration Induced Heart Motion and Indications of Gated Delivery for Left-Sided Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Qi, X. Sharon, E-mail: xiangrong.qi@ucdenver.edu [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Hu, Angela [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Wang Kai [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Newman, Francis [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Crosby, Marcus; Hu Bin; White, Julia; Li, X. Allen [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)

    2012-04-01

    Purpose: To investigate respiration-induced heart motion for left-sided breast irradiation using a four-dimensional computed tomography (4DCT) technique and to determine novel indications to assess heart motion and identify breast patients who may benefit from a gated treatment. Methods and Materials: Images of 4DCT acquired during free breathing for 20 left-sided breast cancer patients, who underwent whole breast irradiation with or without regional nodal irradiation, were analyzed retrospectively. Dose distributions were reconstructed in the phases of 0%, 20%, and 50%. The intrafractional heart displacement was measured in three selected transverse CT slices using D{sub LAD} (the distance from left ascending aorta to a fixed line [connecting middle point of sternum and the body] drawn on each slice) and maximum heart depth (MHD, the distance of the forefront of the heart to the line). Linear regression analysis was used to correlate these indices with mean heart dose and heart dose volume at different breathing phases. Results: Respiration-induced heart displacement resulted in observable variations in dose delivered to the heart. During a normal free-breathing cycle, heart-induced motion D{sub LAD} and MHD changed up to 9 and 11 mm respectively, resulting in up to 38% and 39% increases of mean doses and V{sub 25.2} for the heart. MHD and D{sub LAD} were positively correlated with mean heart dose and heart dose volume. Respiratory-adapted gated treatment may better spare heart and ipsilateral-lung compared with the conventional non-gated plan in a subset of patients with large D{sub LAD} or MHD variations. Conclusion: Proposed indices offer novel assessment of heart displacement based on 4DCT images. MHD and D{sub LAD} can be used independently or jointly as selection criteria for respiratory gating procedure before treatment planning. Patients with great intrafractional MHD variations or tumor(s) close to the diaphragm may particularly benefit from the gated

  10. Echography and operated or irradiated breasts; Echographie et seins operes, irradies

    Energy Technology Data Exchange (ETDEWEB)

    Baratte, B.; Neel-Paprocki, V.; Grumbach, Y. [Centre Hospitalier Universitaire, 80 - Amiens (France)

    1995-12-31

    Since 1985, the medical survey of patients operated even for benign or malignant initial breast injury comprises an X-ray mammal examination and a mammal echography. Until 1993, the echography was performed with a CGR scanner device with a 7.5 MHz barrette. Now, a GE RTX 400 device with two MHz barrettes is used, one with a removable interposition equipment and the other for echography controlled punctures. Echographic modifications are dependent on the treatment used: partial or complete surgery and/or irradiation. Early and late normal echographic aspects must be known. Echography is particularly efficient for the diagnosis of post-surgery hematoma, lymphocele and abscess and for the detection of recurrence in the case of dense breast. Its combination with X-ray radiography can solve most diagnosis problems. In any case of doubt, puncture or tru-cut biopsy must be done, and if not sufficient, the use of NMR imaging remains of great help. (J.S.).

  11. Electron beam irradiation after reconstruction with silicone gel implant in breast cancer

    International Nuclear Information System (INIS)

    Krishnan, L.; Krishnan, E.C.

    1986-01-01

    Irradiation for breast cancer in the presence of a silicone gel breast prosthesis is sometimes necessary. There is a concern among radiation and other oncologists as to whether the presence of the prosthetic implant would interfere with delivery of the needed irradiation doses. Electron beams, with their finite penetration and rapid fall-off, offer a mode of adequately treating the recurrence and minimizing the radiation to the underlying normal structures, such as the lung and the heart. The dose distribution using 9-20 MeV electrons in the presence of a breast prosthesis is compared to the dose distribution without the implant in a tissue equivalent water phantom. The results reveal no significant difference in the dose delivered due to the presence of the prosthesis. Clinical verification of the dosimetry in the presence of the prosthesis confirmed that the presence of the silicone gel implant does not compromise treatment by irradiation in the management of breast cancer

  12. Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience.

    Science.gov (United States)

    Jethwa, Krishan R; Kahila, Mohamed M; Mara, Kristin C; Harmsen, William S; Routman, David M; Pumper, Geralyn M; Corbin, Kimberly S; Sloan, Jeff A; Ruddy, Kathryn J; Hieken, Tina J; Park, Sean S; Mutter, Robert W

    2018-05-01

    Accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) are treatment options for early-stage breast cancer. The purpose of this study was to compare patient-reported-outcomes (PRO) between patients receiving multi-channel intra-cavitary brachytherapy APBI or WBI. Between 2012 and 2015, 131 patients with ductal carcinoma in situ (DCIS) or early stage invasive breast cancer were treated with adjuvant APBI (64) or WBI (67) and participated in a PRO questionnaire. The linear analog scale assessment (LASA), harvard breast cosmesis scale (HBCS), PRO-common terminology criteria for adverse events- PRO (PRO-CTCAE), and breast cancer treatment outcome scale (BCTOS) were used to assess quality of life (QoL), pain, fatigue, aesthetic and functional status, and breast cosmesis. Comparisons of PROs were performed using t-tests, Wilcoxon rank-sum, Chi square, Fisher exact test, and regression methods. Median follow-up from completion of radiotherapy and questionnaire completion was 13.3 months. There was no significant difference in QoL, pain, or fatigue severity, as assessed by the LASA, between treatment groups (p > 0.05). No factors were found to be predictive of overall QoL on regression analysis. BCTOS health-related QoL scores were similar between treatment groups (p = 0.52).The majority of APBI and WBI patients reported excellent/good breast cosmesis, 88.5% versus 93.7% (p = 0.37). Skin color change (p = 0.011) and breast elevation (p = 0.01) relative to baseline were more common in the group receiving WBI. APBI and WBI were both associated with favorable patient-reported outcomes in early follow-up. APBI resulted in a lesser degree of patient-reported skin color change and breast elevation relative to baseline.

  13. Bi-tangential hybrid IMRT for sparing the shoulder in whole breast irradiation.

    Science.gov (United States)

    Farace, P; Deidda, M A; Iamundo de Cumis, I; Iamundo de Curtis, I; Deiana, E; Farigu, R; Lay, G; Porru, S

    2013-11-01

    A bi-tangential technique is proposed to reduce undesired doses to the shoulder produced by standard tangential irradiation. A total of 6 patients affected by shoulder pain and reduced functional capacity after whole-breast irradiation were retrospectively analysed. The standard tangential plan used for treatment was compared with (1) a single bi-tangential plan where, to spare the shoulder, the lateral open tangent was split into two half-beams at isocentre, with the superior portion rotated by 10-20° medially with respect to the standard lateral beam; (2) a double bi-tangential plan, where both the tangential open beams were split. The planning target volume (PTV) coverage and the dose to the portion of muscles and axilla included in the standard tangential beams were compared. PTV95 % of standard plan (91.9 ± 3.8) was not significantly different from single bi-tangential plan (91.8 ± 3.4); a small but significant (p < 0.01) decrease was observed with the double bi-tangential plan (90.1 ± 3.7). A marked dose reduction to the muscle was produced by the single bi-tangential plan around 30-40 Gy. The application of the double bi-tangential technique further reduced the volume receiving around 20 Gy, but did not markedly affect the higher doses. The dose to the axilla was reduced both in the single and the double bi-tangential plans. The single bi-tangential technique would have been able to reduce the dose to shoulder and axilla, without compromising target coverage. This simple technique is valuable for irradiation after axillary lymph node dissection or in patients without dissection due to negative or low-volume sentinel lymph node disease.

  14. Bi-tangential hybrid IMRT for sparing the shoulder in whole breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Farace, P.; Deidda, M. A.; Iamundo de Curtis, I.; Deiana, E.; Farigu, R.; Lay, G.; Porru, S. [Regional Oncological Hospital, Cagliari (Italy). Dept. of Radio-Oncology

    2013-11-15

    Background and purpose: A bi-tangential technique is proposed to reduce undesired doses to the shoulder produced by standard tangential irradiation. Patients and methods: A total of 6 patients affected by shoulder pain and reduced functional capacity after whole-breast irradiation were retrospectively analysed. The standard tangential plan used for treatment was compared with (1) a single bi-tangential plan where, to spare the shoulder, the lateral open tangent was split into two half-beams at isocentre, with the superior portion rotated by 10-20 medially with respect to the standard lateral beam; (2) a double bi-tangential plan, where both the tangential open beams were split. The planning target volume (PTV) coverage and the dose to the portion of muscles and axilla included in the standard tangential beams were compared. Results: PTV95 % of standard plan (91.9 {+-} 3.8) was not significantly different from single bi-tangential plan (91.8 {+-} 3.4); a small but significant (p < 0.01) decrease was observed with the double bi-tangential plan (90.1 {+-} 3.7). A marked dose reduction to the muscle was produced by the single bi-tangential plan around 30-40 Gy. The application of the double bi-tangential technique further reduced the volume receiving around 20 Gy, but did not markedly affect the higher doses. The dose to the axilla was reduced both in the single and the double bi-tangential plans. Conclusion: The single bi-tangential technique would have been able to reduce the dose to shoulder and axilla, without compromising target coverage. This simple technique is valuable for irradiation after axillary lymph node dissection or in patients without dissection due to negative or low-volume sentinel lymph node disease. (orig.)

  15. Bi-tangential hybrid IMRT for sparing the shoulder in whole breast irradiation

    International Nuclear Information System (INIS)

    Farace, P.; Deidda, M.A.; Iamundo de Curtis, I.; Deiana, E.; Farigu, R.; Lay, G.; Porru, S.

    2013-01-01

    Background and purpose: A bi-tangential technique is proposed to reduce undesired doses to the shoulder produced by standard tangential irradiation. Patients and methods: A total of 6 patients affected by shoulder pain and reduced functional capacity after whole-breast irradiation were retrospectively analysed. The standard tangential plan used for treatment was compared with (1) a single bi-tangential plan where, to spare the shoulder, the lateral open tangent was split into two half-beams at isocentre, with the superior portion rotated by 10-20 medially with respect to the standard lateral beam; (2) a double bi-tangential plan, where both the tangential open beams were split. The planning target volume (PTV) coverage and the dose to the portion of muscles and axilla included in the standard tangential beams were compared. Results: PTV95 % of standard plan (91.9 ± 3.8) was not significantly different from single bi-tangential plan (91.8 ± 3.4); a small but significant (p < 0.01) decrease was observed with the double bi-tangential plan (90.1 ± 3.7). A marked dose reduction to the muscle was produced by the single bi-tangential plan around 30-40 Gy. The application of the double bi-tangential technique further reduced the volume receiving around 20 Gy, but did not markedly affect the higher doses. The dose to the axilla was reduced both in the single and the double bi-tangential plans. Conclusion: The single bi-tangential technique would have been able to reduce the dose to shoulder and axilla, without compromising target coverage. This simple technique is valuable for irradiation after axillary lymph node dissection or in patients without dissection due to negative or low-volume sentinel lymph node disease. (orig.)

  16. Pathology of breast cancer in women irradiated for acute postpartum mastitis

    International Nuclear Information System (INIS)

    Dvoretsky, P.M.; Woodard, E.; Bonfiglio, T.A.; Hempelmann, L.H.; Morse, I.P.

    1980-01-01

    The gross and microscopic pathology of breast cancers in women irradiated for acute postpartum mastitis was compared to the breast cancers found in the sisters of the irradiated women. In considering the lesions in the two populations, the size, location, histologic type, histologic grade, inflammatory response, lymphatic and blood vascular invasion, nipple involvement, axillary lymph node metastases, and menopausal status at the time of diagnosis were statistically indistinguishable. The only parameter that was different in the two populations was the desmoplastic response to the malignant lesion. The control population had more marked fibrosis within the cancers compared with the irradiated women

  17. Single dose IOERT versus whole breast irradiation. Cosmetic results in breast-conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Struikmans, Henk [Medical Centre Haaglanden, Radiotherapy Centre West, The Hague (Netherlands); Leiden University Medical Centre, Department of Radiotherapy, Leiden (Netherlands); Snijders, Malou; Mast, Mirjam E.; Fisscher, Ursula; Petoukhova, Anna; Koper, Peter [Medical Centre Haaglanden, Radiotherapy Centre West, The Hague (Netherlands); Franssen, Jan-Huib; Speijer, Gabrielle [HAGA Medical Centre, Department of Radiotherapy, The Hague (Netherlands); Immink, Marcelle J. [Reinier de Graaf Medical Centre, Department of Radiotherapy, Delft (Netherlands); Leiden University Medical Centre, Department of Radiotherapy, Leiden (Netherlands); Marinelli, Andreas [Medical Centre Haaglanden, Department of Surgery, The Hague (Netherlands); Merkus, Jos [HAGA Medical Centre, Department of Surgery, The Hague (Netherlands)

    2016-10-15

    Scarce data are available about the cosmetic result of single dose intraoperative electron radiotherapy (IOERT) in breast-conserving radiotherapy. We included 71 breast cancer patients. Breast-conserving surgery and sentinel node procedure had started almost 3 years earlier. Subsequently, 26 patients were treated with IOERT and 45 patients received postoperative whole breast irradiation (WBI). For both groups we determined seven dimensionless asymmetry features. We compared the subjectively and the objectively derived cosmetic scores with each other. For four asymmetry features we noted significantly smaller differences for patients treated with IOERT when compared to those treated with WBI: relative breast contour difference, relative breast area difference and relative breast overlap difference. After correcting for excision volume a significant difference was noticed also for relative lower breast contour. For the IOERT group the cosmetic scores ''excellent or good'' as determined by each patient and one physician were 88 and 96 %, respectively. When the overall cosmetic scores for patients treated with IOERT and WBI were compared to those of the objectively derived scores, there was a fair level of agreement. For patients treated with IOERT we noted less asymmetry and high rates of ''good or excellent'' subjectively derived cosmetic scores. The level of agreement between the subjectively and the objectively derived cosmetic scores was limited. Due to the small sample size and the design of the study no definitive conclusions can be drawn. (orig.) [German] Es sind nur wenige Daten zum kosmetischen Ergebnis nach alleiniger intraoperativer Radiotherapie mittels Elektronen (IOERT) in der brusterhaltenden Behandlung verfuegbar. In einer komparativen Kohortenanalyse wurden 71 Brustkrebspatientinnen eingeschlossen. Ihre brusterhaltende Operation mit Sentinel-Lymphknotenverfahren begann 3 Jahre vorher. Im Anschluss erhielten 26

  18. Accelerated partial-breast irradiation using proton beams: Initial clinical experience

    International Nuclear Information System (INIS)

    Kozak, Kevin R.; Smith, Barbara L.; Adams, Judith C.; Kornmehl, Ellen; Katz, Angela; Gadd, Michele; Specht, Michelle; Hughes, Kevin; Gioioso, Valeria; Lu, H.-M.; Braaten, Kristina; Recht, Abram; Powell, Simon N.; DeLaney, Thomas F.; Taghian, Alphonse G.

    2006-01-01

    Purpose: We present our initial clinical experience with proton, three-dimensional, conformal, external beam, partial-breast irradiation (3D-CPBI). Methods and Materials: Twenty patients with Stage I breast cancer were treated with proton 3D-CPBI in a Phase I/II clinical trial. Patients were followed at 3 to 4 weeks, 6 to 8 weeks, 6 months, and every 6 months thereafter for recurrent disease, cosmetic outcome, toxicity, and patient satisfaction. Results: With a median follow-up of 12 months (range, 8-22 months), no recurrent disease has been detected. Global breast cosmesis was judged by physicians to be good or excellent in 89% and 100% of cases at 6 months and 12 months, respectively. Patients rated global breast cosmesis as good or excellent in 100% of cases at both 6 and 12 months. Proton 3D-CPBI produced significant acute skin toxicity with moderate to severe skin color changes in 79% of patients at 3 to 4 weeks and moderate to severe moist desquamation in 22% of patients at 6 to 8 weeks. Telangiectasia was noted in 3 patients. Three patients reported rib tenderness in the treated area, and one rib fracture was documented. At last follow-up, 95% of patients reported total satisfaction with proton 3D-CPBI. Conclusions: Based on our study results, proton 3D-CPBI offers good-to-excellent cosmetic outcomes in 89% to 100% of patients at 6-month and 12-month follow-up and nearly universal patient satisfaction. However, proton 3D-CPBI, as used in this study, does result in significant acute skin toxicity and may potentially be associated with late skin (telangiectasia) and rib toxicity. Because of the dosimetric advantages of proton 3D-CPBI, technique modifications are being explored to improve acute skin tolerance

  19. Case report of complete atrioventricular block following therapeutic irradiation for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nishizawa, Tadashi; Suzuki, Ichiro; Kobayashi, Jun; Terashima, Masafumi

    1987-12-01

    A 49-year-old woman developed complete atrioventricular (A-V) block 16 years after radiotherapy for breast cancer. The patient had received 60 Gy of cobalt 60 irradiation for left breast cancer arising 3 years after contracting right breast cancer. It took one year before complete A-V block was fixed, during which two-degree A-V block, atrial fibrillation, and sinus rhythm were predominant. She had myocardial insertion of pacemaker electrode. Fibrosis and hyaloid degeneration of the pericardium and thickened sclerosis of the epicardium seemed to be radiation-induced. There was no evidence of recurrence of breast cancer. (Namekawa, K.).

  20. Comparison of three techniques for skin total irradiation with electrons

    International Nuclear Information System (INIS)

    Batista, Delano V.S.; Bardella, Lucia H.; Rosa, Luiz A.R. da

    2011-01-01

    This paper compared three techniques of skin total irradiation with electrons: 1) horizontal positioning, 2) vertical positioning - rotatory technique and 3) vertical positioning - six fields technique. For that, a anthropomorphic phantom was positioned according to the recommendation for each technique and was i radiated at the linear accelerator by using the 6 MeV electrons. Radiochromic films were positioned on the surface in various regions of the phantom for measurement of absorbed dose. A ionization chamber was positioned inside of equivalent issue plates for dose evaluation due to the photons produced by electron stopping. The technique 2 and 3 have shown too similar in the results and number or discrepant points (8 and 10 respectively) of prescription lower than the technique 1 (22 points). The total body dose of photons of the 1, 2 and 3 techniques was 2.2%, 5.3% and 5.2% respectively

  1. Patterns of Failure After MammoSite Brachytherapy Partial Breast Irradiation: A Detailed Analysis

    International Nuclear Information System (INIS)

    Chen, Sea; Dickler, Adam; Kirk, Michael; Shah, Anand; Jokich, Peter; Solmos, Gene; Strauss, Jonathan; Dowlatshahi, Kambiz; Nguyen, Cam; Griem, Katherine

    2007-01-01

    Purpose: To report the results of a detailed analysis of treatment failures after MammoSite breast brachytherapy for partial breast irradiation from our single-institution experience. Methods and Materials: Between October 14, 2002 and October 23, 2006, 78 patients with early-stage breast cancer were treated with breast-conserving surgery and accelerated partial breast irradiation using the MammoSite brachytherapy applicator. We identified five treatment failures in the 70 patients with >6 months' follow-up. Pathologic data, breast imaging, and radiation treatment plans were reviewed. For in-breast failures more than 2 cm away from the original surgical bed, the doses delivered to the areas of recurrence by partial breast irradiation were calculated. Results: At a median follow-up time of 26.1 months, five treatment failures were identified. There were three in-breast failures more than 2 cm away from the original surgical bed, one failure directly adjacent to the original surgical bed, and one failure in the axilla with synchronous distant metastases. The crude failure rate was 7.1% (5 of 70), and the crude local failure rate was 5.7% (4 of 70). Estimated progression-free survival at 48 months was 89.8% (standard error 4.5%). Conclusions: Our case series of 70 patients with >6 months' follow-up and a median follow-up of 26 months is the largest single-institution report to date with detailed failure analysis associated with MammoSite brachytherapy. Our failure data emphasize the importance of patient selection when offering partial breast irradiation

  2. Reduced Mortality With Partial-Breast Irradiation for Early Breast Cancer: A Meta-Analysis of Randomized Trials

    Energy Technology Data Exchange (ETDEWEB)

    Vaidya, Jayant S., E-mail: jayant.vaidya@ucl.ac.uk [Division of Surgery and Interventional Science, University College London, London (United Kingdom); Department of Surgery, Royal Free Hospital, London (United Kingdom); Department of Surgery, Whittington Health, London (United Kingdom); Bulsara, Max [Department of Biostatistics, University of Notre Dame, Fremantle, WA (Australia); Wenz, Frederik [Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Mannheim (Germany); Coombs, Nathan [Department of Surgery, Great Western Hospital, Swindon (United Kingdom); Singer, Julian [Department of Clinical Oncology, The Princess Alexandra Hospital, Harlow (United Kingdom); Ebbs, Stephen [Croydon University Hospital, Croydon (United Kingdom); Massarut, Samuele [National Cancer Institute, Centro di Riferimento Oncologico, Aviano (Italy); Saunders, Christobel [School of Surgery, University of Western Australia, Perth, WA (Australia); Douek, Michael [Department of Surgery, Kings College London, London (United Kingdom); Williams, Norman R. [Division of Surgery and Interventional Science, University College London, London (United Kingdom); Joseph, David [Departments of Radiation Oncology, and Surgery, Sir Charles Gairdner Hospital, Perth, WA (Australia); Tobias, Jeffrey S. [Department of Clinical Oncology, University College London Hospitals, London (United Kingdom); Baum, Michael [Division of Surgery and Interventional Science, University College London, London (United Kingdom)

    2016-10-01

    Purpose: With earlier detection and more effective treatment, mortality from breast cancer continues to fall and it has become increasingly important to reduce the toxicity of treatments. Partial-breast radiation therapy, which focuses radiation to the tumor bed, may achieve this aim. We analyzed mortality differences in randomized trials of partial-breast irradiation (PBI). Methods and Materials: We included data from published randomized trials of PBI (alone or as part of a risk-adapted approach) versus whole-breast irradiation (WBI) for invasive breast cancer suitable for breast-conserving therapy. We identified trials using PubMed and Google searches with the terms “partial breast irradiation” OR “intraoperative radiotherapy” OR “IMRT” OR (“accelerated” AND “radiation”) AND “randomised/randomized,” as well as through discussion with colleagues in the field. We calculated the proportion of patients who had events in each randomized arm at 5 years' follow-up and created a forest plot using Stata, version 14.1. Results: We identified 9 randomized trials of PBI versus WBI in invasive breast cancer; 5-year outcomes were available for non–breast cancer mortality in 5 trials (n=4489) and for breast cancer mortality in 4 trials (n=4231). The overall mortality was 4.9%. There was no detectable heterogeneity between the trials for any of the outcomes. There was no difference in the proportion of patients dying of breast cancer (difference, 0.000% [95% confidence interval (CI), −0.7 to +0.7]; P=.999). Non–breast cancer mortality with PBI was lower than with WBI (difference, 1.1% [95% CI, −2.1% to −0.2%]; P=.023). Total mortality with PBI was also lower than with WBI (difference, 1.3% [95% CI, −2.5% to 0.0%]; P=.05). Conclusions: Use of PBI instead of WBI in selected patients results in a lower 5-year non–breast cancer and overall mortality, amounting to a 25% reduction in relative terms. This information should be included when

  3. Reduced Mortality With Partial-Breast Irradiation for Early Breast Cancer: A Meta-Analysis of Randomized Trials

    International Nuclear Information System (INIS)

    Vaidya, Jayant S.; Bulsara, Max; Wenz, Frederik; Coombs, Nathan; Singer, Julian; Ebbs, Stephen; Massarut, Samuele; Saunders, Christobel; Douek, Michael; Williams, Norman R.; Joseph, David; Tobias, Jeffrey S.; Baum, Michael

    2016-01-01

    Purpose: With earlier detection and more effective treatment, mortality from breast cancer continues to fall and it has become increasingly important to reduce the toxicity of treatments. Partial-breast radiation therapy, which focuses radiation to the tumor bed, may achieve this aim. We analyzed mortality differences in randomized trials of partial-breast irradiation (PBI). Methods and Materials: We included data from published randomized trials of PBI (alone or as part of a risk-adapted approach) versus whole-breast irradiation (WBI) for invasive breast cancer suitable for breast-conserving therapy. We identified trials using PubMed and Google searches with the terms “partial breast irradiation” OR “intraoperative radiotherapy” OR “IMRT” OR (“accelerated” AND “radiation”) AND “randomised/randomized,” as well as through discussion with colleagues in the field. We calculated the proportion of patients who had events in each randomized arm at 5 years' follow-up and created a forest plot using Stata, version 14.1. Results: We identified 9 randomized trials of PBI versus WBI in invasive breast cancer; 5-year outcomes were available for non–breast cancer mortality in 5 trials (n=4489) and for breast cancer mortality in 4 trials (n=4231). The overall mortality was 4.9%. There was no detectable heterogeneity between the trials for any of the outcomes. There was no difference in the proportion of patients dying of breast cancer (difference, 0.000% [95% confidence interval (CI), −0.7 to +0.7]; P=.999). Non–breast cancer mortality with PBI was lower than with WBI (difference, 1.1% [95% CI, −2.1% to −0.2%]; P=.023). Total mortality with PBI was also lower than with WBI (difference, 1.3% [95% CI, −2.5% to 0.0%]; P=.05). Conclusions: Use of PBI instead of WBI in selected patients results in a lower 5-year non–breast cancer and overall mortality, amounting to a 25% reduction in relative terms. This information should be included when

  4. Simplified field-in-field technique for a large-scale implementation in breast radiation treatment

    International Nuclear Information System (INIS)

    Fournier-Bidoz, Nathalie; Kirova, Youlia M.; Campana, Francois; Dendale, Rémi; Fourquet, Alain

    2012-01-01

    We wanted to evaluate a simplified “field-in-field” technique (SFF) that was implemented in our department of Radiation Oncology for breast treatment. This study evaluated 15 consecutive patients treated with a simplified field in field technique after breast-conserving surgery for early-stage breast cancer. Radiotherapy consisted of whole-breast irradiation to the total dose of 50 Gy in 25 fractions, and a boost of 16 Gy in 8 fractions to the tumor bed. We compared dosimetric outcomes of SFF to state-of-the-art electronic surface compensation (ESC) with dynamic leaves. An analysis of early skin toxicity of a population of 15 patients was performed. The median volume receiving at least 95% of the prescribed dose was 763 mL (range, 347–1472) for SFF vs. 779 mL (range, 349–1494) for ESC. The median residual 107% isodose was 0.1 mL (range, 0–63) for SFF and 1.9 mL (range, 0–57) for ESC. Monitor units were on average 25% higher in ESC plans compared with SFF. No patient treated with SFF had acute side effects superior to grade 1-NCI scale. SFF created homogenous 3D dose distributions equivalent to electronic surface compensation with dynamic leaves. It allowed the integration of a forward planned concomitant tumor bed boost as an additional multileaf collimator subfield of the tangential fields. Compared with electronic surface compensation with dynamic leaves, shorter treatment times allowed better radiation protection to the patient. Low-grade acute toxicity evaluated weekly during treatment and 2 months after treatment completion justified the pursuit of this technique for all breast patients in our department.

  5. Decreased Lung Perfusion After Breast/Chest Wall Irradiation: Quantitative Results From a Prospective Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Liss, Adam L., E-mail: adamliss68@gmail.com [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Marsh, Robin B. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Kapadia, Nirav S. [Department of Radiation Oncology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (United States); McShan, Daniel L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Rogers, Virginia E. [Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M.; Moran, Jean M.; Brock, Kristy K.; Schipper, Matt J.; Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Biostatistics Unit, University of Michigan, Ann Arbor, Michigan (United States); Flaherty, Kevin R. [Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Frey, Kirk A. [Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Pierce, Lori J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2017-02-01

    Purpose: To quantify lung perfusion changes after breast/chest wall radiation therapy (RT) using pre- and post-RT single photon emission computed tomography/computed tomography (SPECT/CT) attenuation-corrected perfusion scans; and correlate decreased perfusion with adjuvant RT dose for breast cancer in a prospective clinical trial. Methods and Materials: As part of an institutional review board–approved trial studying the impact of RT technique on lung function in node-positive breast cancer, patients received breast/chest wall and regional nodal irradiation including superior internal mammary node RT to 50 to 52.2 Gy with a boost to the tumor bed/mastectomy scar. All patients underwent quantitative SPECT/CT lung perfusion scanning before RT and 1 year after RT. The SPECT/CT scans were co-registered, and the ratio of decreased perfusion after RT relative to the pre-RT perfusion scan was calculated to allow for direct comparison of SPECT/CT perfusion changes with delivered RT dose. The average ratio of decreased perfusion was calculated in 10-Gy dose increments from 0 to 60 Gy. Results: Fifty patients had complete lung SPECT/CT perfusion data available. No patient developed symptoms consistent with pulmonary toxicity. Nearly all patients demonstrated decreased perfusion in the left lung according to voxel-based analyses. The average ratio of lung perfusion deficits increased for each 10-Gy increment in radiation dose to the lung, with the largest changes in regions of lung that received 50 to 60 Gy (ratio 0.72 [95% confidence interval 0.64-0.79], P<.001) compared with the 0- to 10-Gy region. For each increase in 10 Gy to the left lung, the lung perfusion ratio decreased by 0.06 (P<.001). Conclusions: In the assessment of 50 patients with node-positive breast cancer treated with RT in a prospective clinical trial, decreased lung perfusion by SPECT/CT was demonstrated. Our study allowed for quantification of lung perfusion defects in a prospective cohort of

  6. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Kowalchik, Kristin V.; Vallow, Laura A.; McDonough, Michelle; Thomas, Colleen S.; Heckman, Michael G.; Peterson, Jennifer L.; Adkisson, Cameron D.; Serago, Christopher; McLaughlin, Sarah A.

    2013-01-01

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  7. The preservation of lotus seeds by irradiation technique

    International Nuclear Information System (INIS)

    Lan Junming; Tang Chuandao

    1990-08-01

    The preservation test results of lotus seeds by gamma-ray irradiation technique are introduced. The results showed that the sitophilus, penicillus and aspergillus oryzae caused the great damage of lotus seeds. It was found that the radiation doses of deactivation for the insects and the mould were 0.8 kGy and 5 kGy respectively. The irradiated seeds packaged in the cloth bags and stored in the storehouse were not damaged by the insects and moulds for three years. The measured resutls also showed that the nutrient compositions were not changed and the pathogenic bacteria were not found. The irradiated lotus seeds are healthy and safe to the people

  8. Selection of oncoplastic surgical technique in Asian breast cancer patients

    Directory of Open Access Journals (Sweden)

    Eui Sun Shin

    2018-01-01

    Full Text Available Background Oncoplastic surgery is being increasingly performed in Korean women; however, unlike Westerners, Korean women usually have small to moderate-sized breasts. To achieve better outcomes in reconstructed breasts, several factors should be considered to determine the optimal surgical method. Methods A total of 108 patients who underwent oncoplastic surgery from January 2013 to December 2016 were retrospectively investigated. We used various methods, including glandular tissue reshaping, latissimus dorsi (LD flap transposition, and reduction oncoplasty, to restore the breast volume and symmetry. Results The mean weight of the tumor specimens was 40.46 g, and the ratio of the tumor specimen weight to breast volume was 0.12 g/mL in the patients who underwent glandular tissue reshaping (n=59. The corresponding values were 101.47 g and 0.14 g/mL, respectively, in the patients who underwent reduction oncoplasty (n=17, and 82.54 g and 0.20 g/mL, respectively, in those treated with an LD flap (n=32. Glandular tissue reshaping was mostly performed in the upper outer quadrant, and LD flap transposition was mostly performed in the lower inner quadrant. No major complications were noted. Most patients were satisfied with the aesthetic results. Conclusions We report satisfactory outcomes of oncoplastic surgical procedures in Korean patients. The results regarding specimen weight and the tumor-to-breast ratio of Asian patients will be a helpful reference point for determining the most appropriate oncoplastic surgical technique.

  9. Breast-conserving therapy with partial or whole breast irradiation: ten-year results of the Budapest randomized trial.

    Science.gov (United States)

    Polgár, Csaba; Fodor, János; Major, Tibor; Sulyok, Zoltán; Kásler, Miklós

    2013-08-01

    To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1-2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n=130) or PBI (n=128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n=88) or 50 Gy electron beam (EB) irradiation (n=40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p=0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p<0.01). Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Breast-conserving therapy with partial or whole breast irradiation: Ten-year results of the Budapest randomized trial

    International Nuclear Information System (INIS)

    Polgár, Csaba; Fodor, János; Major, Tibor; Sulyok, Zoltán; Kásler, Miklós

    2013-01-01

    Background and purpose: To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Patients and methods: Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1–2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n = 88) or 50 Gy electron beam (EB) irradiation (n = 40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. Results: After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p = 0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p < 0.01). Conclusions: Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI

  11. Content of DNA in cancerous tumours of the breast before and after large-fractionated irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shiukashvili, N N

    1976-07-01

    The article presents the results of microspectrophotometric investigation of DNA in different cancerous tumors of the breast gland before and after large-fractionated irradiation. The study of quantitative content of DNA in the non-irradiated tumors of the breast of different histological structure showed that parenchymatous cells are characterized by a definite variety in the DNA content with a different level of their polyploidy. This points to the fact that different histological forms of the breast cancer are distinguished by the character of the components differentiation. The comparative assessment of the ploidity of the cancerous cells of irradiated and non-irradiated tumors revealed that under the changed conditions of co-existence in all histological forms of cancer new modal classes of the cells develop and general quantity of the DNA content decreases. This testifies to the fact that the histological forms of the breast cancer are not equal sensitive tumors. A microspectrophotometric study of the breast tumors makes it possible to reveal the injury of the malignant tumor cells in the initial period of irradiation, when it is difficult to discover clear-cut dystrophical changes during histological investigation.

  12. Application of irradiation techniques to food and foodstuffs

    International Nuclear Information System (INIS)

    Kwon, Joong Ho; Cho, Han Ok; Byun, Myung Woo; Kim, Suc Won; Yang, Jae Seung.

    1990-01-01

    In a comparative research on the decontaminating effects of ginseng leaf tea, ethylene oxide (EO) and 5 kGy gamma-irradiated groups could reduce microorganisms below the detectable level. And there is no growth of microoganisms after three months of storage at 30 deg C. The decimal reduction dose (D 10 value) for microorganisms contaminated were 0.70 - 0.95 kGy. EO fumigation and irradiation at 5 kGy had little effects on soluble matters, sugar, amino acid, polyphenols and pigments. However, EO fumigation caused a significant change in the amount of ascorbic acid, free amino acid, moisture, pH and acidity of the sample. In the sensory evaluation, irradiated samples showed no significant difference from the non-treated control in overall flavor, taste, color and acceptability. The extracts of EO-fumigated samples, however, were significantly different in color and taste from other groups even after three months of storage. On the other hand, GC analysis tendency with storage time, resulting in the formation of significant amounts of the secondary products such as ethylene chlorohydrin and ethylene glycol. Based on the above results, it can be concluded that an optimum dose range (5kGy) of gamma irradiation effectively improves the microbiological quality of ginseng leaf tea, suggesting that irradiation techniques are a potential alternative to chemical fumigant, ethylene oxide. (author)

  13. Glutathione Transferase GSTπ In Breast Tumors Evaluated By Three Techniques

    Directory of Open Access Journals (Sweden)

    Rafael Molina

    1993-01-01

    Full Text Available The glutathione transferases are involved in intracellular detoxification reactions. One of these, GSTπ, is elevated in some breast cancer cells, particularly cells selected for resistance to anticancer agents. We evaluated GSTπ expression in 60 human breast tumors by three techniques, immunohistochemistry, Northern hybridization, and Western blot analysis. There was a significant positive correlation between the three methods, with complete concordance seen in 64% of the tumors. There was strong, inverse relationship between GSTπ expression and steroid receptor status with all of the techniques utili zed. [n addition, there was a trend toward higher GSTπ expression in poorly differentiated tumors, but no correlation was found between tumor GSTπ content and DNA ploidy or %S-phase. GSTπ expression was also detected in adjacent benign breast tissue as well as infiltrating lymphocytes; this expression may contribute to GSTπ measurements using either Northern hybridization or Western blot analysis. These re sults suggest that immunohistochemistry is the method of choice for measuring GSTπ in breast tumors.

  14. Eleven-year follow-up results in the delay of breast irradiation after conservative breast surgery in node-negative breast cancer patients

    International Nuclear Information System (INIS)

    Vujovic, Olga; Yu, Edward; Cherian, Anil; Dar, A. Rashid; Stitt, Larry; Perera, Francisco

    2006-01-01

    Purpose: This retrospective review was conducted to determine if delay in the start of radiotherapy after conservative breast surgery had any detrimental effect on local recurrence or disease-free survival in node-negative breast cancer patients. Methods and Materials: A total of 568 patients with T1 and T2, N0 breast cancer were treated with breast-conserving surgery and breast irradiation, without adjuvant systemic therapy, between January 1, 1985 and December 31, 1992 at the London Regional Cancer Centre. The time intervals from definitive breast surgery to breast irradiation used for analysis were 0 to 8 weeks (201 patients), greater than 8 to 12 weeks (235 patients), greater than 12 to 16 weeks (91 patients), and greater than 16 weeks (41 patients). Kaplan-Meier estimates of time to local-recurrence and disease-free survival rates were calculated. Results: Median follow-up was 11.2 years. Patients in all 4 time intervals were similar in terms of age and pathologic features. No statistically significant difference was seen between the 4 groups in local recurrence or disease-free survival with surgery radiotherapy interval (p = 0.521 and p = 0.222, respectively). The overall local-recurrence rate at 5 and 10 years was 4.6% and 11.3%, respectively. The overall disease-free survival at 5 and 10 years was 79.6% and 67.0%, respectively. Conclusion: This retrospective study suggests that delay in the start of breast irradiation of up to 16 weeks from definitive surgery does not increase the risk of recurrence in node-negative breast cancer patients. The certainty of these results is limited by the retrospective nature of this analysis

  15. Partial breast irradiation as second conservative treatment for local breast cancer recurrence

    International Nuclear Information System (INIS)

    Hannoun-Levi, Jean-Michel; Houvenaeghel, Gilles; Ellis, Steve; Teissier, Eric; Alzieu, Claude; Lallement, Michel; Cowen, Didier

    2004-01-01

    Purpose: Mastectomy is the treatment of reference for local relapse after breast cancer (BC). The aim of this study was to document the feasibility and the results of associating lumpectomy with partial breast irradiation by interstitial brachytherapy (IB) as local treatment for an isolated ipsilateral BC local recurrence (LR). Methods and materials: Between 1975 and 1996 at Marseille and Nice Cancer Institutes, 4026 patients received lumpectomy and radiotherapy (RT) (50-80 Gy) for a localized breast cancer of which 473 presented a LR. Among these patients, 69 (14.6%) received a second lumpectomy followed by IB, which delivered 30 Gy (Nice, n = 24) or 45-50 Gy (Marseille, n = 45) with 3 to 8 192 Ir wires in 1 or 2 planes on the 85% isodose. Results: Median age at LR was 58.2 years, median follow-up since primary BC was 10 years, and median follow-up after the second conservative treatment was 50.2 months (range, 2-139 months). Immediate tolerance was good in all cases. Grade 2 to 3 long-term complications (LTC) according to IB dose were 0%, 28%, and 32%, respectively, for 30 Gy, 45 to 46 Gy, and 50 Gy (p 0.01). Grade 2 to 3 LTC according to total dose were 4% and 30%, respectively, for total doses (initial RT plus IB) ≤ 100 Gy or >100 Gy (p = 0.008). Logistic regression showed that the only factor associated with Grade 2 to 3 complications was higher IB doses (p = 0.01). We noted 11 second LRs (LR2), 10 distant metastases (DM), and 5 specific deaths. LR2 occurred either in the tumor bed (50.8%) or close to the tumor bed (34.3%) or in another quadrant (14.9%). Kaplan-Meier 5-year freedom from (FF) LR2 (FFLR2), FFDM, and DFS were 77.4%, 86.7%, and 68.9%, respectively. Overall 5-year survival (OS) was 91.8%. Univariate analysis showed the following factors associated with a higher FFLR2: (1) number of wires used for IB (3-4 vs. 5-8 wires, p = 0.006), (2) IB doses (30-45 Gy vs. 46-60 Gy, p = 0.05), (3) number of planes (1 vs. 2, p = 0.05), (4) interval between

  16. Fat Necrosis After Partial-Breast Irradiation With Brachytherapy or Electron Irradiation Versus Standard Whole-Breast Radiotherapy-4-Year Results of a Randomized Trial

    International Nuclear Information System (INIS)

    Loevey, Katalin; Fodor, Janos; Major, Tibor; Szabo, Eva; Orosz, Zsolt; Sulyok, Zoltan; Janvary, Levente; Froehlich, Georgina; Kasler, Miklos; Polgar, Csaba

    2007-01-01

    Purpose: To examine the incidence and clinical relevance of fat necrosis after accelerated partial-breast irradiation (PBI) using interstitial high-dose-rate brachytherapy (HDR-BT) in comparison with partial-breast electron irradiation (ELE) and whole-breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 early-stage breast cancer patients were randomized to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy HDR-BT (n = 88) or 50 Gy ELE (n = 40). The incidence of fat necrosis, its impact on cosmetic outcome, accompanying radiologic features, and clinical symptoms were evaluated. Results: The 4-year actuarial rate of fat necrosis was 31.1% for all patients, and 31.9%, 36.5%, and 17.7% after WBI, HDR-BT and ELE, respectively (p WBI/HDR-BT = 0.26; p WBI/ELE = 0.11; p ELE/HDR-BT = 0.025). The respective rate of asymptomatic fat necrosis was 20.2%, 25.3%, and 10% of patients. The incidence of symptomatic fat necrosis was not significantly different after WBI (8.5%), HDR-BT (11.4%), and ELE (7.5%). Symptomatic fat necrosis was significantly associated with a worse cosmetic outcome, whereas asymptomatic fat necrosis was not. Fat necrosis was detectable with mammography and/or ultrasound in each case. Additional imaging examinations were required in 21% of cases and aspiration cytology in 42%. Conclusions: Asymptomatic fat necrosis is a common adverse event of breast-conserving therapy, having no significant clinical relevance in the majority of the cases. The incidence of both symptomatic and asymptomatic fat necrosis is similar after conventional WBI and accelerated partial-breast HDR-BT

  17. Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

    Science.gov (United States)

    Goffman, Thomas E; Laronga, Christine; Wilson, Lori; Elkins, David

    2004-01-01

    The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage.

  18. Radiation recall secondary to adjuvant docetaxel after balloon-catheter based accelerated partial breast irradiation

    International Nuclear Information System (INIS)

    Wong, Nathan W.; Wong, William W.; Karlin, Nina J.; Gray, Richard J.

    2010-01-01

    For early stage breast cancer, wide local excision and post-operative whole breast irradiation is a standard treatment. If adjuvant chemotherapy is recommended, radiation is usually given after completion of chemotherapy. In recent years, accelerated partial breast irradiation (APBI) with balloon-cathetered based brachytherapy has become an option for selected patients. For these patients, adjuvant chemotherapy would have to be administered after radiation. The sequence of treatment with radiation followed by chemotherapy results in increased risk of radiation recall reaction (RRD) in these patients. Docetaxel is becoming a more commonly used drug as adjuvant treatment for breast cancer. Here we report a case of docetaxel induced RRD after APBI with balloon-cathetered based brachytherapy. Such reaction would have an adverse impact on the cosmetic outcome and quality of life of the patient. For patients who develop an intense skin reaction after the administration of docetaxel following APBI, RRD should be considered in the differential diagnosis.

  19. Target volume delineation in external beam partial breast irradiation: Less inter-observer variation with preoperative- compared to postoperative delineation

    International Nuclear Information System (INIS)

    Leij, Femke van der; Elkhuizen, Paula H.M.; Janssen, Tomas M.; Poortmans, Philip; Sangen, Maurice van der; Scholten, Astrid N.; Vliet-Vroegindeweij, Corine van; Boersma, Liesbeth J.

    2014-01-01

    The challenge of adequate target volume definition in external beam partial breast irradiation (PBI) could be overcome with preoperative irradiation, due to less inter-observer variation. We compared the target volume delineation for external beam PBI on preoperative versus postoperative CT scans of twenty-four breast cancer patients

  20. Breast Cancer Following Spinal Irradiation for a Childhood Cancer: A Report from the Childhood Cancer Survivor Study

    Science.gov (United States)

    Moskowitz, Chaya S.; Malhotra, Jyoti; Chou, Joanne F.; Wolden, Suzanne L.; Weathers, Rita E.; Stovall, Marilyn; Armstrong, Gregory T.; Leisenring, Wendy M.; Neglia, Joseph P.; Robison, Leslie L.; Oeffinger, Kevin C.

    2015-01-01

    Summary It has been suggested that pediatric patients treated with spinal irradiation may have an elevated risk of breast cancer. Among a cohort of 363 long-term survivors of a pediatric central nervous system tumor or leukemia treated with spinal irradiation, there was little evidence of an increased breast cancer risk. PMID:26391961

  1. Tangential breast irradiation with or without internal mammary chain irradiation: results of a randomized trial

    International Nuclear Information System (INIS)

    Kaija, Holli; Maunu, Pitkaenen

    1995-01-01

    A prospective randomized study was made of 270 patients with unilateral stage I or II invasive breast cancer treated by segmental resection, axillary dissection and radiation at the University Hospital of Tampere, Finland, between 1989 and 1991. The aim of the study was to determine whether there is any advantage or disadvantage if the internal mammary chains (IMC) are included in the radiation target volume. The medial and lateral two-field technique was used and the target volumes were determined randomly either to include the internal mammary chain (IMC-RT) or not (no-IMC-RT). The prevalence of radiation pneumonitis was 16% and there was no significant difference between the IMC- and no-IMC-groups (18 vs. 14%). Skin reactions were equal in both groups. Lung fibrosis was more common in the IMC-RT group. In conclusion: radiation of internal mammary chain after conservative surgery does not lead to an increase in clinically important skin or pulmonary complications. Whether it prevents recurrences or new primaries of the opposite breast is too early to say because of the short follow-up time

  2. Ion beam techniques for analyzing polymers irradiated by ions

    International Nuclear Information System (INIS)

    Rickards, J.; Zironi, E.P.; Andrade, E.; Dominguez, B.

    1992-01-01

    In the study of the effects of ion beam irradiation of polymers very large doses can be administered in short times. Thousands of MGy can be produced in a small volume of a sample in a few minutes by bombarding with typical ion beam currents. For instance, in an experiment done to observe the effects of 750 keV proton irradiation PVC, using a collimator of 1 mm diameter, 1 μC of charge integration deposits a dose of 50 MGy. The use of ion beams also opens up the possibility of using the same beam for irradiation and for analysis of the effects, using the well known ion beam analysis techniques. PIXE allows the measurement of chlorine in PVC. Polymers containing fluorine can be measured with the resonant nuclear reaction (RNR) technique, which is specific only to certain elements. The amount of hydrogen in the sample and its profile can be obtained using energy recoil detection analysis (ERDA); carbon, oxygen, and nitrogen can be measured and profiled using Rutherford backscattering (RBS) and also using the (d,p) and (d, α) nuclear reactions (NR). Loss of mass is one effect that can be studied using these techniques. It was studied in two different polymers, PVC and CR-39, in order to determine carbon buildup during ion irradiation. It was concluded that carbon builds up following different mechanisms in these two materials, due to the different possibilities of forming volatile compounds. It is also suggested that CR-39 should be a good material for ion beam lithography. (author)

  3. Is lymph node irradiation useful after conservative for early breast cancer

    International Nuclear Information System (INIS)

    Gava, A.; Coghetto, F.

    1989-01-01

    Twenty-four lectures were reviewed of the XXXIII SIRMN National Congress (Rome october 1988) on the conservative radiosurgical treatment of breast cancer. A whole of 3462 cases were divided into 2 groups: group A - 2824 patients who underwent targeted radiotherapy after conservative surgery (mostly quadrantectomy) - and group B - 638 patients where, in case of N+ and internal quadrant tumors, irradiation was extended to lymph nodes. No significant differences were demonstrated between group A and group B as far as locoregional relapse were concerned. Thus, no significant advantage seems to be yielded by lymphnode irradiation in the early treatment of breast cancer

  4. Radiation-induced cancer of the esophagus after postoperative irradiation for breast cancer

    International Nuclear Information System (INIS)

    Ito, Ichiro; Miyaishi, Kazuo; Mitsuhashi, Norio; Ito, Jun; Inoue, Tomio

    1978-01-01

    Two cases of radiation-induced cancer of the esophagus after postoperative irradiation for breast cancer were reported. Latent period of case 1 (cervical esophagus) was 12 years, and case 2 (middle thoracic esophagus) was 16 years. Radiographically the lesions were both serrated, and histologically, case 1 was ''poorly differentiated'' and case 2 was ''moderately differentiated'' squamous cell carcinoma. Histological types of basic breast cancer were both papillotubular carcinomas. Previous irradiation doses were 4180 rads for case 1 and 1860 rads for case 2. The esophageal cancers were remarkably improved by radiation therapy. It should be emphasized that radiation therapy is useful for the radiation-induced cancer of the esophagus. (author)

  5. Accelerated partial breast irradiation using robotic radiotherapy: a dosimetric comparison with tomotherapy and three-dimensional conformal radiotherapy.

    Science.gov (United States)

    Rault, Erwann; Lacornerie, Thomas; Dang, Hong-Phuong; Crop, Frederik; Lartigau, Eric; Reynaert, Nick; Pasquier, David

    2016-02-27

    Accelerated partial breast irradiation (APBI) is a new breast treatment modality aiming to reduce treatment time using hypo fractionation. Compared to conventional whole breast irradiation that takes 5 to 6 weeks, APBI is reported to induce worse cosmetic outcomes both when using three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). These late normal tissue effects may be attributed to the dose volume effect because a large portion of the non-target breast tissue volume (NTBTV) receives a high dose. In the context of APBI, non-coplanar beams could spare the NTBTV more efficiently. This study evaluates the dosimetric benefit of using the Cyberknife (CK) for APBI in comparison to IMRT (Tomotherapy) and three dimensional conformal radiotherapy (3D-CRT). The possibility of using surgical clips, implanted during surgery, to track target movements is investigated first. A phantom of a female thorax was designed in-house using the measurements of 20 patients. Surgical clips of different sizes were inserted inside the breast. A treatment plan was delivered to the mobile and immobile phantom. The motion compensation accuracy was evaluated using three radiochromic films inserted inside the breast. Three dimensional conformal radiotherapy (3D-CRT), Tomotherapy (TOMO) and CK treatment plans were calculated for 10 consecutive patients who received APBI in Lille. To ensure a fair comparison of the three techniques, margins applied to the CTV were set to 10 mm. However, a second CK plan was prepared using 3 mm margins to evaluate the benefits of motion compensation. Only the larger clips (VITALITEC Medium-Large) could be tracked inside the larger breast (all gamma indices below 1 for 1 % of the maximum dose and 1 mm). All techniques meet the guidelines defined in the NSABP/RTOG and SHARE protocols. As the applied dose volume constraints are very strong, insignificant dosimetric differences exist between techniques regarding the PTV

  6. Accelerated partial breast irradiation using robotic radiotherapy: a dosimetric comparison with tomotherapy and three-dimensional conformal radiotherapy

    International Nuclear Information System (INIS)

    Rault, Erwann; Lacornerie, Thomas; Dang, Hong-Phuong; Crop, Frederik; Lartigau, Eric; Reynaert, Nick; Pasquier, David

    2016-01-01

    Accelerated partial breast irradiation (APBI) is a new breast treatment modality aiming to reduce treatment time using hypo fractionation. Compared to conventional whole breast irradiation that takes 5 to 6 weeks, APBI is reported to induce worse cosmetic outcomes both when using three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). These late normal tissue effects may be attributed to the dose volume effect because a large portion of the non-target breast tissue volume (NTBTV) receives a high dose. In the context of APBI, non-coplanar beams could spare the NTBTV more efficiently. This study evaluates the dosimetric benefit of using the Cyberknife (CK) for APBI in comparison to IMRT (Tomotherapy) and three dimensional conformal radiotherapy (3D-CRT). The possibility of using surgical clips, implanted during surgery, to track target movements is investigated first. A phantom of a female thorax was designed in-house using the measurements of 20 patients. Surgical clips of different sizes were inserted inside the breast. A treatment plan was delivered to the mobile and immobile phantom. The motion compensation accuracy was evaluated using three radiochromic films inserted inside the breast. Three dimensional conformal radiotherapy (3D-CRT), Tomotherapy (TOMO) and CK treatment plans were calculated for 10 consecutive patients who received APBI in Lille. To ensure a fair comparison of the three techniques, margins applied to the CTV were set to 10 mm. However, a second CK plan was prepared using 3 mm margins to evaluate the benefits of motion compensation. Only the larger clips (VITALITEC Medium-Large) could be tracked inside the larger breast (all gamma indices below 1 for 1 % of the maximum dose and 1 mm). All techniques meet the guidelines defined in the NSABP/RTOG and SHARE protocols. As the applied dose volume constraints are very strong, insignificant dosimetric differences exist between techniques regarding the PTV

  7. Three-Dimensional Intrafractional Motion of Breast During Tangential Breast Irradiation Monitored With High-Sampling Frequency Using a Real-Time Tumor-Tracking Radiotherapy System

    International Nuclear Information System (INIS)

    Kinoshita, Rumiko; Shimizu, Shinichi; Taguchi, Hiroshi; Katoh, Norio; Fujino, Masaharu; Onimaru, Rikiya; Aoyama, Hidefumi; Katoh, Fumi; Omatsu, Tokuhiko; Ishikawa, Masayori; Shirato, Hiroki

    2008-01-01

    Purpose: To evaluate the three-dimensional intrafraction motion of the breast during tangential breast irradiation using a real-time tracking radiotherapy (RT) system with a high-sampling frequency. Methods and Materials: A total of 17 patients with breast cancer who had received breast conservation RT were included in this study. A 2.0-mm gold marker was placed on the skin near the nipple of the breast for RT. A fluoroscopic real-time tumor-tracking RT system was used to monitor the marker. The range of motion of each patient was calculated in three directions. Results: The mean ± standard deviation of the range of respiratory motion was 1.0 ± 0.6 mm (median, 0.9; 95% confidence interval [CI] of the marker position, 0.4-2.6), 1.3 ± 0.5 mm (median, 1.1; 95% CI, 0.5-2.5), and 2.6 ± 1.4 (median, 2.3; 95% CI, 1.0-6.9) for the right-left, craniocaudal, and anteroposterior direction, respectively. No correlation was found between the range of motion and the body mass index or respiratory function. The mean ± standard deviation of the absolute value of the baseline shift in the right-left, craniocaudal, and anteroposterior direction was 0.2 ± 0.2 mm (range, 0.0-0.8 mm), 0.3 ± 0.2 mm (range, 0.0-0.7 mm), and 0.8 ± 0.7 mm (range, 0.1-1.8 mm), respectively. Conclusion: Both the range of motion and the baseline shift were within a few millimeters in each direction. As long as the conventional wedge-pair technique and the proper immobilization are used, the intrafraction three-dimensional change in the breast surface did not much influence the dose distribution

  8. Technique for sparing previously irradiated critical normal structures in salvage proton craniospinal irradiation

    International Nuclear Information System (INIS)

    McDonald, Mark W; Wolanski, Mark R; Simmons, Joseph W; Buchsbaum, Jeffrey C

    2013-01-01

    Cranial reirradiation is clinically appropriate in some cases but cumulative radiation dose to critical normal structures remains a practical concern. The authors developed a simple technique in 3D conformal proton craniospinal irradiation (CSI) to block organs at risk (OAR) while minimizing underdosing of adjacent target brain tissue. Two clinical cases illustrate the use of proton therapy to provide salvage CSI when a previously irradiated OAR required sparing from additional radiation dose. The prior radiation plan was coregistered to the treatment planning CT to create a planning organ at risk volume (PRV) around the OAR. Right and left lateral cranial whole brain proton apertures were created with a small block over the PRV. Then right and left lateral “inverse apertures” were generated, creating an aperture opening in the shape of the area previously blocked and blocking the area previously open. The inverse aperture opening was made one millimeter smaller than the original block to minimize the risk of dose overlap. The inverse apertures were used to irradiate the target volume lateral to the PRV, selecting a proton beam range to abut the 50% isodose line against either lateral edge of the PRV. Together, the 4 cranial proton fields created a region of complete dose avoidance around the OAR. Comparative photon treatment plans were generated with opposed lateral X-ray fields with custom blocks and coplanar intensity modulated radiation therapy optimized to avoid the PRV. Cumulative dose volume histograms were evaluated. Treatment plans were developed and successfully implemented to provide sparing of previously irradiated critical normal structures while treating target brain lateral to these structures. The absence of dose overlapping during irradiation through the inverse apertures was confirmed by film. Compared to the lateral X-ray and IMRT treatment plans, the proton CSI technique improved coverage of target brain tissue while providing the least

  9. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation : Is IMRT more beneficial than VMAT?

    Science.gov (United States)

    Sakka, Mazen; Kunzelmann, Leonie; Metzger, Martin; Grabenbauer, Gerhard G

    2017-10-01

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  10. Anti-angiogenic activity in metastasis of human breast cancer cells irradiated by a proton beam

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyu-Shik; Shin, Jin-Sun; Nam, Kyung-Soo [Dongguk University, Gyeongju (Korea, Republic of); Shon, Yun-Hee [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2012-07-15

    Angiogenesis is an essential process of metastasis in human breast cancer. We investigated the effects of proton beam irradiation on angiogenic enzyme activities and their expressions in MCF-7 human breast cancer cells. The regulation of angiogenic regulating factors, of transforming growth factor-β (TGF-β) and of vesicular endothelial growth factor (VEGF) expression in breast cancer cells irradiated with a proton beam was studied. Aromatase activity and mRNA expression, which is correlated with metastasis, were significantly decreased by irradiation with a proton beam in a dose-dependent manner. TGF-β and VEGF transcriptions were also diminished by proton beam irradiation. In contrast, transcription of tissue inhibitors of matrix metalloproteinases (TIMPs), also known as biological inhibitors of matrix metalloproteinases (MMPs), was dose-dependently enhanced. Furthermore, an increase in the expression of TIMPs caused the MMP-9 activity to be diminished and the MMP-9 and the MMP-2 expressions to be decreased. These results suggest that inhibition of angiogenesis by proton beam irradiation in breast cancer cells is closely related to inhibitions of aromatase activity and transcription and to down-regulation of TGF-β and VEGF transcription.

  11. Comparison between magnetic resonance findings and conventional techniques (ultrasonography and mammography) in breast disease

    International Nuclear Information System (INIS)

    Martin, J.L.; Garofono, J.M.; Berquet, A.; Fernandez, F.J.; Fuentes, P.; Alvarez de Cienfuegos, E.

    1996-01-01

    Although mammography is indisputably the best diagnostic method for detecting breast abnormalities, there are other techniques, such as ultrasonography and magnetic resonance, which are increasingly widely employed as additional indispensable aids. The present work compares mammography, ultrasound and magnetic resonance images of normal breast and of the major pathologies that can be observed in breast, including sclerosing adenosis, giant fibroadenoma, multifocal carcinoma, fibrocystic breast disease, infiltrating duct carcinoma, colloid carcinoma, radical scar, abscess and breast prosthesis. (Author) 10 refs

  12. Technique of manufacturing specimen of irradiated fuel rods

    International Nuclear Information System (INIS)

    Min, Duck Seok; Seo, Hang Seok; Min, Duck Kee; Koo, Dae Seo; Lee, Eun Pyo; Yang, Song Yeol

    1999-04-01

    Technique of manufacturing specimen of irradiated fuel rods to perform efficient PIE is developed by analyzing the relation between requiring time of manufacturing specimen and manufacturing method in irradiated fuel rods. It takes within an hour to grind 1 mm of specimen thickness under 150 rpm in speed of grinding, 600 g gravity in force using no.120, no.240, no.320 of grinding paper. In case of no.400 of grinding paper, it takes more an hour to grind the same thickness as above. It takes up to a quarter to grind 80-130 μm in specimen thickness using no.400 of grinding paper. When grinding time goes beyond 15 minutes, the grinding thickness of specimen does not exist. The polishing of specimen with 150 Rpms in speed of grinding machine, 600 g gravity in force, 10 minutes in polishing time using diamond paste 15 μm on polishing cloths amounts to 50 μm in specimen thickness. In case of diamond paste 9 μm on polishing cloth, the polishing of specimen amounts to 20 μm. The polishing thickness of specimen with 15 minutes in polishing time using 6 μm, 3 μm, 1 μm, 1/4 μm does not exist. Technique of manufacturing specimen of irradiated fuel rods will have application to the destructive examination of PIE. (author). 6 refs., 1 tab., 10 figs

  13. Case Report and Dosimetric Analysis of an Axillary Recurrence After Partial Breast Irradiation with Mammosite Catheter

    International Nuclear Information System (INIS)

    Shah, Anand P.; Dickler, Adam; Kirk, Michael C.; Chen, Sea S.; Strauss, Jonathan B.; Coon, Alan B.; Turian, Julius V.; Siziopikou, Kalliopi; Dowlat, Kambiz; Griem, Katherine L.

    2008-01-01

    Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity. The following is a case of a 64-year-old woman with early-stage breast cancer treated with PBI who failed regionally in the ipsilateral axilla. With our dosimetric analysis, we found that the entire area of this axillary failure would have likely received at least 45 Gy if WBRT had been used, enough to sterilize microscopic disease. With PBI, this area received a mean dose of only 2.8 Gy, which raises the possibility that this regional failure may have been prevented had WBRT been used instead of PBI

  14. Setup accuracy for prone and supine whole breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Mulliez, Thomas; Vercauteren, Tom; Greveling, Annick van; Speleers, Bruno; Neve, Wilfried de; Veldeman, Liv [University Hospital Ghent, Department of Radiotherapy, Ghent (Belgium); Gulyban, Akos [University Hospital Ghent, Department of Radiotherapy, Ghent (Belgium); University Hospital Liege, Department of Radiotherapy, Liege (Belgium)

    2016-04-15

    To evaluate cone-beam computed tomography (CBCT) based setup accuracy and margins for prone and supine whole breast irradiation (WBI). Setup accuracy was evaluated on 3559 CBCT scans of 242 patients treated with WBI and uncertainty margins were calculated using the van Herk formula. Uni- and multivariate analysis on individual margins was performed for age, body mass index (BMI) and cup size. The population-based margin in vertical (VE), lateral (LA) and longitudinal (LO) directions was 10.4/9.4/9.4 mm for the 103 supine and 10.5/22.4/13.7 mm for the 139 prone treated patients, being significantly (p < 0.01) different for the LA and LO directions. Multivariate analysis identified a significant (p < 0.05) correlation between BMI and the LO margin in supine position and the VE/LA margin in prone position. In this series, setup accuracy is significantly worse in prone compared to supine position for the LA and LO directions. However, without proper image-guidance, uncertainty margins of about 1 cm are also necessary for supine WBI. For patients with a higher BMI, larger margins are required. (orig.) [German] Ziel der Arbeit war es, die interfraktionelle Repositionierungsgenauigkeit in Bauchlage (BL) versus Rueckenlage (RL) bei Ganzbrustbestrahlung (GBB) mittels Cone-Beam-CT (CBCT) zu bestimmen, um die notwendigen PTV-Sicherheitsabstaende zu definieren. Die Repositionierungsgenauigkeit wurde basierend an 3559 CBCT-Scans von 242 mit GBB behandelten Patienten ausgewertet. Die PTV-Sicherheitsabstaende wurden unter Verwendung der ''van-Herk''-Formel berechnet. Uni- und multivariable Analysen wurden fuer Sicherheitsabstaende in jede Richtung auf Basis von Alter, Body-Mass-Index (BMI) und Koerbchengroesse durchgefuehrt. Die basierend auf den taeglichen CBCT-Verschiebungen berechneten PTV-Sicherheitsabstaende betrugen in anteroposteriorer (AP), lateraler (LT oder links-rechts) und kraniokaudaler (CC) Richtung 10,4/9,4/9,4 mm fuer die RL (103 Patienten) und

  15. Ten-year results of the treatment of early-stage breast carcinoma in elderly women using breast-conserving surgery and definitive breast irradiation

    International Nuclear Information System (INIS)

    Solin, Lawrence J.; Schultz, Delray J.; Fowble, Barbara L.

    1995-01-01

    Purpose: The optimal management of breast cancer in elderly women is not well established. Therefore, the present study was undertaken to evaluate the outcome of breast cancer in elderly women treated with breast-conserving surgery and definitive breast irradiation. Methods and Materials: An analysis was performed of 558 women age ≥ 50 years treated with breast-conserving surgery and definitive breast irradiation for Stages I-II invasive carcinoma of the breast. Of the 558 total women, there were 173 elderly women age ≥ 65 years and a comparison group of 385 women age 50-64 years. Treatment for all women included complete gross excision of the primary tumor, pathologic axillary lymph node staging, and definitive breast irradiation. Adjuvant systemic chemotherapy was used in 18% (102 out of 558) of the overall group. Adjuvant tamoxifen was used in 17% (94 out of 558) of the overall group. The median follow-up after treatment was 6.2 years (mean = 6.4 years; range 0.1-15.4 years). Results: Elderly patients age ≥ 65 years and patients age 50-64 years were both found to have tumors with adverse prognostic features, including clinical T2 lesions (43 vs. 34%, respectively; p = 0.055), estrogen receptor negativity (9 vs. 16%, respectively; p = 0.13), and progesterone receptor negativity (17 vs. 21%, respectively; p = 0.50). Pathologic axillary lymph node staging showed that 24% of the elderly women were node positive, including 8% with four or more positive nodes, which was not different from women age 50-64 years (p = 0.23). There was no difference between the two age groups for the rate of deaths from breast cancer at 10 years (13 vs. 13%, respectively; p = 0.71). However, there was a significant difference between the two age groups for the rate of deaths from intercurrent disease at 10 years (11 vs. 2%, respectively; p = 0.0006). There were no differences between the two age groups for the 10-year rates of overall survival (77 vs. 85%, respectively; p = 0

  16. WE-EF-BRA-10: Prophylactic Cranial Irradiation Reduces the Incidence of Brain Metastasis in a Mouse Model of Metastatic Breast Cancerr

    Energy Technology Data Exchange (ETDEWEB)

    Smith, D; Debeb, B; Larson, R; Diagaradjane, P; Woodward, W [MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with acute lymphoblastic leukemia and small-cell lung cancer. We examined whether PCI could benefit breast cancer patients at high risk of developing brain metastases. Methods: We utilized our mouse model in which 500k green fluorescent protein (GFP)-labeled breast cancer cells injected into the tail vein of SCID/Beige mice resulted in brain metastases in approximately two-thirds of untreated mice. To test the efficacy of PCI, one set of mice was irradiated five days after cell injection with a single fraction of 4-Gy (two 2-Gy opposing fields) whole-brain irradiation on the XRAD 225Cx small-animal irradiator. Four controls were included: a non-irradiated group, a group irradiated two days prior to cell injection, and two groups irradiated 3 or 6 weeks after cell injection. Mice were sacrificed four and eight weeks post-injection and were evaluated for the presence of brain metastases on a fluorescent stereomicroscope. Results: The incidence of brain metastasis in the non-irradiated group was 77% and 90% at four and eight weeks, respectively. The PCI group had a significantly lower incidence, 20% and 30%, whereas the other three control groups had incidence rates similar to the non-treated control (70% to 100%). Further, the number of metastases and the metastatic burden were also significantly lower in the PCI group compared to all other groups. Conclusion: The timing of irradiation to treat subclinical disease is critical, as a small dose of whole-brain irradiation given five days after cell injection abrogated tumor burden by greater than 90%, but had no effect when administered twenty-one days after cell injection. PCI is likely to benefit breast cancer patients at high risk of developing brain metastases and should be strongly considered in the clinic.

  17. Structural analysis of irradiated crotoxin by spectroscopic techniques

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Karina C. de; Fucase, Tamara M.; Silva, Ed Carlos S. e; Chagas, Bruno B.; Buchi, Alisson T.; Viala, Vincent L.; Spencer, Patrick J.; Nascimento, Nanci do, E-mail: kcorleto@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Centro de Biotecnologia

    2013-07-01

    Snake bites are a serious public health problem, especially in subtropical countries. In Brazil, the serum, the only effective treatment in case of snake bites, is produced in horses which, despite of their large size, have a reduced lifespan due to the high toxicity of the antigen. Ionizing radiation has been successfully employed to attenuate the biological activity of animal toxins. Crotoxin, the main toxic compound from Crotalus durissus terrificus (Cdt), is a heterodimeric protein composed of two subunits: crotapotin and phospholipase A{sub 2}. Previous data indicated that this protein, following irradiation process, undergoes unfolding and/or aggregation, resulting in a much lower toxic antigen. The exact mechanisms and structural modifications involved in aggregation process are not clear yet. This work investigates the effects of ionizing radiation on crotoxin employing Infrared Spectroscopy, Circular Dichroism and Dynamic Light Scattering techniques. The infrared spectrum of lyophilized crotoxin showed peaks corresponding to the vibrational spectra of the secondary structure of crotoxin, including β-sheet, random coil, α-helix and β-turns. We calculated the area of these spectral regions after adjusting for baseline and normalization using the amide I band (1590-1700 cm{sup -1}), obtaining the variation of secondary structures of the toxin following irradiation. The Circular Dichroism spectra of native and irradiated crotoxin suggests a conformational change within the molecule after the irradiation process. This data indicates structural changes between the samples, apparently from ordered conformation towards a random coil. The analyses by light scattering indicated that the irradiated crotoxin formed multimers with an average molecular radius 100 folds higher than the native toxin. (author)

  18. Structural analysis of irradiated crotoxin by spectroscopic techniques

    International Nuclear Information System (INIS)

    Oliveira, Karina C. de; Fucase, Tamara M.; Silva, Ed Carlos S. e; Chagas, Bruno B.; Buchi, Alisson T.; Viala, Vincent L.; Spencer, Patrick J.; Nascimento, Nanci do

    2013-01-01

    Snake bites are a serious public health problem, especially in subtropical countries. In Brazil, the serum, the only effective treatment in case of snake bites, is produced in horses which, despite of their large size, have a reduced lifespan due to the high toxicity of the antigen. Ionizing radiation has been successfully employed to attenuate the biological activity of animal toxins. Crotoxin, the main toxic compound from Crotalus durissus terrificus (Cdt), is a heterodimeric protein composed of two subunits: crotapotin and phospholipase A 2 . Previous data indicated that this protein, following irradiation process, undergoes unfolding and/or aggregation, resulting in a much lower toxic antigen. The exact mechanisms and structural modifications involved in aggregation process are not clear yet. This work investigates the effects of ionizing radiation on crotoxin employing Infrared Spectroscopy, Circular Dichroism and Dynamic Light Scattering techniques. The infrared spectrum of lyophilized crotoxin showed peaks corresponding to the vibrational spectra of the secondary structure of crotoxin, including β-sheet, random coil, α-helix and β-turns. We calculated the area of these spectral regions after adjusting for baseline and normalization using the amide I band (1590-1700 cm -1 ), obtaining the variation of secondary structures of the toxin following irradiation. The Circular Dichroism spectra of native and irradiated crotoxin suggests a conformational change within the molecule after the irradiation process. This data indicates structural changes between the samples, apparently from ordered conformation towards a random coil. The analyses by light scattering indicated that the irradiated crotoxin formed multimers with an average molecular radius 100 folds higher than the native toxin. (author)

  19. Transsexual Mastectomy: Selection of Appropriate Technique According to Breast Characteristics

    Directory of Open Access Journals (Sweden)

    Hüsamettin Top

    2017-04-01

    Full Text Available Background: Subcutaneous mastectomy for female- to-male transsexuals is usually the first surgical pro- cedure in sexual reassignment. The main objective of subcutaneous mastectomy is to create an aesthetically pleasing male chest contour by removing all glandular tissue while minimizing chest wall scars. Aims: In this paper, we present our experience with subcutaneous mastectomy performed in female-to- male transsexual patients. The authors recommend their point of view to aid in selecting the most suitable subcutaneous mastectomy technique depending on breast characteristics. Study Design: Retrospective cross-sectional study. Methods: Between March 2011 and December 2014, 52 patients underwent bilateral subcutaneous mastec- tomies (total of 104 mastectomies, performed using the following four techniques: Webster semicircular, concentric circular, vertical, and apron flap. The tech- nique decision depended on the breast size, degree of skin excess, skin elasticity, chest width, nipple areolar complex size and position. Results: Seventeen patients (32.7% were operated with Webster semicircular, 7 patients (13.5% with con- centric periareolar, 12 patients with vertical (23%; and 16 patients (30.8% with the apron flap technique. The overall postoperative complication rate was 13.4%. All patients were satisfied with the aesthetic results of their subcutaneous mastectomies within the follow-up period. Conclusion: To obtain higher patient satisfaction with aesthetic results and lower postoperative complication rates, breast characteristics are evaluated in a detailed fashion, while choosing the ideal technique of Female-to-Male (FtM subcutaneous mastectomy. The presented surgical new algorithm facilitates the selection of the most reliable surgical technique

  20. Technique of radiotherapeutic treatment of breast cancer with scarcity means

    International Nuclear Information System (INIS)

    Velazquez M, S.; Carrera M, F.; Bayo L, E.; Gutierrez B, L.; Gomez-Millan B, J.

    1998-01-01

    The objective of this work is to show the particularities in the treatment simulation localization, in the volume selection and in the main planning strategies motive by our scarcity means during the first year of performance. It was utilized a computerized tomograph, an X-ray equipment with tele commanded table. Also it was utilized a radio opaque lattice of marked center and knowing space and also a magnetic pointer for indicating 80 cm length between focus-skin. Putting the patient on an inclined plane of self design and manufacture, it was realized three cuts at different levels over what are limited the clinical target volume (CTV) and it is optimized the isocenter through its determined localization by equations. It was employed equations for the radiobiological prediction about fibrosis and dermatitis. It was utilized another techniques or procedures for planning such as personnel wedges or the dose equilibrium in three points of the breast. It was evaluated toxicities (EORTC-RTOG). The results were as follow: Acute dermatitis (grade 1: 23 %; grade 2: 59 %; grade 3: 18 %). Acute pneumonitis (grade 1: 4.3 %); acute pharyngitis (grade 1: 11 %; grade 2: 3.7 %. In conservator treatment of breast it was obtained excellent aesthetic results in 15 %; good 72 %; moderate 11 %; and bad 3 %. The good aesthetic results by the combined use of the optimization techniques in clinical dosimetry, personnel wedges, isocenter therapy and computerized planning in the radiotherapeutic treatment of the breast cancer. (Author)

  1. Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer.

    Science.gov (United States)

    McGuffin, M; Merino, T; Keller, B; Pignol, J-P

    2017-03-01

    Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. Overall, HDR was the most expensive ($14 400), followed by PBSI ($8700), with WBI proving the least expensive ($6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about $10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.

    Science.gov (United States)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-09-22

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean irradiation.

  3. Changes of initiation, promotion and metastatic enzyme system in human breast cancer with the proton irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Y. H.; Kim, S. W.; Lee, K. S.; Mo, J. Y. [Dongguk University, Seoul (Korea, Republic of)

    2010-04-15

    Proton irradiations in the cells were significantly decreased cell viability but increased the QR activity in a dose-dependent manner. Cell viability was 92.3%, 88.4%, 81.8%, 72.4%, 68.9% at doses of 0.5, 2, 8, 16, and 32 Gy, respectively. At doses of 2, 8, 16, and 32 Gy, QR activity was increased 1.27-, 1.31-, 1.45- and 2.08-fold. However, negligible GST activity in the cells was detected and the activity was not changed by proton irradiation. Proton irradiation also increased GSH contents by 1.18- and 1.21-fold at doses of 0.5 and 2 Gy. In contrast, the ODC activity, a key enzyme in polyamine biosynthesis and tumor promotion, was decreased in a dose-dependent manner. We also investigated anti-metastatic effects of proton beam irradiation in breast cancer cells. Invasion and wound healing assay showed that metastatic activities in breast cancer cells were significantly decreased in a dose-dependent manner by proton beam irradiation. In zymography of MMP-9, the activity was slightly diminished. These results suggest that breast cancer chemopreventive potential was increased with proton irradiation by increasing the QR activity and the GSH levels and by inhibiting the ODC activity.

  4. Changes of initiation, promotion and metastatic enzyme system in human breast cancer with the proton irradiation

    International Nuclear Information System (INIS)

    Sohn, Y. H.; Kim, S. W.; Lee, K. S.; Mo, J. Y.

    2010-04-01

    Proton irradiations in the cells were significantly decreased cell viability but increased the QR activity in a dose-dependent manner. Cell viability was 92.3%, 88.4%, 81.8%, 72.4%, 68.9% at doses of 0.5, 2, 8, 16, and 32 Gy, respectively. At doses of 2, 8, 16, and 32 Gy, QR activity was increased 1.27-, 1.31-, 1.45- and 2.08-fold. However, negligible GST activity in the cells was detected and the activity was not changed by proton irradiation. Proton irradiation also increased GSH contents by 1.18- and 1.21-fold at doses of 0.5 and 2 Gy. In contrast, the ODC activity, a key enzyme in polyamine biosynthesis and tumor promotion, was decreased in a dose-dependent manner. We also investigated anti-metastatic effects of proton beam irradiation in breast cancer cells. Invasion and wound healing assay showed that metastatic activities in breast cancer cells were significantly decreased in a dose-dependent manner by proton beam irradiation. In zymography of MMP-9, the activity was slightly diminished. These results suggest that breast cancer chemopreventive potential was increased with proton irradiation by increasing the QR activity and the GSH levels and by inhibiting the ODC activity.

  5. Microbiological and sensory evaluation of the shelf-life of irradiated chicken breast meat

    International Nuclear Information System (INIS)

    Miyagusku, L.; Chen, F.; Leitao, M.F. de F.; Baffa, O.

    2003-01-01

    Kraft paper boxes containing 10 expanded polystyrene trays with 200g skinless deboned chicken breast each were irradiated with 60 Co source of a Nordion JS7500 irradiator. The trays were previously wrapped with polyethylene film. The samples were exposed to 1.5; 3.0 and 7.0 kGy doses in the static mode at 0º and 180º in relation to the irradiation beam. Set of 18 alanine+paraffin dosimeters per treatment were distributed inside the boxes for evaluation of irradiation dose homogeneity. A separeted dose calibration curve was obtained by irradiating in the range of 1 to 10kGy. After the irradiation, the chicken breasts were stored at 5±1ºC for 39 days and were analysed microbiologically in total psychrotrophic aerobic bacteria, total mesophilic aerobic bacteria, molds and yeasts, Pseudomonas spp, Enterobacteriaceae, lactic bacteria counts and E.coli during the storage period. The results revealed a linear behaviour of the alanine+paraffin dosimeters in the range of 1 to 10kGy irradiation. In regard to the microbiological aspect, compared to the shelf-life of 5 days for the controls, there were a increasing of 1.75; 4.40 e 7.0 times shelf-life for chicken breasts irradiated with 1.5; 3.0 and 7.0kGy, respectively. There was an increasing change of the smell of burnt as the irradiation doses increased. Thus, 3kGy dose was considered as the ideal dose to assure a longer shelf-life to the product, without perceptible changes in the aspect [pt

  6. Total lymphoid irradiation in the Wistar rat: technique and dosimetry

    International Nuclear Information System (INIS)

    Hoogenhout, J.; Kazem, I.; de Jong, J.

    1983-01-01

    The technical and dosimetric aspects of total lymphoid irradiation (TLI) in the Wistar rat were evaluated as part of a set-up to develop a new model for tumor xenotransplantation. Information obtained from anatomical dissections, radionuclide imaging of the spleen, lymphography and chromolymphography was used to standardize the localization portals cut out in a lead plate. The two portals encompassed the lymphoid tissue above and below the diaphragm. A specially designed masonite phantom was used to measure the dose distribution in the simulated target volumes. Ionization chamber dosimetery, thermoluminescence dosimetry and film densitometry were used for measuring exposure and absorbed dose. Irradiation was performed with 250 kV X rays (HVL 3.1 mm Cu). The dose rate was regulated by adjusting the treatment distance. The dose inhomogeneity measured in the target volumes varied between 80-100%. The side scatter dose to non target tissues under the shielded area between the two portals ranged between 20-30%. The technique and dosimetry of total lymphoid irradiation in Wistar rats are now standardized and validated and pave the way for tumor xenotransplantation experiments

  7. An evaluation of the accuracy of semi-permanent skin marks for breast cancer irradiation

    International Nuclear Information System (INIS)

    Probst, H.; Dodwell, D.; Gray, J.C.; Holmes, M.

    2006-01-01

    A randomised trial was designed to investigate the accuracy of semi-permanent ink marks versus permanent tattoos for early stage breast cancer irradiation. No significant difference in random and systematic errors was identified between the two groups. On multivariate analysis no specific patient characteristic had a major influence on the systematic errors identified

  8. An evaluation of the accuracy of semi-permanent skin marks for breast cancer irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Probst, H. [Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield S10 2BP (United Kingdom)]. E-mail: h.probst@shu.ac.uk; Dodwell, D. [Cookridge Hospital Leeds (United Kingdom); Gray, J.C. [University of Newcastle (United Kingdom); Holmes, M. [Leeds Metropolitan University (United Kingdom)

    2006-08-15

    A randomised trial was designed to investigate the accuracy of semi-permanent ink marks versus permanent tattoos for early stage breast cancer irradiation. No significant difference in random and systematic errors was identified between the two groups. On multivariate analysis no specific patient characteristic had a major influence on the systematic errors identified.

  9. Microbiology, sensory evaluation and shelf life of irradiated chicken breast fillets stored in air or vacuum

    OpenAIRE

    Mantilla, Samira Pirola Santos; Santos, Érica Barbosa; Vital, Helio de Carvalho; Mano, Sérgio Borges; Freitas, Mônica Queiroz de; Franco, Robson Maia

    2011-01-01

    This work investigated the effects of different packaging methods (air and vacuum) combined with irradiation (0.0, 2.0 and 3.0 kGy) on the preservation of chicken breast fillets stored at 1ºC for up to 18 days by sensorial test, determination of pH and bacterial growth. The findings indicated that the post-irradiation lag phase increased with the dose, leading to an extension in shelf-life. Vacuum-packed samples irradiated at 3.0 kGy exhibited the longest shelf life. Among the analyzed bacter...

  10. Influence of adjuvant irradiation on shoulder joint function after mastectomy for breast carcinoma

    International Nuclear Information System (INIS)

    Ryttov, N.; Blichert-Toft, M.; Madsen, E.L.; Weber, J.

    1983-01-01

    The influence of postoperative radiation therapy on ipsilateral shoulder function following mastectomy was evaluated from a series of 52 women with primarily operable carcinoma of the breast. Mastectomy and partial axillary dissection were carried out in all patients. In addition, 29 of the patients received postoperative irradiation with 36.6 Gy applied mid-axillarily in 12 fractions with irradiation twice a week. A significant impairment of the active shoulder mobility was found in the irradiated group (p<0.01). The passive mobility did not differ significantly between the two groups. The impairment of active shoulder mobility is suggested to be caused by radiation induced subcutaneous fibrosis. (Auth.)

  11. MO-E-BRD-02: Accelerated Partial Breast Irradiation in Brachytherapy: Is Shorter Better?

    International Nuclear Information System (INIS)

    Todor, D.

    2015-01-01

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  12. MO-E-BRD-02: Accelerated Partial Breast Irradiation in Brachytherapy: Is Shorter Better?

    Energy Technology Data Exchange (ETDEWEB)

    Todor, D. [Virginia Commonwealth University (United States)

    2015-06-15

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  13. Prototype volumetric ultrasound tomography image guidance system for prone stereotactic partial breast irradiation: proof-of-concept

    Science.gov (United States)

    Chiu, Tsuicheng D.; Parsons, David; Zhang, Yue; Hrycushko, Brian; Zhao, Bo; Chopra, Rajiv; Kim, Nathan; Spangler, Ann; Rahimi, Asal; Timmerman, Robert; Jiang, Steve B.; Lu, Weiguo; Gu, Xuejun

    2018-03-01

    Accurate dose delivery in stereotactic partial breast irradiation (S-PBI) is challenging because of the target position uncertainty caused by breast deformation, the target volume changes caused by lumpectomy cavity shrinkage, and the target delineation uncertainty on simulation computed tomography (CT) images caused by poor soft tissue contrast. We have developed a volumetric ultrasound tomography (UST) image guidance system for prone position S-PBI. The system is composed of a novel 3D printed rotation water tank, a patient-specific resin breast immobilization cup, and a 1D array ultrasound transducer. Coronal 2D US images were acquired in 5° increments over a 360° range, and planes were acquired every 2 mm in elevation. A super-compounding technique was used to reconstruct the image volume. The image quality of UST was evaluated with a BB-1 breast phantom and BioZorb surgical marker, and the results revealed that UST offered better soft tissue contrast than CT and similar image quality to MR. In the evaluated plane, the size and location of five embedded objects were measured and compared to MR, which is considered as the ground truth. Objects’ diameters and the distances between objects in UST differ by approximately 1 to 2 mm from those in MR, which showed that UST offers the image quality required for S-PBI. In future work we will develop a robotic system that will be ultimately implemented in the clinic.

  14. Application of gamma irradiation technique for the preservation of propolis

    International Nuclear Information System (INIS)

    Matsuda, Andrea Harumi

    2002-01-01

    Irradiation has been recognized as an efficient method for the reduction of deteriorating and pathogenic microorganisms in foods. Propolis is a resinous product made by bees from material processed by the bee's own metabolism and resins from plants. The aim of this work was the application of gamma irradiation technique for the preservation of propolis, because of its efficiency in the reduction of the microbial load. The changes on the total flavonoids content, phenolic compounds and other characteristics required for the qualification and characterization of Brazilian propolis were also analysed. Propolis samples from Juiz de Fora region, Minas Gerais, were irradiated in a 60 Co source, with doses from 0 to 10kGy for the microbiological analyses and 5.0, 7.0 and 10.0kGy for the physico-chemical analyses. The physico-chemical that have been made were: determination of total flavonoids content, semi-quantitative determination of phenolic compounds (artepelin-C, kempferol, chrysin, galangin and quercetin), dry matter analysis, humidity, ash content, mechanical mass and waxes. The ionizing radiation has shown to be efficient in the reduction of the microbial load. Total coliforms determination showed a great reduction with the dose of 3kGy and concerning mesophile aerobic bacteria a systematic reduction was observed, achieving values <10 UFC/g for the dose of 10kGy; similar results was obtained for molds and yeasts. Salmonella assays were negative for all samples. There was no significant alteration on total flavonoids contents nor on the composition of phenolic compounds as a consequence of radiation application at the assayed conditions. The complementary analyses of dry matter and humidity contents, ashes, mechanical mass and waxes did not shown changes after irradiation even with the maximum dose of 10kGy, remaining the results within the standards required by the Brazilian legislation. (author)

  15. Diagnostic accuracy of new imaging techniques in breast diseases

    Energy Technology Data Exchange (ETDEWEB)

    Gordenne, W; Bauduin, E [Liege Univ. (Belgium)

    1989-01-01

    During the last decade, the hypothetical carcinogenic effects of mammography have lead to new technical developments in X-ray diagnosis and to use of other imaging techniques such as ultrasonography (US), transillumination, magnetic resonance imaging (MRI). Many preliminary studies were published but few clinical trials are really convincing. According to the definition of a diagnostic tool, none of these new modalities is supposed to supplant mammography in the diagnosis of breast cancer. Improvements are expected by digital mammography in the near future. (Authors).

  16. Two-dimensional versus three-dimensional treatment planning of tangential breast irradiation

    International Nuclear Information System (INIS)

    Damen, E.M.F.; Bruinvis, I.A.D.; Mijnheer, B.J.

    1995-01-01

    Purpose: Full three-dimensional (3-D) treatment planning requires 3-D patient contours and density information, derived either from CT scanning or from other 3-D contouring methods. These contouring techniques are time consuming, and are often not available or cannot be used. Two-dimensional (2-D) treatment planning can be performed using only a few patient contours, made with much simpler techniques, in combination with simulator images for estimating the lung position. In order to investigate the need for full 3-D planning, we compared the performance of both a 2-D and a 3-D planning system in calculating absolute dose values and relative dose distributions in tangential breast irradiation. Methods: Two breast-shaped phantoms were used in this study. The first phantom consists of a polyethylene mould, filled with water and cork to mimic the lung. An ionization chamber can be inserted in the phantom at fixed positions. The second phantom is made of 25 transverse slices of polystyrene and cork, made with a computerized milling machine from CT information. In this phantom, films can be inserted in three sagittal planes. Both phantoms have been irradiated with two tangential 8 MV photon beams. The measured dose distribution has been compared with the dose distribution predicted by the two planning systems. Results: In the central plane, the 3-D planning system predicts the absolute dose with an accuracy of 0.5 - 4%. The dose at the isocentre of the beams agrees within 0.5% with the measured dose. The 2-D system predicts the dose with an accuracy of 0.9 - 3%. The dose calculated at the isocentre is 2.6% higher than the measured dose, because missing lateral scatter is not taken into account in this planning system. In off-axis planes, the calculated absolute dose agrees with the measured dose within 4% for the 2-D system and within 6% for the 3-D system. However, the relative dose distribution is predicted better by the 3-D planning system. Conclusions: This study

  17. SU-C-BRB-03: Cross-Institutional Validation of An Ultrafast Automatic Planning Platform for Breast Irradiation

    International Nuclear Information System (INIS)

    Li, T; Lockamy, V; Anne, P; Simone, N; Yu, Y; Sheng, Y; Wu, QJ

    2016-01-01

    Purpose: Recently an ultrafast automatic planning system for breast irradiation using tangential beams was developed by modeling relationships between patient anatomy and achieved dose distribution. This study evaluates the performance of this system when applied to a different patient population and dose calculation algorithm. Methods: The system and its anatomy-to-dose models was developed at institution A based on 20 cases, which were planned using manual fluence painting technique and calculated WITH heterogeneity correction. Institution B uses field-in-field planning technique and dose calculation WITHOUT heterogeneity correction. 11 breast cases treated at Institution B were randomly selected for retrospective study, including left and right sides, and different breast size (irradiated volumes defined by Jaw/MLC opening range from 875cc to 3516cc). Comparisons between plans generated automatically (Auto-Plans) and those used for treatment (Clinical-Plans) included: energy choice (single/mixed), volumes receiving 95%/100%/105%/110% Rx dose (V95%/V100%/V105%/V100%) relative to irradiated volume, D1cc, and LungV20Gy. Results: In 9 out of 11 cases single/mixed energy choice made by the software agreed with Clinical-Plans. For the remaining 2 cases software recommended using mixed energy and dosimetric improvements were observed. V100% were similar (p=0.223, Wilcoxon Signed-Rank test) between Auto-Plans and Clinical-Plans (57.6±8.9% vs. 54.8±9.5%). V95% is 2.3±3.0% higher for Auto-Plans (p=0.027), indicating reduced cold areas. Hot spot volume V105% were significantly reduced in Auto-Plan by 14.4±7.2% (p=0.004). Absolute V105% was reduced from 395.6±359.9cc for Clinical-Plans to 108.7±163cc for Auto-Plans. D1cc was 107.4±2.8% for Auto-Plans, and 109.2±2.4% for Clinical-Plans (p=0.056). LungV20Gy were 13.6±4.0% for Auto-Plan vs. 14.0±4.1% for Clinical-Plans (p=0.043). All optimizations were finished within 1.5min. Conclusion: The performance of this

  18. SU-C-BRB-03: Cross-Institutional Validation of An Ultrafast Automatic Planning Platform for Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Li, T; Lockamy, V; Anne, P; Simone, N; Yu, Y [Thomas Jefferson University, Philadelphia, PA (United States); Sheng, Y; Wu, QJ [Duke University, Durham, NC (United States)

    2016-06-15

    Purpose: Recently an ultrafast automatic planning system for breast irradiation using tangential beams was developed by modeling relationships between patient anatomy and achieved dose distribution. This study evaluates the performance of this system when applied to a different patient population and dose calculation algorithm. Methods: The system and its anatomy-to-dose models was developed at institution A based on 20 cases, which were planned using manual fluence painting technique and calculated WITH heterogeneity correction. Institution B uses field-in-field planning technique and dose calculation WITHOUT heterogeneity correction. 11 breast cases treated at Institution B were randomly selected for retrospective study, including left and right sides, and different breast size (irradiated volumes defined by Jaw/MLC opening range from 875cc to 3516cc). Comparisons between plans generated automatically (Auto-Plans) and those used for treatment (Clinical-Plans) included: energy choice (single/mixed), volumes receiving 95%/100%/105%/110% Rx dose (V95%/V100%/V105%/V100%) relative to irradiated volume, D1cc, and LungV20Gy. Results: In 9 out of 11 cases single/mixed energy choice made by the software agreed with Clinical-Plans. For the remaining 2 cases software recommended using mixed energy and dosimetric improvements were observed. V100% were similar (p=0.223, Wilcoxon Signed-Rank test) between Auto-Plans and Clinical-Plans (57.6±8.9% vs. 54.8±9.5%). V95% is 2.3±3.0% higher for Auto-Plans (p=0.027), indicating reduced cold areas. Hot spot volume V105% were significantly reduced in Auto-Plan by 14.4±7.2% (p=0.004). Absolute V105% was reduced from 395.6±359.9cc for Clinical-Plans to 108.7±163cc for Auto-Plans. D1cc was 107.4±2.8% for Auto-Plans, and 109.2±2.4% for Clinical-Plans (p=0.056). LungV20Gy were 13.6±4.0% for Auto-Plan vs. 14.0±4.1% for Clinical-Plans (p=0.043). All optimizations were finished within 1.5min. Conclusion: The performance of this

  19. SU-F-J-130: Margin Determination for Hypofractionated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Geady, C [Ryerson University (Canada); Keller, B; Hahn, E; Vesprini, D; Soliman, H; Lee, J [University of Toronto, Sunnybrook Health Sciences Center, Toronto, Ontario (Canada); Ruschin, M; McCann, C [University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Makhani, N; Bosnic, S [Sunnybrook Health Sciences Center, Toronto, Ontario (Canada)

    2016-06-15

    Purpose: To determine the Planning Target Volume (PTV) margin for Hypofractionated Partial Breast Irradiation (HPBI) using the van Herk formalism (M=2.5∑+0.7σ). HPBI is a novel technique intended to provide local control in breast cancer patients not eligible for surgical resection, using 40 Gy in 5 fractions prescribed to the gross disease. Methods: Setup uncertainties were quantified through retrospective analysis of cone-beam computed tomography (CBCT) data sets, collected prior to (prefraction) and after (postfraction) treatment delivery. During simulation and treatment, patients were immobilized using a wing board and an evacuated bag. Prefraction CBCT was rigidly registered to planning 4-dimensional computed tomography (4DCT) using the chest wall and tumor, and translational couch shifts were applied as needed. This clinical workflow was faithfully reproduced in Pinnacle (Philips Medical Systems) to yield residual setup and intrafractional error through translational shifts and rigid registrations (ribs and sternum) of prefraction CBCT to 4DCT and postfraction CBCT to prefraction CBCT, respectively. All ten patients included in this investigation were medically inoperable; the median age was 84 (range, 52–100) years. Results: Systematic (and random) setup uncertainties (in mm) detected for the left-right, craniocaudal and anteroposterior directions were 0.4 (1.5), 0.8 (1.8) and 0.4 (1.0); net uncertainty was determined to be 0.7 (1.5). Rotations >2° in any axis occurred on 8/72 (11.1%) registrations. Conclusion: Preliminary results suggest a non-uniform setup margin (in mm) of 2.2, 3.3 and 1.7 for the left-right, craniocaudal and anteroposterior directions is required for HPBI, given its immobilization techniques and online setup verification protocol. This investigation is ongoing, though published results from similar studies are consistent with the above findings. Determination of margins in breast radiotherapy is a paradigm shift, but a necessary

  20. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Kühr, Marietta; Wolfgarten, Matthias; Stölzle, Marco; Leutner, Claudia; Höller, Tobias; Schrading, Simone; Kuhl, Christiane; Schild, Hans; Kuhn, Walther; Braun, Michael

    2011-01-01

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size ≤3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget’s disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  1. Potential Impact of Preoperative Magnetic Resonance Imaging of the Breast on Patient Selection for Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kuehr, Marietta, E-mail: marietta.kuehr@ukb.uni-bonn.de [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Wolfgarten, Matthias; Stoelzle, Marco [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany); Leutner, Claudia [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Hoeller, Tobias [Department of Medical Statistics and Epidemiology, University of Bonn, Bonn (Germany); Schrading, Simone; Kuhl, Christiane; Schild, Hans [Department of Radiology, Center of Integrated Oncology, University of Bonn, Bonn (Germany); Kuhn, Walther; Braun, Michael [Department of Obstetrics and Gynecology and Center of Integrated Oncology, University of Bonn, Bonn (Germany)

    2011-11-15

    Purpose: Accelerated partial breast irradiation (APBI) after breast-conserving therapy is currently under investigation in prospective randomized studies. Multifocality and multicentricity are exclusion criteria for APBI. Preoperative breast magnetic resonance imaging (MRI) can detect ipsilateral and contralateral invasive tumor foci or ductal carcinoma in situ in addition to conventional diagnostic methods (clinical examination, mammography, and ultrasonography). The objective of this retrospective study was to evaluate the impact of preoperative MRI on patient selection for APBI. Methods and Materials: From 2002 to 2007, a total of 579 consecutive, nonselected patients with newly diagnosed early-stage breast cancer received preoperative breast MRI in addition to conventional imaging studies at the Bonn University Breast Cancer Center. In retrospect, 113 patients would have met the criteria for APBI using conventional imaging workup (clinical tumor size {<=}3 cm; negative axillary lymph node status; unifocal disease; no evidence of distant metastases; no invasive lobular carcinoma, ductal and lobular carcinoma in situ, or Paget's disease). We analyzed the amount of additional ipsilateral and contralateral tumor foci detected by MRI. Results: MRI detected additional tumor foci in 8.8% of patients eligible for APBI (11 tumor foci in 10 of 113 patients), either ipsilateral (n = 7, 6.2%) or contralateral (n = 4, 3.5%). In 1 patient, MRI helped detect additional tumor focus both ipsilaterally and contralaterally. Conclusions: Preoperative breast MRI is able to identify additional tumor foci in a clinically relevant number of cases in this highly selected group of patients with low-risk disease and may be useful in selecting patients for APBI.

  2. An investigation into the management of acute skin reactions from tangential breast irradiation

    International Nuclear Information System (INIS)

    Meegan, M.A.; Haycocks, T.R.

    1997-01-01

    This research examined the acute skin reaction of two consecutive groups receiving tangetial breast irradiation for carcinoma of the breast. The first group used the traditional skin care advice of using warm water only within the treatment area, while the second group continued with their normal skin care regime. Data was collected on the physical manifestations of the acute reaction, medical history, the use of concurrent cytotoxic agents, treatment parameters and skin care products used. Statistical analysis using the T-test method showed no difference in the skin reaction between the two groups. The investigation has lead to a change of policy in the management of acute breast reactions. Patients receiving radiation therapy to the breast or chest wall can now use their routine skin care products with no adverse effect on skin reactions. (author)

  3. Increased detection of lymphatic vessel invasion by D2-40 (podoplanin) in early breast cancer: possible influence on patient selection for accelerated partial breast irradiation.

    NARCIS (Netherlands)

    Debald, M.; Polcher, M.; Flucke, U.E.; Walgenbach-Brunagel, G.; Walgenbach, K.J.; Holler, T.; Wolfgarten, M.; Rudlowski, C.; Buttner, R.; Schild, H.; Kuhn, W.; Braun, M.

    2010-01-01

    PURPOSE: Several international trials are currently investigating accelerated partial breast irradiation (APBI) for patients with early-stage breast cancer. According to existing guidelines, patients with lymphatic vessel invasion (LVI) do not qualify for APBI. D2-40 (podoplanin) significantly

  4. Effect of high-dose irradiation on quality characteristics of ready-to-eat chicken breast

    International Nuclear Information System (INIS)

    Yun, Hyejeong; Haeng Lee, Kyung; Jung Lee, Hyun; Woon Lee, Ju; Uk Ahn, Dong; Jo, Cheorun

    2012-01-01

    High-dose (higher than 30 kGy) irradiation has been used to sterilize specific-purposed foods for safe and long-term storage. The objective of this study was to investigate the effect of high-dose irradiation on the quality characteristics of ready-to-eat chicken breast in comparison with those of the low-dose irradiation. Ready-to-eat chicken breast was manufactured, vacuum-packaged, and irradiated at 0, 5, and 40 kGy. The populations of total aerobic bacteria were 4.75 and 2.26 Log CFU/g in the samples irradiated at 0 and 5 kGy, respectively. However, no viable cells were detected in the samples irradiated at 40 kGy. On day 10, bacteria were not detected in the samples irradiated at 40 kGy but the number of bacteria in the samples irradiated at 5 kGy was increased. The pH at day 0 was higher in the samples irradiated at 40 kGy than those at 0 and 5 kGy. The 2-thiobarbituric acid reactive substance (TBARS) values of the samples were not significantly different on day 0. However, on day 10, the TBARS value was significantly higher in the samples irradiated at 40 kGy than those at 0 and 5 kGy. There was no difference in the sensory scores of the samples, except for off-flavor, which was stronger in samples irradiated at 5 and 40 kGy than control. However, no difference in off-flavor between the irradiated ones was observed. After 10 days of storage, only the samples irradiated at 40 kGy showed higher off-flavor score. SPME-GC–MS analysis revealed that 5 kGy of irradiation produced 2-methylbutanal and 3-methylbutanal, which were not present in the control, whereas 40 kGy of irradiation produced hexane, heptane, pentanal, dimethly disulfide, heptanal, and nonanal, which were not detected in the control or the samples irradiated at 5 kGy. However, the amount of compounds such as allyl sulfide and diallyl disulfide decreased significantly in the samples irradiated at 5 kGy and 40 kGy. - Highlights: ► Comparison of high (40 kGy) and low-dose irradiation (5 kGy) on

  5. Radiation techniques used in patients with breast cancer: Results of a survey in Spain

    Science.gov (United States)

    Algara, Manuel; Arenas, Meritxell; De las Peñas Eloisa Bayo, Dolores; Muñoz, Julia; Carceller, José Antonio; Salinas, Juan; Moreno, Ferran; Martínez, Francisco; González, Ezequiel; Montero, Ángel

    2012-01-01

    Aim To evaluate the resources and techniques used in the irradiation of patients with breast cancer after lumpectomy or mastectomy and the status of implementation of new techniques and therapeutic schedules in our country. Background The demand for cancer care has increased among the Spanish population, as long as cancer treatment innovations have proliferated. Radiation therapy in breast cancer has evolved exponentially in recent years with the implementation of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, image guided radiotherapy and hypofractionation. Material and Methods An original survey questionnaire was sent to institutions participating in the SEOR-Mama group (GEORM). In total, the standards of practice in 969 patients with breast cancer after surgery were evaluated. Results The response rate was 70% (28/40 centers). In 98.5% of cases 3D conformal treatment was used. All the institutions employed CT-based planning treatment. Boost was performed in 56.4% of patients: electrons in 59.8%, photons in 23.7% and HDR brachytherapy in 8.8%. Fractionation was standard in 93.1% of patients. Supine position was the most frequent. Only 3 centers used prone position. The common organs of risk delimited were: homolateral lung (80.8%) and heart (80.8%). In 84% histograms were used. An 80.8% of the centers used isocentric technique. In 62.5% asymmetric fields were employed. CTV was delimited in 46.2%, PTV in 65% and both in 38.5%. A 65% of the centers checked with portal films. IMRT and hypofractionation were used in 1% and in 5.5% respectively. Conclusion In most of centers, 3D conformal treatment and CT-based planning treatment were used. IMRT and hypofractionation are currently poorly implemented in Spain. PMID:24377012

  6. Soybean diet breast tumor incidence in irradiated rats

    International Nuclear Information System (INIS)

    Troll, W.; Wiesner, R.

    1980-01-01

    The relationship between feeding a diet rich in protease inhibitors and the reduction of mammary cancer induced by x-irradiation in Sprague-Dawley rats was examined. Of a total of 145 irradiated animals, 44% of the 45 rats fed a raw soybean diet containing a high concentration of protease inhibitor developed mammary tumors as compared to 74% of 50 rats fed a casein diet containing no protease inhibitor. Animals fed Purina rat chow which contained low levels of protease inhibitor exhibited a 70% mammary tumor incidence. No spontaneous neoplasms were found in any of the non-irradiated animals on the raw soybean diet whereas about 10% of the animals on the protease-free diet developed tumors. Thus, soybeans which are rich in protease inhibitors reduced the induction of mammary cancer in x-irradiated rats. This suggested that diets rich in protease inhibitors may contribute to reducing cancer incidence in man. (author)

  7. Development and verification of an excel program for calculation of monitor units for tangential breast irradiation with external photon beams

    International Nuclear Information System (INIS)

    Woldemariyam, M.G.

    2015-07-01

    The accuracy of MU calculation performed with Prowess Panther TPS (for Co-60) and Oncentra (for 6MV and 15MV x-rays) for tangential breast irradiation was evaluated with measurements made in an anthropomorphic phantom using calibrated Gafchromic EBT2 films. Excel programme which takes in to account external body surface irregularity of an intact breast or chest wall (hence absence of full scatter condition) using Clarkson’s sector summation technique was developed. A single surface contour of the patient obtained in a transverse plane containing the MU calculation point was required for effective implementation of the programme. The outputs of the Excel programme were validated with the respective outputs from the 3D treatment planning systems. The variations between the measured point doses and their calculated counterparts by the TPSs were within the range of -4.74% to 4.52% (mean of -1.33% and SD of 2.69) for the prowess panther TPS and -4.42% to 3.14% (mean of -1.47% and SD of -3.95) for the Oncentra TPS. The observed degree of deviation may be attributed to limitations of the dose calculation algorithm within the TPSs, set up inaccuracies of the phantom during irradiation and inherent uncertainties associated with radiochromic film dosimetry. The percentage deviations between MUs calculated with the two TPSs and the Excel program were within the range of -3.45% and 3.82% (mean of 0.83% and SD of 2.25). The observed percentage deviations are within the 4% action level recommended by TG-114. This indicates that the Excel program can be confidently employed for calculation of MUs for 2D planned tangential breast irradiations or to independently verify MUs calculated with another calculation methods. (au)

  8. Digital Image Processing Technique for Breast Cancer Detection

    Science.gov (United States)

    Guzmán-Cabrera, R.; Guzmán-Sepúlveda, J. R.; Torres-Cisneros, M.; May-Arrioja, D. A.; Ruiz-Pinales, J.; Ibarra-Manzano, O. G.; Aviña-Cervantes, G.; Parada, A. González

    2013-09-01

    Breast cancer is the most common cause of death in women and the second leading cause of cancer deaths worldwide. Primary prevention in the early stages of the disease becomes complex as the causes remain almost unknown. However, some typical signatures of this disease, such as masses and microcalcifications appearing on mammograms, can be used to improve early diagnostic techniques, which is critical for women’s quality of life. X-ray mammography is the main test used for screening and early diagnosis, and its analysis and processing are the keys to improving breast cancer prognosis. As masses and benign glandular tissue typically appear with low contrast and often very blurred, several computer-aided diagnosis schemes have been developed to support radiologists and internists in their diagnosis. In this article, an approach is proposed to effectively analyze digital mammograms based on texture segmentation for the detection of early stage tumors. The proposed algorithm was tested over several images taken from the digital database for screening mammography for cancer research and diagnosis, and it was found to be absolutely suitable to distinguish masses and microcalcifications from the background tissue using morphological operators and then extract them through machine learning techniques and a clustering algorithm for intensity-based segmentation.

  9. Nuclear techniques in animal production and health and food irradiation

    International Nuclear Information System (INIS)

    Cetinkaya, N.

    2002-01-01

    Nuclear techniques applied to animal production and health are concentrated in three main fields: Animal nutrition, reproduction and animal health. Isotopic markers, both radioactive (''1''4C, ''5 1 Cr, 32 P and 35 S) and stable ( 15 N), have been used in the development of feeding strategies by understanding the rumen fermentation process, and how protein and other nutrients are utilized to determine a balanced diet for meeting animal requirements for growth, pregnancy and lactation. The simple and easily applicable technology was developed for the preparation of a urea mineral multi nutrient block as a supplement and animal cake for the replacement of concentrate feed used by dairy cattle holders. The model was developed in Yerli Kara Cattle and its cross-breeds to estimate protein requirements of animals. Progesterone immunoassays (RIA/EIA) make it possible to control the reproductive performance of cattle, sheep and goats. A milk progesterone enzyme immunoassay kit known as Reprokon was developed at our Center. The kit has licensed by the Ministry of Agriculture and Rural Affairs. As for animal diseases, especially parasitic infections, nuclear techniques have proved to be of great value, namely in the production of irradiated vaccines against helminitic diseases. The Enzyme Linked Immunosorbent assay (ELISA) diagnostic techniques were used on the diagnosis of babesiosis, a disease which cause great economic loss in livestock in Turkey. Food irradiation is the treatment of raw, semi-processed or processed food or food ingredients with ionizing radiation to achieve a reduction of losses due to insect infestation, germination of root crops, spoilage and deterioration of perishable produce, and/or the control of microorganisms and other organisms that cause food borne diseases

  10. Palliative Spleen Irradiation: Can we Standardize its Technique?

    International Nuclear Information System (INIS)

    NAZMY, M.S.; RADWAN, A.; MOKHTAR, M.

    2008-01-01

    To explore the pattern of practice of palliative splenic irradiation (PSI) at the National Cancer Institute (NCI), Cairo University. Patients and Methods: The medical records of patients referred for PSI during the time period from 1990 to 2005 were retrospectively reviewed. We compared the three most common planning techniques (two parallel opposing, single direct field, anterior and lateral fields). Results: Eighteen patients who received PSI were identified. Thirteen patients were diagnosed as CML and 5 as CLL. The mean age of the patients was 44 (±16) years and the majority were men (60%). Spleen enlargement was documented in all cases. The single direct anterior field was the most commonly used technique. The dose per fraction ranged from 25 c Gy to 100 c Gy. The total dose ranged from 125 c Gy to 1200 c Gy and the median was 200 c Gy (mean 327 c Gy). There was no significant difference between CML and CLL patients regarding the dose level. Three out of 5 CLL patients and only one out of 13 CML patients received re-irradiation. All patients showed subjective improvement regarding pain and swelling. There was a significant increase in the hemoglobin level and a significant decrease in the WBC count. The single direct field shows variations in the dose from 56 to 102%; however, it is the simplest and the best regarding the dose to the surrounding normal tissues especially the kidney and the liver. Conclusion: PSI has a significant palliative benefit. Although the most widely accepted technique is the 2 parallel opposing anterior-posterior fields, single anterior field is also considered as a suitable option. Higher doses are needed for CLL patients compared to CML patients

  11. Elastography of the Breast: Imaging Techniques and Pitfalls in Interpretation

    International Nuclear Information System (INIS)

    Moon, Woo Kyung; Chang, Jung Min; Cho, Nariya

    2011-01-01

    Ultrasound (US) elastography is a tool that indicates the hardness of a lesion. Recent studies using elastography with freehand compression have shown similar diagnostic performance to conventional US in differentiating benign lesions from malignant breast masses. On the other hand, the acquired information is not quantitative, and the reliability of the imaging technique to correctly compress the tissue depends on the skill of the operator, resulting in substantial interobserver variability during data acquisition and interpretation. To overcome this, shear wave elastography was developed to provide quantitative information on the tissue elasticity. The system works by remotely inducing mechanical vibrations through the acoustic radiation force created by a focused US beam. This review discusses the principles and examination techniques of the two types of elastography systems and provides practical points to reduce the interobserver variability or errors during data acquisition and interpretation

  12. Elastography of the Breast: Imaging Techniques and Pitfalls in Interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Woo Kyung; Chang, Jung Min; Cho, Nariya [Seoul National University Hospital, Seoul (Korea, Republic of)

    2011-12-15

    Ultrasound (US) elastography is a tool that indicates the hardness of a lesion. Recent studies using elastography with freehand compression have shown similar diagnostic performance to conventional US in differentiating benign lesions from malignant breast masses. On the other hand, the acquired information is not quantitative, and the reliability of the imaging technique to correctly compress the tissue depends on the skill of the operator, resulting in substantial interobserver variability during data acquisition and interpretation. To overcome this, shear wave elastography was developed to provide quantitative information on the tissue elasticity. The system works by remotely inducing mechanical vibrations through the acoustic radiation force created by a focused US beam. This review discusses the principles and examination techniques of the two types of elastography systems and provides practical points to reduce the interobserver variability or errors during data acquisition and interpretation

  13. Possible radiation induced cancer of the thoracic esophagus after postoperative irradiation for the breast cancer

    International Nuclear Information System (INIS)

    Ueda, Mamoru; Matsubara, Toshiki; Kasumi, Fujio; Nishi, Mitsumasa; Kajitani, Tamaki

    1991-01-01

    We report 11 patients with cancer of the thoracic esophagus developing after postoperative irradiation therapy for breast cancer. Irradiation was done immediately after mastectomy in these patients and the irradiation field included the unilateral or bilateral parasternal region. They received a total dose ranging from 35 Gy to 60 Gy and the dose received to the thoracic esophagus was estimated from 10 Gy to 48 Gy. All cancer sites were involved in the irradiation field. The latent intervals of 10 patients from radiation to the manifest of cancer ranged from 10 to 19 years. Among 4777 women undergoing mastectomy for breast cancer between 1946 and 1980 in our hospital, 8 women (0.17%) developed cancer of the thoracic esophagus, whereas 5 (0.335%) out of 1534 women treated with mastectomy and radiotherapy with Linac between 1964 and 1980 developed cancer of the thoracic esophagus. Higher incidence of esophageal cancer in patients treated with surgery and radiation suggests that these cancers might be induced by radiation. Eight patients had esophagectomy and 4 patients of them received postoperative irradiation. They have survived from 9 months to 13 years. Two patients were controlled well by the irradiation alone. It is interesting that radiation therapy is sensitive to the possible radiation induced cancer of the thoracic esophagus. Follow up study should be directed to the possible development of second malignancy in patients who survive for a long time after radiation therapy. (author)

  14. Air-electron stream interactions during magnetic resonance IGRT. Skin irradiation outside the treatment field during accelerated partial breast irradiation

    International Nuclear Information System (INIS)

    Park, Jong Min; Shin, Kyung Hwan; Wu, Hong-Gyun; Kim, Jung-in; Park, So-Yeon; Kim, Jin Ho; Jeon, Seung Hyuck; Choi, Noorie

    2018-01-01

    To investigate and to prevent irradiation outside the treatment field caused by an electron stream in the air generated by the magnetic field during magnetic resonance image-guided accelerated partial breast irradiation (APBI). In all, 20 patients who received APBI with a magnetic resonance image-guided radiation therapy (MR-IGRT) system were prospectively studied. The prescription dose was 38.5 Gy in 10 fractions of 3.85 Gy and delivered with a tri-cobalt system (the ViewRay system). For each patient, primary plans were delivered for the first five fractions and modified plans with different gantry angles from those of the primary plan (in-treatment plans) were delivered for the remaining five fractions to reduce the skin dose. A 1 cm thick bolus was placed in front of the patient's jaw, ipsilateral shoulder, and arm to shield them from the electron stream. Radiochromic EBT3 films were attached to the front (towards the breast) and back (towards the head) of the bolus during treatment. Correlations between the measured values and the tumor locations, treatment times, and tumor sizes were investigated. For a single fraction delivery, the average areas of the measured isodoses of 14% (0.54 Gy), 12% (0.46 Gy), and 10% (0.39 Gy) at the front of the boluses were as large as 3, 10.4, and 21.4 cm 2 , respectively, whereas no significant dose could be measured at the back of the boluses. Statistically significant but weak correlations were observed between the measured values and the treatment times. During radiotherapy for breast cancer with an MR-IGRT system, the patient must be shielded from electron streams in the air generated by the interaction of the magnetic field with the beams of the three-cobalt treatment unit to avoid unwanted irradiation of the skin outside the treatment field. (orig.) [de

  15. Preliminary Results on Setup Precision of Prone-Lateral Patient Positioning for Whole Breast Irradiation

    International Nuclear Information System (INIS)

    Veldeman, Liv; Speleers, Bruno; Bakker, Marlies; Jacobs, Filip; Coghe, Marc; De Gersem, Werner; Impens, Aline; Nechelput, Sarah; De Wagter, Carlos

    2010-01-01

    Purpose: The aim of this study was to develop a rapid and reproducible technique for prone positioning and to compare dose-volume indices in prone and supine positions. Methods and Materials: Eighteen patients underwent computed tomography imaging for radiotherapy planning in prone and supine position. Experience was gained in the first eight patients, which lead to modifications of the Horizon prone breast board (Civco Medical Solutions, Orange City, Iowa, USA) and the patient setup technique. A unilateral breast holder (U-BH) was developed (Van de Velde, Schellebelle, Belgium) to retract the contralateral breast away from the treated breast. The technique was then applied to an additional 10 patients. The setup precision was evaluated using daily cone-beam CT. Results: Modifications to the breast board were made to secure a prone-lateral rather then a pure prone position. We evolved from a classical setup using laser marks on the patients' body to a direct breast setup using marks on the breast only. The setup precision of the direct positioning procedure with the modified breast board and the U-BH is comparable to supine setup data in the literature. Dose-volume indices for heart and lung show significantly better results for prone than for supine position, and dose homogeneity within the treated breast did not differ according to the treatment position. Conclusions: The setup precision of our prone-lateral positioning technique is comparable to supine data in literature. Our data show the advantage of prone radiotherapy to spare the lung and heart. Further research is necessary to reduce the duration of prone setup.

  16. Impact of Lymph Node Status on Clinical Outcomes After Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, J. Ben; Shaitelman, Simona [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Grills, Inga S.; Chen, Peter Y. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Oakland University William Beaumont School of Medicine, Royal Oak, MI (United States); Dekhne, Nayana [Breast Care Center, Beaumont Health System, William Beaumont Hospital, Royal Oak, MI (United States); Jaiyesimi, Ishmael [Department of Medical Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Wallace, Michelle; Mitchell, Christina K. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Oakland University William Beaumont School of Medicine, Royal Oak, MI (United States)

    2012-03-01

    Purpose: To compare outcomes after accelerated partial breast irradiation (APBI) between node-negative and node-positive patients. Methods and Materials: A total of 534 patients with early-stage breast cancer received APBI including 39 node-positive (N+) cases. Clinical, pathologic, and treatment-related factors were compared between node-negative (N-) and N+ cohorts. Local recurrence (LR), regional recurrence (RR), axillary failure (AF), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed. Results: N+ patients were younger (p = 0.04), had larger tumors (p < 0.001), and were more likely to receive chemotherapy (p < 0.001). Mean follow-up was 7.8 years for N+ patients and 6.3 years for N- patients (p = 0.06). No differences were seen in 5-year actuarial rates of LR (2.2% vs. 2.6%, p = 0.86), AF (0% vs. 0%, p = 0.69), DFS (90.0% vs. 88.0%, p = 0.79), or OS (91.0 vs. 84.0%, p = 0.65) between the two groups, whereas higher rates of RR (0% vs. 6.1%, p < 0.001) and DM (2.2% vs. 8.9%, p = 0.005) were noted in N+ patients. A trend for improved CSS (p = 0.06), was seen in N- patients. Age, tumor size, receptor status, T-stage, chemotherapy, APBI technique, and nodal status (p = 0.86) were not associated with LR, while a trend for an association with LR was noted with close/positive margins, (p = 0.07), and failure to receive adjuvant hormonal therapy (p = 0.06). Conclusions: No differences were seen in the rates of LR or AF between N- and N+ patients after APBI. These results support the continued enrollment of node-positive patients in Phase III trials evaluating the efficacy of APBI including the National Surgical Adjuvant Breast and Bowel Project-B39/Radiation Therapy Oncology Group 0413.

  17. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, Andrea M.; Portschy, Pamela R. [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Lee, Chung [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Le, Chap T. [Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Han, Linda K. [Department of Surgery, Indiana University, Indianapolis, Indiana (United States); Washington, Tara [Vantage Oncology, Redhawk and Wildomar Centers California, Wildomar, California (United States); Kinney, Michael [Center for Advanced Breast Care, Arlington Heights, Illinois (United States); Bretzke, Margit [Surgical Specialists of Minnesota, Minneapolis, Minnesota (United States); Tuttle, Todd M., E-mail: tuttl006@umn.edu [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States)

    2013-11-01

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended.

  18. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    International Nuclear Information System (INIS)

    Abbott, Andrea M.; Portschy, Pamela R.; Lee, Chung; Le, Chap T.; Han, Linda K.; Washington, Tara; Kinney, Michael; Bretzke, Margit; Tuttle, Todd M.

    2013-01-01

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended

  19. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    International Nuclear Information System (INIS)

    Nichols, Elizabeth; Kesmodel, Susan B.; Bellavance, Emily; Drogula, Cynthia; Tkaczuk, Katherine; Cohen, Randi J.; Citron, Wendla; Morgan, Michelle; Staats, Paul; Feigenberg, Steven; Regine, William F.

    2017-01-01

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 ( 21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

  20. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Elizabeth, E-mail: Enichols1@umm.edu [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Kesmodel, Susan B.; Bellavance, Emily; Drogula, Cynthia [Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Tkaczuk, Katherine [Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Cohen, Randi J.; Citron, Wendla; Morgan, Michelle [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Staats, Paul [Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Feigenberg, Steven; Regine, William F. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)

    2017-03-15

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

  1. Can We Predict Plan Quality for External Beam Partial Breast Irradiation: Results of a Multicenter Feasibility Study (Trans Tasman Radiation Oncology Group Study 06.02)

    Energy Technology Data Exchange (ETDEWEB)

    Kron, Tomas, E-mail: Tomas.Kron@petermac.org [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia); School of Science, Engineering and Technology, Royal Melbourne Institute of Technology University, Melbourne, Victoria (Australia); Willis, David; Link, Emma [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Lehman, Margot [Princess Alexandra Hospital, Department of Radiation Oncology, Brisbane, Queensland (Australia); Campbell, Gillian [Auckland City Hospital, Department of Radiation Oncology, Auckland (New Zealand); O' Brien, Peter [Newcastle Calvary Mater Hospital, Department of Radiation Oncology, Newcastle, NSW (Australia); Chua, Boon [Peter MacCallum Cancer Centre, Departments of Radiation Oncology, Physical Sciences and Radiation Therapy, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria (Australia)

    2013-11-15

    Purpose: Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose–volume parameters of organs at risk. Methods and Materials: Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose–volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. Results: The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in <1% of the heart volume receiving 5 Gy or less. It was more difficult to meet the heart dose constraint for left-sided and medially located tumors. Conclusions: Partial breast irradiation using 3-dimensional conformal RT was feasible within the study constraints. The ratio of planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI.

  2. Can We Predict Plan Quality for External Beam Partial Breast Irradiation: Results of a Multicenter Feasibility Study (Trans Tasman Radiation Oncology Group Study 06.02)

    International Nuclear Information System (INIS)

    Kron, Tomas; Willis, David; Link, Emma; Lehman, Margot; Campbell, Gillian; O'Brien, Peter; Chua, Boon

    2013-01-01

    Purpose: Partial breast irradiation (PBI) after lumpectomy may be an option for selected patients with early breast cancer. A feasibility study of accelerated PBI delivered using external beam 3-dimensional conformal radiation therapy (RT) was undertaken at 8 Australasian centers. The present study evaluated the impact of patient, tumor, and RT technique-related factors on the quality of RT plans as determined by the dose–volume parameters of organs at risk. Methods and Materials: Forty-eight patients were enrolled in the study. All RT plans were centrally reviewed using predefined dosimetric criteria before commencement and after completion of protocol therapy. The RT plans of 47 patients met the dose–volume constraints, and all 47 patients received PBI to a prescribed dose of 38.5 Gy in 10 fractions. The RT plan quality was determined by volumes of the ipsilateral whole breast, lung, and heart that received 50% and 95%; 30%; and 5% of the prescribed dose, respectively. Patient, tumor, and RT technique-related factors were investigated for association with the parameters of RT plan quality. Results: The ratio of the planning target volume to the ipsilateral whole-breast volume was significantly associated with the ipsilateral breast doses on multiple variable analyses. The distance of the postlumpectomy surgical cavity from the heart and lung were predictive for heart and lung doses, respectively. A distance between surgical cavity and heart of >4 cm typically resulted in <1% of the heart volume receiving 5 Gy or less. It was more difficult to meet the heart dose constraint for left-sided and medially located tumors. Conclusions: Partial breast irradiation using 3-dimensional conformal RT was feasible within the study constraints. The ratio of planning target volume to ipsilateral whole-breast volume and the distance of surgical cavity from the heart were significant predictors of the quality of treatment plan for external beam PBI

  3. Dosimetric considerations and early clinical experience of accelerated partial breast irradiation using multi-lumen applicators in the setting of breast augmentation

    Science.gov (United States)

    Akhtari, Mani; Pino, Ramiro; Scarboro, Sarah B.; Bass, Barbara L.; Miltenburg, Darlene M.; Butler, E. Brian

    2015-01-01

    Purpose Accelerated partial breast irradiation (APBI) is an accepted treatment option in breast-conserving therapy for early stage breast cancer. However, data regarding outcomes of patients treated with multi-lumen catheter systems who have existing breast implants is limited. The purpose of this study was to report treatment parameters, outcomes, and possible dosimetric correlation with cosmetic outcome for this population of patients at our institution. Material and methods We report the treatment and outcome of seven consecutive patients with existing breast implants and early stage breast cancer who were treated between 2009 and 2013 using APBI following lumpectomy. All patients were treated twice per day for five days to a total dose of 34 Gy using a high-dose-rate 192Ir source. Cosmetic outcomes were evaluated using the Harvard breast cosmesis scale, and late toxicities were reported using the Radiation Therapy Oncology Group (RTOG) late radiation morbidity schema. Results After a mean follow-up of 32 months, all patients have remained cancer free. Six out of seven patients had an excellent or good cosmetic outcome. There were no grade 3 or 4 late toxicities. The average total breast implant volume was 279.3 cc, received an average mean dose of 12.1 Gy, and a maximum dose of 234.1 Gy. The average percentage of breast implant volume receiving 50%, 75%, 100%, 150%, and 200% of the prescribed dose was 15.6%, 7.03%, 4.6%, 1.58%, and 0.46%, respectively. Absolute volume of breast implants receiving more than 50% of prescribed dose correlated with worse cosmetic outcomes. Conclusions Accelerated partial breast irradiation using a multi-lumen applicator in patients with existing breast implants can safely be performed with promising early clinical results. The presence of the implant did not compromise the ability to achieve dosimetric criteria; however, dose to the implant and the irradiated implant volume may be related with worse cosmetic outcomes. PMID:26816499

  4. Influence of irradiation on therapy-associated psychological distress in breast carcinoma patients

    International Nuclear Information System (INIS)

    Mose, Stephan; Budischewski, Kai Michael; Rahn, Angelika Notburga; Zander-Heinz, Anja Christina; Bormeth, Sabine; Boettcher, Heinz Dietrich

    2001-01-01

    Purpose: To confirm our assumptions regarding factors that apparently cause psychological distress related to adjuvant radiotherapy in breast cancer patients and to evaluate variables that can predict therapy-associated distress. Methods and Materials: Between January 1997 and April 1998, 111 women (33-84 years) with early-stage breast cancer were irradiated (56 Gy) after breast-conserving surgery. Patients were given self-assessment questionnaires on the first and last day of radiotherapy. Statistical analysis was performed using the structural equation model LISREL, variance analysis, and regression analysis. Results: The internal subject-related factors (coping, radiation-related anxiety, physical distress, psychological distress) reciprocally influenced each other, whereas external radiotherapy-specific factors (environmental influence, confidence in the medical staff) were causally related to coping, anxiety, and distress. Fifty-three percent of the women felt distressed because cancer affected the breast; 48% were initially afraid of radiotherapy. For 36%, anxiety was not reduced during treatment. Highly distressed women were identified by the following parameters: ≤58 years; initial anxiety; they were affected by having breast cancer, were negatively affected by environmental factors, and did not find distraction helpful. Conclusion: Despite considerable individual variability in breast cancer patients, it seems possible to identify women who run a high risk of therapy-associated distress. In these patients, psychosocial support is necessary to reduce treatment-related anxiety and to stabilize confidence in the medical staff

  5. Optimization of registration template of cone-beam CT guided whole breast irradiation after lumpectomy of breast cancer

    International Nuclear Information System (INIS)

    Wang Dongqing; Li Hongsheng; Zhou Tao; Liu Tonghai; Yu Ningsha; Li Baosheng

    2010-01-01

    Objective: To optimize the registration template of kilovoltage cone-beam CT (CBCT) guided radiotherapy in whole breast irradiation (WBI) after lumpectomy of breast cancer. Methods: From April 2006 to July 2009, twelve patients undergoing WBI with intensity-modulated radiotherapy (IMRT) were recruited in this study. All patients were performed with both conventional planning CT and CBCT integrated on Varian 23EX. Six distinguishable reference points (the diameter 1 mm) around the lumpectomy cavity and the surrounding gland on the planning CT image were marked. The images were manually registered offline based on the breast surface, surgical clips, breast gland, contiguous rib, ipsilateral lung and its external contours, respectively. The same six reference points were then marked on the CBCT image. The performance of the five registration templates was compared using the concept of registration error, while the registration time was taken into account. The registration error was calculated based on the six reference points' translations between the planning CT image and CBCT image, and analyzed with SPSS 13.0 software using one-way ANOVA. Results: The values of the registration error for the breast surface, surgical clips, breast gland, contiguous rib, ipsilateral lung and its external contours were (0.60±0.20), (0.43±0.15), (0.49±0.19), (0.69±0.36) and (0.94±0.49) cm, respectively, and the registration time were (3.8±1.1), (3.0±0.9), (4.7±1.7), (4.3±1.3) and (4.5±1.3) min, respectively. There was no statistical difference between the breast surface, surgical clips and breast gland registration template (t=0.48-1.36, P<0.05), the same result trend to contiguous rib compared with ipsilateral lung (t=2.00, P=0.055), however, there was significant difference between surgical clips and the last two registration methods (t=2.08-4.08, P<0.05). Conclusions: In this initial study with a modest number of patients, surgical clips show a best registration template

  6. Magnetic resonance imaging of breast. Actual technique and indications

    International Nuclear Information System (INIS)

    Tardivon, Anne

    2007-01-01

    Optimal breast MRI protocols are required using dedicated breast coils, high spatial resolution dynamic sequences (morphologic criteria are significantly more accurate than kinetic criteria) and bolus injection of contrast medium. Any abnormal MR enhancement must be described using BI-RADSMRI lexicon. Main indications of breast MRI are: suspicion of intra-capsular rupture (silicone implants), local relapse in a treated breast, search for breast cancer (metastatic axillary lymph nodes), locals staging of a breast cancer (dense breasts), follow-up of cancer under neoadjuvant chemotherapy, and screening in high-risk patients (gene mutation background). MRI is also useful for patients with unresolved problems at standard imaging (high negative predictive value of MRI). In patients with breast cancer, it is important to underline the need for radiologists to work with the multidisciplinary team and the ability to perform MR-guided biopsies for additional suspicious enhancements. (author) [es

  7. Accelerated Partial Breast Irradiation Consensus Statement From the American Society for Radiation Oncology (ASTRO)

    International Nuclear Information System (INIS)

    Smith, Benjamin D.; Arthur, Douglas W.; Buchholz, Thomas A.; Haffty, Bruce G.; Hahn, Carol A.; Hardenbergh, Patricia H.; Julian, Thomas B.; Marks, Lawrence B.; Todor, Dorin A. Ph.D.; Vicini, Frank A.; Whelan, Timothy J.; White, Julia; Wo, Jennifer Y.; Harris, Jay R.

    2009-01-01

    Purpose: To present guidance for patients and physicians regarding the use of accelerated partial-breast irradiation (APBI), based on current published evidence complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database yielded 645 candidate original research articles potentially applicable to APBI. Of these, 4 randomized trials and 38 prospective single-arm studies were identified. A Task Force composed of all authors synthesized the published evidence and, through a series of meetings, reached consensus regarding the recommendations contained herein. Results: The Task Force proposed three patient groups: (1) a 'suitable' group, for whom APBI outside of a clinical trial is acceptable, (2) a 'cautionary' group, for whom caution and concern should be applied when considering APBI outside of a clinical trial, and (3) an 'unsuitable' group, for whom APBI outside of a clinical trial is not generally considered warranted. Patients who choose treatment with APBI should be informed that whole-breast irradiation (WBI) is an established treatment with a much longer track record that has documented long-term effectiveness and safety. Conclusion: Accelerated partial-breast irradiation is a new technology that may ultimately demonstrate long-term effectiveness and safety comparable to that of WBI for selected patients with early breast cancer. This consensus statement is intended to provide guidance regarding the use of APBI outside of a clinical trial and to serve as a framework to promote additional clinical investigations into the optimal role of APBI in the treatment of breast cancer.

  8. Chest CT findings in breast cancer patients treated with postoperative irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yeon Joo; Kim, Kun Il; Lee, Suk Hong; Kim, Dong Won; Bae, Yeong Tae [College of Medicine, Pusan National Univ., Pusan (Korea, Republic of)

    2002-07-01

    The determine the chest CT findings in breast cancer patients who have undergone postoperative irradiation. The chest CT findings in 36 female patients who underwent breast surgery and radiotherapy between May 1996 and March 2000 were rerospectively analysed. Prior to radiotheraphy, baseline chest CT depicted normal parenchyma in all cases. In 11 patients, the ipsilateral breast and chest wall were irradiated using opposed tangential fields, while 25 were treated by the four fields method (opposed tangential fields plus anterior and posterior supraclavicular/high axillary fields), with a total dose of 5040-5400 cGy for 5-9 weeks. CT after radiotherapy demonstrated reticular opacity (n=24), perpendicular linear opacity (n=15), traction bronchiectasis (n=7), consolidation (n=6), ground glass attenuation (n=3), pathologic rib fractures (n=3) pleural effusion (n=2), and pleural thickening (n=1), while in five patients no abnormality was observed. in addition, in the anterolateral lung area of 23 (64%) of 36 patients who underwent tangential beam irradiation, CT demonstrated peripheral opacities. When supraclavicular and axillary portals were used, radiation-induced lung changes mostly occurred at the apex of the lung (n=24). Chest radiographs were abnormal in 26 patients and normal in ten; in five of these ten, CT demonstrated reticular opacity. Depending on the irradiation CT findings of radiation-induced lung injury in breast cancer include areas of increased opacity with or without fibrosis, in apical and/or anterior subpleural regions. CT may help differentiate radiation-induced parenchymal change from superimposed or combined lung disease.

  9. Pituitary inactivation by intrapituitary strontium 90 irradiation with cancer of the breast with generalized metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kayser, I

    1973-09-24

    Pituitary inactivation by intrapituitary Sr/sup 90/ irradiation was carried out on ten female patients with cancer of the breast with generalized metastases by the paranasal, transethmoido-sphenoidal way. The applied dose was 40,000 rad at 4 mm from the surface of the applicators. A direct relation between free interval, remission frequency and survival time could be observed. The remission time was longer with increasing age.

  10. Detection of irradiated spices by different physical techniques

    International Nuclear Information System (INIS)

    Chabane, S.; Pouliquen-Sonaglia, I.; Raffi, J.

    2001-01-01

    We used thermoluminescence, electron spin resonance, and viscosimetric measurements to establish whether or not a spice had been irradiated. Thermoluminescence, using the 1788 EN official protocol with an alternative method for the extraction of mineral impurities, led to proof of irradiation or proof of no treatment. Electron spin resonance led to different spectrum shapes depending on the chemical composition of the spices; ESR could only be used as proof of irradiation up to several weeks after irradiation, and only for some spices. Viscosimetric measurements carried out on spice suspensions led to a presumption of treatment (or of no treatment) and possibly to of of irradiation. (author)

  11. Cancer of the breast: Conservation surgery and curative radiation therapy - Technique

    International Nuclear Information System (INIS)

    Brady, L.W.; Bedwinek, J.M.; Markoe, A.M.; Micaily, B.; Damsker, J.I.; Karlsson, U.L.

    1987-01-01

    Current evidence strongly suggests that radiation therapy following conservation surgery in the primary local management of stage I and stage II breast cancer can achieve survival and local-regional control rates that are comparable to those obtained by radical and modified radical mastectomy. Since primary radiation therapy has the benefit of leaving the patient with intact and cosmetically acceptable breasts, it should be considered as a viable and reasonable alternative to radical mastectomy. An analysis of current series of primary radiation data suggests that total excision of the tumor should be carried out. An axillary node sampling or dissection including level 1 and level 2 axillary nodes (those lying beneath and lateral to the pectoralis minor muscle) should be carried out in addition to tumor excision since knowledge of the axillary nodal status serves as a prognostic indicator and facilitates the intelligent selection of those patients for adjuvant hormonal or chemotherapy. Technique then becomes a critical and important part of the management of the patient. No effort should be spared to insure that the volumes irradiated are properly chosen, receive the appropriate dose to maximize the potential for local-regional control and done within the context of minimization of complication from the treatment program. It is only under these circumstances that the best in terms of long-term survival and cosmetic can be achieved

  12. Usefulness of Oncoplastic Volume Replacement Techniques after Breast Conserving Surgery in Small to Moderate-sized Breasts

    Directory of Open Access Journals (Sweden)

    Jung Dug Yang

    2012-09-01

    Full Text Available BackgroundIn Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful.MethodsFrom January 2007 to December 2011, 104 women underwent a total of 107 breast-conserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP flap or a thoracodorsal artery perforator (TDAP flap.ResultsThe mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n=9, thoracoepigastric flap (n=7, ICAP flap (n=25, TDAP flap (n=12, and LD flap (n=54. There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results.ConclusionsOncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts.

  13. [Accelerated partial breast irradiation with image-guided intensity-modulated radiotherapy following breast-conserving surgery - preliminary results of a phase II clinical study].

    Science.gov (United States)

    Mészáros, Norbert; Major, Tibor; Stelczer, Gábor; Zaka, Zoltán; Mózsa, Emõke; Fodor, János; Polgár, Csaba

    2015-06-01

    The purpose of the study was to implement accelerated partial breast irradiation (APBI) by means of image-guided intensity-modulated radiotherapy (IG-IMRT) following breast-conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive (St I-II) breast cancer who underwent BCS were enrolled in our phase II prospective study. Postoperative APBI was given by means of step and shoot IG-IMRT using 4 to 5 fields to a total dose of 36.9 Gy (9×4.1 Gy) using a twice-a-day fractionation. Before each fraction, series of CT images were taken from the region of the target volume using a kV CT on-rail mounted in the treatment room. An image fusion software was used for automatic image registration of the planning and verification CT images. Patient set-up errors were detected in three directions (LAT, LONG, VERT), and inaccuracies were adjusted by automatic movements of the treatment table. Breast cancer related events, acute and late toxicities, and cosmetic results were registered and analysed. At a median follow-up of 24 months (range 12-44) neither locoregional nor distant failure was observed. Grade 1 (G1), G2 erythema, G1 oedema, and G1 and G2 pain occurred in 21 (35%), 2 (3.3%), 23 (38.3%), 6 (10%) and 2 (3.3%) patients, respectively. No G3-4 acute side effects were detected. Among late radiation side effects G1 pigmentation, G1 fibrosis, and G1 fat necrosis occurred in 5 (8.3%), 7 (11.7%), and 2 (3.3%) patients, respectively. No ≥G2 late toxicity was detected. Excellent and good cosmetic outcome was detected in 45 (75%) and 15 (25%) patients. IG-IMRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. Preliminary results are promising, early radiation side effects are minimal, and cosmetic results are excellent.

  14. Hypofractionated regional nodal irradiation for breast cancer: Examining the data and potential for future studies

    International Nuclear Information System (INIS)

    Badiyan, Shahed N.; Shah, Chirag; Arthur, Douglas; Khan, Atif J.; Freedman, Gary; Poppe, Matthew M.; Vicini, Frank A.

    2014-01-01

    Limited data are available examining the role of hypofractionated radiation schedules in the management of women requiring regional nodal irradiation (RNI). The purpose of this review is to examine the available literature for the efficacy (where available) and toxicity of hypofractionated radiation schedules in breast cancer with RNI limited to the axilla and supraclavicular regions. Multiple randomized and prospective studies have documented the safety and efficacy of hypofractionated schedules delivering whole breast irradiation (WBI) alone. Subsets from these randomized trials and smaller prospective/single-institution studies have documented the feasibility of hypofractionated RNI but the limited numbers prevent definitive conclusions and limited efficacy data are available. With regard to possible toxicity affecting organs at risk with RNI, key structures include the breast, skin, heart, lungs, axilla (lymphedema), and brachial plexus. Based on data from several randomized trials, hypofractionated radiation is not associated with significant changes in breast toxicity/cosmesis or cardiac toxicity; the addition of hypofractionated RNI would not be expected to change the rates of breast or cardiac toxicity. While RNI has been shown to increase rates of pulmonary toxicity, hypofractionated RNI has not been associated with more frequent pulmonary complications than standard RNI. Moving forward, future studies will have to evaluate for increased lung toxicity. With regard to lymphedema, data from randomized hypofractionated WBI trials failed to demonstrate an increase in lymphedema and smaller studies utilizing hypofractionated RNI have failed to as well. Data from head and neck cancer as well as hypofractionated breast radiation with RNI have failed to demonstrate an increase in brachial plexopathy with the exception of older trials that used much larger dose per fraction (>4 Gy/fraction) schedules. At this time, published data support the feasibility of

  15. SU-F-T-289: MLC Fluence Sonogram Based Delivery Quality Assurance for Bilateral Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Thiyagarajan, Rajesh; Karrthick, KP; Kataria, Tejinder; Mahendran, Ramu; Selvan, Tamil; Duraikannu, Palani [Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana (India); Raj, Nambi [Department of Physics, School of Advanced sciences, VIT University, Vellore (India); Arunai, N

    2016-06-15

    Purpose: Performing DQA for Bilateral (B-L) breast tomotherapy is a challenging task due to the limitation of any commercially available detector array or film. Aim of this study is to perform DQA for B-L breast tomotherapy plan using MLC fluence sinogram. Methods: Treatment plan was generated on Tomotherapy system for B-L breast tumour. B-L breast targets were given 50.4 Gy prescribed over 28 fractions. Plan is generated with 6 MV photon beam & pitch was set to 0.3. As the width of the total target is 39 cm (left & right) length is 20 cm. DQA plan delivered without any phantom on the mega voltage computed tomography (MCVT) detector system. The pulses recorded by MVCT system were exported to the delivery analysis software (Tomotherapy Inc.) for reconstruction. The detector signals are reconstructed to a sonogram and converted to MLC fluence sonogram. The MLC fluence sinogram compared with the planned fluence sinogram. Also point dose measured with cheese phantom and ionization chamber to verify the absolute dose component Results: Planned fluence sinogram and reconstructed MLC fluence sinogram were compared using Gamma metric. MLC positional difference and intensity of the beamlet were used as parameters to evaluate gamma. 3 mm positional difference and 3% beamlet intensity difference were used set for gamma calculation. A total of 26784 non-zero beamlets were included in the analysis out of which 161 beamlets had gamma more than 1. The gamma passing rate found to be 99.4%. Point dose measurements were within 1.3% of the calculated dose. Conclusion: MLC fluence sinogram based delivery quality assurance performed for bilateral breast irradiation. This would be a suitable alternate for large volume targets like bilateral breast, Total body irradiation etc. However conventional method of DQA should be used to validate this method periodically.

  16. Low-power laser irradiation did not stimulate breast cancer cells following ionizing radiation

    Science.gov (United States)

    Silva, C. R.; Camargo, C. F. M.; Cabral, F. V.; Ribeiro, M. S.

    2016-03-01

    Cancer has become a public health problem worldwide. Radiotherapy may be a treatment to a number of types of cancer, frequently using gamma-radiation with sources such as 137Cs and 60Co, with varying doses, dose rates, and exposure times to obtain a better as a stimulant for cell proliferation and tissue healing process. However, its effects on cancer cells are not yet well elucidated. The purpose of this work was to evaluate the effects of the LPL on breast cancer cultures after ionizing radiation. The breast cancer-MDA-MB-231 cells were gamma irradiated by a 60Co source, with dose of 2.5 Gy. After 24h, cells were submitted to LPL irradiation using a red laser emitting at λ= 660 nm, with output power of 40 mW and exposure time of 30 s and 60 s. The plates were uniformly irradiated, with energy of 1.2 J and 2.4 J, respectively. Cell viability was analyzed using the exclusion method with trypan blue. Our results show that breast cancer cells submitted to LPL after ionizing radiation remained 95 % viable. No statistically significant differences were observed between laser and control untreated cells, (P > 0.05). These findings suggest that LPL did not influenced cancer cells viability.

  17. Target volume delineation in external beam partial breast irradiation: less inter-observer variation with preoperative- compared to postoperative delineation

    NARCIS (Netherlands)

    Leij, F. van der; Elkhuizen, P.H.M.; Janssen, T.M.; Poortmans, P.M.P.; Sangen, M. van der; Scholten, A.N.; Vliet-Vroegindeweij, C. van; Boersma, L.J.

    2014-01-01

    The challenge of adequate target volume definition in external beam partial breast irradiation (PBI) could be overcome with preoperative irradiation, due to less inter-observer variation. We compared the target volume delineation for external beam PBI on preoperative versus postoperative CT scans of

  18. Irradiation doses on thyroid gland during the postoperative irradiation for breast cancer

    Directory of Open Access Journals (Sweden)

    Mustafa Akın

    2014-01-01

    Conclusions: In majority of the node-positive breast cancer patients treated with 3D CRT, the thyroid gland was exposed to considerable doses. On the other hand, for 44% of the patients are at risk for developing thyroid function abnormalities which should be considered during the routine follow-up.

  19. Why the concern about irradiation as a food preservation technique?

    International Nuclear Information System (INIS)

    Anon

    2001-01-01

    Full text: Irradiation is a food preservation process that like the more traditional and alternative methods is intended to keep food safe to eat by delaying the natural decomposition processes that result from bacterial action. Preservation of foods by irradiation, although still not available in Australia, is readily accepted in some 44 countries, including France. This project is set up to examine if a sample of fresh fruits and vegetables, when irradiated to the recommended 'preservation' dose level, becomes 'radioactive'. By placing the 'irradiated' sample, together with an identical 'control' sample of the same fresh fruit and vegetables, in an x-radiography cassette in a shielded 'cave', differences in film 'blackening' over the exposure period would indicate relative radioactivity from within the respective samples. Also, using simultaneous daily photographs of both the 'irradiated' and non-irradiated 'control' samples, the delay of onset of visible decay of both can be determined

  20. Mammographic findings after breast cancer treatment with local excision and definitive irradiation

    International Nuclear Information System (INIS)

    Dershaw, D.D.; Shank, B.; Reisinger, S.

    1987-01-01

    Following local excision and definitive irradiation of 163 breast cancers in 160 women, alterations in mammographic patterns were observed for up to 7 years. Skin thickening was observed in 96% of mammograms obtained within 1 year of completing therapy and was most pronounced in women treated with iridium implant, chemotherapy, or axillary dissection. In 76% of mammograms, alterations in the parenchymal pattern, including coarsening of stroma and increased breast density, were seen at 1 year. Neither skin nor parenchymal changes progressed after 1 year. Within 3 years of treatment the parenchymal density, which usually regressed, did not change in all patients. At 3 years skin thickness and the parenchymal pattern had returned to normal in less than 50% of the breasts of these women. Scars developed in approximately one-quarter of women. They were present on the initial post-treatment mammogram and remained unchanged on serial studies. Coarse, benign calcifications also developed in the breasts of about one-quarter of women. Microcalcifications developed in 11 breasts; biopsy specimens of six were benign. Benign microcalcifications may be related to therapy

  1. Toxicity and cosmetic outcome of three-dimensional conformal radiotherapy for accelerated partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Gatti, M.; Bresciani, S.; Ponzone, R.; Panaia, R.; Salatino, A.; Stasi, M.; Gabriele, P. [IRCC, Candiolo (Italy)

    2011-10-15

    Full text of publication follows: Purpose.- To analyse the incidence and severity of acute and late normal tissue toxicity and cosmetic outcome using three - dimensional conformal radiotherapy to deliver accelerated partial breast irradiation. Patients and Methods.- 70 patients with stage I disease were treated with three-dimensional conformal radiotherapy for accelerated partial breast irradiation, in an approved protocol. The prescribed dose was 34 Gy in all patients delivered in 10 fractions over 5 consecutive days. On all CT scans gross tumor volume (GTV ) was defined around surgical clips. A 1.5 cm margin was added in order to account for clinical target volume (CTV) . A margin of 1 cm was added to CTI to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the specifications as dictated in the NSABP/RTOG protocol. After treatment, patients underwent a clinical and cosmetic evaluation every 3 months. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed by the physicians using the controlateral untreated breast as the reference (Harvard scale). Results.- Median patient age was 66 years (range 51-80). Median follow-up was 15 months (range 6-46). Tumor size was < 10 mm in 33 patients (53%) and > 2 cm in 4(6%). The mean value of the ratio between the PTV and the whole ipsilateral breast volume was 38 % and the median percentage whole breast volume that received 95 % of prescribed dose was 34% (range 16%-55%). The rate of G1 and G2 acute skin toxicity was 28% and 2% respectively and the late toxicity was 17% (G1). G2 or greater toxicities were not observed. The most pronounced G1 late toxicity was subcutaneous fibrosis, developed in 3 patients. The cosmetic outcome was excellent in 83% and good in 17%. Conclusion.- Accelerated partial breast irradiation using three-dimensional conformal radiotherapy is technically feasible with very low acute and late toxicity. Long

  2. Toxicity and cosmetic outcome of three-dimensional conformal radiotherapy for accelerated partial breast irradiation

    International Nuclear Information System (INIS)

    Gatti, M.; Bresciani, S.; Ponzone, R.; Panaia, R.; Salatino, A.; Stasi, M.; Gabriele, P.

    2011-01-01

    Full text of publication follows: Purpose.- To analyse the incidence and severity of acute and late normal tissue toxicity and cosmetic outcome using three - dimensional conformal radiotherapy to deliver accelerated partial breast irradiation. Patients and Methods.- 70 patients with stage I disease were treated with three-dimensional conformal radiotherapy for accelerated partial breast irradiation, in an approved protocol. The prescribed dose was 34 Gy in all patients delivered in 10 fractions over 5 consecutive days. On all CT scans gross tumor volume (GTV ) was defined around surgical clips. A 1.5 cm margin was added in order to account for clinical target volume (CTV) . A margin of 1 cm was added to CTI to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the specifications as dictated in the NSABP/RTOG protocol. After treatment, patients underwent a clinical and cosmetic evaluation every 3 months. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed by the physicians using the controlateral untreated breast as the reference (Harvard scale). Results.- Median patient age was 66 years (range 51-80). Median follow-up was 15 months (range 6-46). Tumor size was 2 cm in 4(6%). The mean value of the ratio between the PTV and the whole ipsilateral breast volume was 38 % and the median percentage whole breast volume that received 95 % of prescribed dose was 34% (range 16%-55%). The rate of G1 and G2 acute skin toxicity was 28% and 2% respectively and the late toxicity was 17% (G1). G2 or greater toxicities were not observed. The most pronounced G1 late toxicity was subcutaneous fibrosis, developed in 3 patients. The cosmetic outcome was excellent in 83% and good in 17%. Conclusion.- Accelerated partial breast irradiation using three-dimensional conformal radiotherapy is technically feasible with very low acute and late toxicity. Long-term results are needed to assess

  3. A physical and engineering study on the irradiation techniques in neutron capture therapy aiming for wider application

    International Nuclear Information System (INIS)

    Sakurai, Y.; Ono, K.; Suzuki, M.; Katoh, I.; Miyatake, S.-I.; Yanagie, H.

    2003-01-01

    The solo-irradiation of thermal neutrons has been applied for brain cancer and malignant melanoma in the boron neutron capture therapy (BNCT) at the medical irradiation facility of Kyoto University Reactor (KUR), from the first clinical trial in 1974. In 1997, after the facility remodeling, the application of the mix-irradiation of thermal and epi-thermal neutrons was started, and the depth dose distribution for brain cancer has been improved in some degree. In 2001, the solo-irradiation of epi-thermal neutrons also started. It is specially mentioned that the application to oral cancers started at the same time. The BNCT clinical trial using epi-thermal neutron irradiation at KUR, amounts to twelve as of March 2003. The seven trials; more than a half of the total trials, are for oral cancers. From this fact, we think that the wider application to the other cancers is required for the future prosperity of BNCT. The cancers applied for BNCT in KUR at the present time, are brain cancer, melanoma and oral cancers, as mentioned above. The cancers, expected to be applied in near future, are liver cancer, pancreas cancer, lung cancer, tongue cancer, breast cancer, etc.. Any cancer is almost incurable by the other therapy including the other radiation therapy. In the wider application of BNCT to these cancers, the dose-distribution control suitable to each cancer and/or each part, is important. The introduction of multi-directional and/or multi-divisional irradiation is also needed. Here, a physical and engineering study using two-dimensional transport calculation and three-dimensional Monte-Carlo simulation for the irradiation techniques in BNCT aiming for wider application is reported

  4. Myocardial infarction among women with early-stage breast cancer treated with conservative surgery and breast irradiation

    International Nuclear Information System (INIS)

    Rutqvist, Lars E.; Liedberg, Anette; Hammar, Niklas; Dalberg, Kristina

    1998-01-01

    Purpose: To assess the possible impact of the irradiation on the risk of acute myocardial infarction among breast cancer patients treated with conservative surgery and postoperative radiation therapy. Methods and Materials: The incidence of and mortality from acute myocardial infarction was assessed in a group of 684 women with early-stage breast cancer diagnosed during 1976-1987 who had been treated with breast conserving surgery plus postoperative radiation therapy given with tangential photon fields. In 94% of the patients the total dose was between 48-52 Gy given with 2 Gy daily fractions 5 days per week for a total treatment period of about 4 (1(2)) - 5 (1(2)) weeks. In 88% of the patients the target volume included the breast parenchyma alone. In the remaining patients regional nodal areas were also irradiated. A concurrent group of 4,996 breast cancer patients treated with mastectomy without postoperative radiation therapy was used as a reference. Results: After a median follow-up of 9 years (range: 5-16 years) 12 conservatively treated patients (1.8%) had developed an acute myocardial infarction and 5 (0.7%) had died due to this disease. The age-adjusted relative hazard of acute myocardial infarction for the conservative group vs. the mastectomy group was 0.6 (95% C.I.: 0.4-1.2) and for death due to this disease 0.4 (0.2-1.1). The incidence of acute myocardial infarction among the conservatively treated women was similar irrespective of tumor laterality. Conclusions: There was no indication of an increased risk of acute myocardial infarction with the radiation therapy among the women treated with conservative surgery. However, due to the small number of events the study could not exclude the possibility that cardiac problems may arise in some patients with left-sided cancers who have their heart located anteriorly in the mediastinum. Individual, three-dimensional dose planning represents one method to identify such patients and is basic to technical changes

  5. Calibration Technique of the Irradiated Thermocouple using Artificial Neural Network

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Tae; Joung, Chang Young; Ahn, Sung Ho; Yang, Tae Ho; Heo, Sung Ho; Jang, Seo Yoon [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    To correct the signals, the degradation rate of sensors needs to be analyzed, and re-calibration of sensors should be followed periodically. In particular, because thermocouples instrumented in the nuclear fuel rod are degraded owing to the high neutron fluence generated from the nuclear fuel, the periodic re-calibration process is necessary. However, despite the re-calibration of the thermocouple, the measurement error will be increased until next re-calibration. In this study, based on the periodically calibrated temperature - voltage data, an interpolation technique using the artificial neural network will be introduced to minimize the calibration error of the C-type thermocouple under the irradiation test. The test result shows that the calculated voltages derived from the interpolation function have good agreement with the experimental sampling data, and they also accurately interpolate the voltages at arbitrary temperature and neutron fluence. That is, once the reference data is obtained by experiments, it is possible to accurately calibrate the voltage signal at a certain neutron fluence and temperature using an artificial neural network.

  6. Training manual on food irradiation technology and techniques. 2. ed.

    International Nuclear Information System (INIS)

    1982-01-01

    The objective of the revised Training Manual is to help scientists to acquire the necessary knowledge needed for performing proper research and development work in the field of food irradiation. The Manual presents an up-to-date picture of the current state of food irradiation and reflects the important advances made in the technology of food irradiation, in the radiation chemistry of foods, in the microbiology of irradiated foods, in wholesomeness and standardization. It contains the following chapters: (1) Radionuclides and radiation; (2) Radiation detection and measurement; (3) Radiation protection; (4) Radiation chemistry; (5) Effects of radiation on living organisms; (6) Preservation of foods; (7) Radiation preservation of foods; (8) Packaging; (9) Combination processes; (10) Limitations of food irradiation; (11) Wholesomeness of irradiated foods; (12) Government regulation of irradiated foods; (13) Food irradiation facilities; (14) Commercial aspects of food irradiation; (15) Literature sources. The practical part of the Manual contains a revised and expanded series of detailed laboratory exercises in the use of ionizing radiation for food processing

  7. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

    International Nuclear Information System (INIS)

    Stegman, Lauren D.; Beal, Katherine P.; Hunt, Margie A.; Fornier, Monica N.; McCormick, Beryl

    2007-01-01

    Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose

  8. Accelerated partial-breast irradiation vs conventional whole-breast radiotherapy in early breast cancer: A case-control study of disease control, cosmesis, and complications

    Directory of Open Access Journals (Sweden)

    Wadasadawala Tabassum

    2009-01-01

    Full Text Available Context: Accelerated partial-breast irradiation (APBI using various approaches is being increasingly employed for selected women with early breast cancer (EBC. Aims: To conduct a case-control study comparing disease control, cosmesis, and complications in patients with EBC undergoing APBI using multicatheter interstitial brachytherapy vs those receiving conventional whole breast radiotherapy (WBRT. Settings and Design: Women with EBC fulfilling the American Brachytherapy Society (ABS criteria were selected as ′cases′ if treated with APBI or as ′controls′ if offered WBRT during the period from May 2000 to December 2004. Materials and Methods: APBI patients were treated with high-dose-rate brachytherapy (HDR to a dose of 34 Gy/10#/6-8 days. WBRT was delivered to the whole breast to a dose of 45 Gy/25# followed by tumor bed boost, either with electrons (15 Gy/6# or interstitial brachytherapy (HDR 10 Gy/1#. Results: At the median follow-up of 43.05 months in APBI and 51.08 months in WBRT there was no difference in overall survival (OS, disease-free survival (DFS, late arm edema, and symptomatic fat necrosis between the two groups. However, APBI resulted in increase in mild breast fibrosis at the tumor bed. Telangiectasias were observed in three patients of the APBI group. The cosmetic outcome was significantly better in the APBI group as compared to the WBRT group (P = 0.003. Conclusions: This study revealed equivalent locoregional and distant disease control in the two groups. APBI offered better overall cosmetic outcome, though at the cost of a slight increase in mild breast fibrosis and telangiectasias.

  9. Nomogram for Predicting the Risk of Locoregional Recurrence in Patients Treated With Accelerated Partial-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wobb, Jessica L. [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Chen, Peter Y., E-mail: PChen@beaumont.edu [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Shah, Chirag [Department of Radiation Oncology, Summa Health System, Akron, Ohio (United States); Moran, Meena S. [Department of Therapeutic Radiology, Yale School of Medicine, Norwich, Connecticut (United States); Shaitelman, Simona F. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Vicini, Frank A. [Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, Farmington, Michigan (United States); Mbah, Alfred K.; Lyden, Maureen [Biostat International Inc, Tampa, Florida (United States); Beitsch, Peter [Department of Surgery, Dallas Breast Center, Dallas, Texas (United States)

    2015-02-01

    Purpose: To develop a nomogram taking into account clinicopathologic features to predict locoregional recurrence (LRR) in patients treated with accelerated partial-breast irradiation (APBI) for early-stage breast cancer. Methods and Materials: A total of 2000 breasts (1990 women) were treated with APBI at William Beaumont Hospital (n=551) or on the American Society of Breast Surgeons MammoSite Registry Trial (n=1449). Techniques included multiplanar interstitial catheters (n=98), balloon-based brachytherapy (n=1689), and 3-dimensional conformal radiation therapy (n=213). Clinicopathologic variables were gathered prospectively. A nomogram was formulated utilizing the Cox proportional hazards regression model to predict for LRR. This was validated by generating a bias-corrected index and cross-validated with a concordance index. Results: Median follow-up was 5.5 years (range, 0.9-18.3 years). Of the 2000 cases, 435 were excluded because of missing data. Univariate analysis found that age <50 years, pre-/perimenopausal status, close/positive margins, estrogen receptor negativity, and high grade were associated with a higher frequency of LRR. These 5 independent covariates were used to create adjusted estimates, weighting each on a scale of 0-100. The total score is identified on a points scale to obtain the probability of an LRR over the study period. The model demonstrated good concordance for predicting LRR, with a concordance index of 0.641. Conclusions: The formulation of a practical, easy-to-use nomogram for calculating the risk of LRR in patients undergoing APBI will help guide the appropriate selection of patients for off-protocol utilization of APBI.

  10. Rib necrosis after postoperative irradiation with 6MeV x-ray to breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Asakawa, H; Watarai, J; Otawa, H [Miyagi Prefectural Adult Disease Center, Natori (Japan)

    1975-04-01

    In order to examine quality of rays in radiation injury in the rib by high energy x-ray, radiation injury in the rib was roentgenologically followed up in the subjects that received postoperative irradiation only with 6 MeV x-ray to breast cancer. The subjects consisted of 79 patients with the age of 30 to 78 and were irradiated with 200 rads of 6 MeV x-ray 5 times a week delivered in 5 to 6 weeks postoperatively. Two fields were irradiated in a day and the total dose reached more than 5,000 rads. Roentgenologic follow up for more than 12 months revealed that rib necrosis occurred in 9 (11%) of 79 patients and that there was no relation to the age of patient. The necrosis was most likely to develop in the right second rib 10 to 23 months after the irradiation and the mean was 16 months. To the rib region where necrosis occurred, 1,880 to 2,230 ret were irradiated and the mean was 2,014 ret. There found no relation between the irradiation dose and occurrence of rib necrosis in the extent of 4,000 to 6,000 rads for tumor doses. Radiation injury in the lung was complicated in 8 (89%) of 9 patients with rib necrosis, indicating high incidence.

  11. A dosimetric comparison of IORT techniques in limited-stage breast cancer

    International Nuclear Information System (INIS)

    Nairz, O.; Deutschmann, H.; Kopp, M.; Wurstbauer, K.; Kametriser, G.; Fastner, G.; Merz, F.; Sedlmayer, F.; Reitsamer, R.; Menzel, C.

    2006-01-01

    Background and purpose: for intraoperative radiotherapy (IORT) during breast-conserving treatment four different techniques have been addressed: interstitial brachytherapy, an inflatable balloon with a central high-dose-rate source (MammoSite), a miniature orthovolt system (Intrabeam), and linac-based electron radiotherapy (IOERT). The dosimetric properties of these methods are compared. Material and methods: planning target volumes (PTVs) of the same size but of different shapes are assumed, corresponding to the technique's specific situs. Dose distributions for the PTVs and for surrounding tissues are demonstrated by dose-volume histograms and a list of physical parameters. A dose inhomogeneity index (DII) is introduced to describe the deviation of a delivered from the prescribed dose, reaching its minimal value 0 in case of perfect homogeneity. Results: in terms of DII, IOERT reaches the lowest value followed by the MammoSite, the Intrabeam and interstitial implants. The surrounding tissues receive the smallest average dose with IOERT, closely followed by the orthovolt system. Conclusion: when comparing simplified geometric figures, IOERT delivers the most homogeneous dose distributions. However, in clinical reality PTVs often present asymmetric shapes instead of ideal geometries. Due to a strictly centric dose fall-off, any system with a round central applicator will have technical limits. During IOERT margin-directed applicator guidance is possible and interstitial brachytherapy allows for polygonal dose shaping. These techniques seem to be superior for asymmetric PTV irradiation. (orig.)

  12. Novel Breast Imaging and Machine Learning: Predicting Breast Lesion Malignancy at Cone-Beam CT Using Machine Learning Techniques.

    Science.gov (United States)

    Uhlig, Johannes; Uhlig, Annemarie; Kunze, Meike; Beissbarth, Tim; Fischer, Uwe; Lotz, Joachim; Wienbeck, Susanne

    2018-05-24

    The purpose of this study is to evaluate the diagnostic performance of machine learning techniques for malignancy prediction at breast cone-beam CT (CBCT) and to compare them to human readers. Five machine learning techniques, including random forests, back propagation neural networks (BPN), extreme learning machines, support vector machines, and K-nearest neighbors, were used to train diagnostic models on a clinical breast CBCT dataset with internal validation by repeated 10-fold cross-validation. Two independent blinded human readers with profound experience in breast imaging and breast CBCT analyzed the same CBCT dataset. Diagnostic performance was compared using AUC, sensitivity, and specificity. The clinical dataset comprised 35 patients (American College of Radiology density type C and D breasts) with 81 suspicious breast lesions examined with contrast-enhanced breast CBCT. Forty-five lesions were histopathologically proven to be malignant. Among the machine learning techniques, BPNs provided the best diagnostic performance, with AUC of 0.91, sensitivity of 0.85, and specificity of 0.82. The diagnostic performance of the human readers was AUC of 0.84, sensitivity of 0.89, and specificity of 0.72 for reader 1 and AUC of 0.72, sensitivity of 0.71, and specificity of 0.67 for reader 2. AUC was significantly higher for BPN when compared with both reader 1 (p = 0.01) and reader 2 (p Machine learning techniques provide a high and robust diagnostic performance in the prediction of malignancy in breast lesions identified at CBCT. BPNs showed the best diagnostic performance, surpassing human readers in terms of AUC and specificity.

  13. Evaluation of two intracavitary high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped volumes of breast tissue

    International Nuclear Information System (INIS)

    Lu, Sharon M.; Scanderbeg, Daniel J.; Barna, Patrick; Yashar, William; Yashar, Catheryn

    2012-01-01

    The SAVI and Contura breast brachytherapy applicators represent 2 recent advancements in brachytherapy technology that have expanded the number of women eligible for accelerated partial breast irradiation in the treatment of early-stage breast cancer. Early clinical experience with these 2 single-entry, multichannel high-dose-rate brachytherapy devices confirms their ease of use and dosimetric versatility. However, current clinical guidelines for SAVI and Contura brachytherapy may result in a smaller or less optimal volume of treated tissue compared with traditional interstitial brachytherapy. This study evaluates the feasibility of using the SAVI and Contura to irradiate larger and irregularly shaped target volumes, approaching what is treatable with the interstitial technique. To investigate whether additional tissue can be treated, 17 patients treated with the SAVI and 3 with the Contura were selected. For each patient, the planning target volume (PTV) was modified to extend 1.1 cm, 1.3 cm, and 1.5 cm beyond the tumor bed cavity. To evaluate dose conformance to an irregularly shaped target volume, 9 patients treated with the SAVI and 3 with the Contura were selected from the original 20 patients. The following asymmetric PTV margin combinations were assessed for each patient: 1.5/0.3, 1.3/0.3, and 1.1/0.3 cm. For all patients, treatment planning was performed, adopting the National Surgical Adjuvant Breast and Bowel Project guidelines, and dosimetric comparisons were made. The 6–1 and 8–1 SAVI devices can theoretically treat a maximal tissue margin of 1.5 cm and an asymmetric PTV with margins ranging from 0.3 to 1.5 cm. The 10–1 SAVI and Contura can treat a maximal margin of 1.3 cm and 1.1 cm, respectively, and asymmetric PTV with margins ranging from 0.3–1.3 cm. Compared with the Contura, the SAVI demonstrated greater dosimetric flexibility. Risk of developing excessive hot spots increased with the size of the SAVI device. Both the SAVI and Contura

  14. A Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation: First Report of Acute Toxicity, Feasibility, and Patient Satisfaction

    Energy Technology Data Exchange (ETDEWEB)

    Dragun, Anthony E., E-mail: aedrag01@louisville.edu [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Quillo, Amy R. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Riley, Elizabeth C. [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Roberts, Teresa L.; Hunter, Allison M. [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Rai, Shesh N. [Department of Biostatistics and Epidemiology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Callender, Glenda G. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Jain, Dharamvir [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); McMasters, Kelly M. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Spanos, William J. [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)

    2013-03-01

    Purpose: To report on early results of a single-institution phase 2 trial of a 5-fraction, once-weekly radiation therapy regimen for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins were eligible to receive whole breast radiation therapy to a dose of 30 Gy in 5 weekly fractions of 6 Gy with or without an additional boost. Elective nodal irradiation was not permitted. There were no restrictions on breast size or the use of cytotoxic chemotherapy for otherwise eligible patients. Patients were assessed at baseline, treatment completion, and at first posttreatment follow-up to assess acute toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and quality of life (European Organization for Research and Treatment of Cancer QLQ-BR23). Results: Between January and September 2011, 42 eligible patients underwent weekly hypofractionated breast irradiation immediately following BCS (69.0%) or at the conclusion of cytotoxic chemotherapy (31.0%). The rates of grade ≥2 radiation-induced dermatitis, pain, fatigue, and breast edema were 19.0%, 11.9%, 9.5%, and 2.4%, respectively. Only 1 grade 3 toxicity—pain requiring a course of narcotic analgesics—was observed. One patient developed a superficial cellulitis (grade 2), which resolved with the use of oral antibiotics. Patient-reported moderate-to-major breast symptoms (pain, swelling, and skin problems), all decreased from baseline through 1 month, whereas breast sensitivity remained stable over the study period. Conclusions: The tolerance of weekly hypofractionated breast irradiation compares well with recent reports of daily hypofractionated whole-breast irradiation schedules. The regimen appears feasible and cost-effective. Additional follow-up with continued accrual is needed to assess late toxicity, cosmesis, and disease-specific outcomes.

  15. A Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation: First Report of Acute Toxicity, Feasibility, and Patient Satisfaction

    International Nuclear Information System (INIS)

    Dragun, Anthony E.; Quillo, Amy R.; Riley, Elizabeth C.; Roberts, Teresa L.; Hunter, Allison M.; Rai, Shesh N.; Callender, Glenda G.; Jain, Dharamvir; McMasters, Kelly M.; Spanos, William J.

    2013-01-01

    Purpose: To report on early results of a single-institution phase 2 trial of a 5-fraction, once-weekly radiation therapy regimen for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins were eligible to receive whole breast radiation therapy to a dose of 30 Gy in 5 weekly fractions of 6 Gy with or without an additional boost. Elective nodal irradiation was not permitted. There were no restrictions on breast size or the use of cytotoxic chemotherapy for otherwise eligible patients. Patients were assessed at baseline, treatment completion, and at first posttreatment follow-up to assess acute toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and quality of life (European Organization for Research and Treatment of Cancer QLQ-BR23). Results: Between January and September 2011, 42 eligible patients underwent weekly hypofractionated breast irradiation immediately following BCS (69.0%) or at the conclusion of cytotoxic chemotherapy (31.0%). The rates of grade ≥2 radiation-induced dermatitis, pain, fatigue, and breast edema were 19.0%, 11.9%, 9.5%, and 2.4%, respectively. Only 1 grade 3 toxicity—pain requiring a course of narcotic analgesics—was observed. One patient developed a superficial cellulitis (grade 2), which resolved with the use of oral antibiotics. Patient-reported moderate-to-major breast symptoms (pain, swelling, and skin problems), all decreased from baseline through 1 month, whereas breast sensitivity remained stable over the study period. Conclusions: The tolerance of weekly hypofractionated breast irradiation compares well with recent reports of daily hypofractionated whole-breast irradiation schedules. The regimen appears feasible and cost-effective. Additional follow-up with continued accrual is needed to assess late toxicity, cosmesis, and disease-specific outcomes

  16. Contralateral breast doses measured by film dosimetry: tangential techniques and an optimized IMRT technique

    International Nuclear Information System (INIS)

    Saur, S; Frengen, J; Fjellsboe, L M B; Lindmo, T

    2009-01-01

    The contralateral breast (CLB) doses for three tangential techniques were characterized by using a female thorax phantom and GafChromic EBT film. Dose calculations by the pencil beam and collapsed cone algorithms were included for comparison. The film dosimetry reveals a highly inhomogeneous dose distribution within the CLB, and skin doses due to the medial fields that are several times higher than the interior dose. These phenomena are not correctly reproduced by the calculation algorithms. All tangential techniques were found to give a mean CLB dose of approximately 0.5 Gy. All wedged fields resulted in higher CLB doses than the corresponding open fields, and the lateral open fields resulted in higher CLB doses than the medial open fields. More than a twofold increase in the mean CLB dose from the medial open field was observed for a 90 deg. change of the collimator orientation. Replacing the physical wedge with a virtual wedge reduced the mean dose to the CLB by 35% and 16% for the medial and lateral fields, respectively. Lead shielding reduced the skin dose for a tangential technique by approximately 50%, but the mean CLB dose was only reduced by approximately 11%. Finally, a technique based on open medial fields in combination with several IMRT fields is proposed as a technique for minimizing the CLB dose. With and without lead shielding, the mean CLB dose using this technique was found to be 0.20 and 0.27 Gy, respectively.

  17. Air-electron stream interactions during magnetic resonance IGRT : Skin irradiation outside the treatment field during accelerated partial breast irradiation.

    Science.gov (United States)

    Park, Jong Min; Shin, Kyung Hwan; Kim, Jung-In; Park, So-Yeon; Jeon, Seung Hyuck; Choi, Noorie; Kim, Jin Ho; Wu, Hong-Gyun

    2018-01-01

    To investigate and to prevent irradiation outside the treatment field caused by an electron stream in the air generated by the magnetic field during magnetic resonance image-guided accelerated partial breast irradiation (APBI). In all, 20 patients who received APBI with a magnetic resonance image-guided radiation therapy (MR-IGRT) system were prospectively studied. The prescription dose was 38.5 Gy in 10 fractions of 3.85 Gy and delivered with a tri-cobalt system (the ViewRay system). For each patient, primary plans were delivered for the first five fractions and modified plans with different gantry angles from those of the primary plan (in-treatment plans) were delivered for the remaining five fractions to reduce the skin dose. A 1 cm thick bolus was placed in front of the patient's jaw, ipsilateral shoulder, and arm to shield them from the electron stream. Radiochromic EBT3 films were attached to the front (towards the breast) and back (towards the head) of the bolus during treatment. Correlations between the measured values and the tumor locations, treatment times, and tumor sizes were investigated. For a single fraction delivery, the average areas of the measured isodoses of 14% (0.54 Gy), 12% (0.46 Gy), and 10% (0.39 Gy) at the front of the boluses were as large as 3, 10.4, and 21.4 cm 2 , respectively, whereas no significant dose could be measured at the back of the boluses. Statistically significant but weak correlations were observed between the measured values and the treatment times. During radiotherapy for breast cancer with an MR-IGRT system, the patient must be shielded from electron streams in the air generated by the interaction of the magnetic field with the beams of the three-cobalt treatment unit to avoid unwanted irradiation of the skin outside the treatment field.

  18. Interobserver variations of target volume delineation and its impact on irradiated volume in accelerated partial breast irradiation with intraoperative interstitial breast implant

    Directory of Open Access Journals (Sweden)

    Ritu Raj Upreti

    2017-02-01

    Full Text Available Purpose: To investigate the interobserver variations in delineation of lumpectomy cavity (LC and clinical target volume (CTV, and its impact on irradiated volume in accelerated partial breast irradiation using intraoperative multicatheter brachytherapy. Material and methods : Delineation of LC and CTV was done by five radiation oncologists on planning computed tomography (CT scans of 20 patients with intraoperative interstitial breast implant. Cavity visualization index (CVI, four-point index ranging from (0 = poor to (3 = excellent was created and assigned by observers for each patient. In total, 200 contours for all observers and 100 treatment plans were evaluated. Spatial concordance (conformity index, CI common , and CIgen, average shift in the center of mass (COM, and ratio of maximum and minimum volumes (V max /V min of LC and CTV were quantified among all observers and statistically analyzed. Variation in active dwell positions (0.5 cm step for each catheter, total reference air kerma (TRAK, volume enclosed by prescription isodose (V100% among observers and its spatial concordance were analyzed. Results : The mean ± SD CI common of LC and CTV was 0.54 ± 0.09, and 0.58 ± 0.08, respectively. Conformity index tends to increase, shift in COM and V max /V min decrease significantly (p < 0.05, as CVI increased. Out of total 309 catheters, 29.8% catheters had no change, 29.8% and 17.5% catheters had variations of 1 and 2 dwell positions (0.5 cm and 1 cm, respectively. 9.3% catheters shown variations ≥ 10 dwell positions (5 cm. The mean ± SD CI common of V100% was 0.75 ± 0.11. The mean observed V max /V min of prescription isodose and TRAK was 1.18 (range, 1.03 to 1.56 and 1.11 (range, 1.03 to 1.35, respectively. Conclusions : Interobserver variability in delineation of target volume was found to be significantly related to CVI. Smaller variability was observed with excellent visualization of LC. Interobserver variations showed dosimetric

  19. Medical irradiation technique saves lives of victims of Lima inferno

    International Nuclear Information System (INIS)

    2002-01-01

    Full text: Nearly 400 people died when fire swept through a crowded market place in the old centre of Lima, Peru, as the city readied for New Year's Eve, 2001. Yet the lives of more than 60 severely burned people were saved because Peru belongs to a programme, initiated and supported by the International Atomic Energy Agency (IAEA), that permits developing countries to maintain their own tissue banks. 'Tissue grafts are routine treatment in developed countries, said Qian Jihui, Deputy Director General and head of the IAEA Department of Technical Cooperation. 'This programme is saving lives and improving significantly the quality of lives for patients in developing countries.' More than 1600 radiation sterilized tissue packs were provided by Peru's atomic energy institute to eight Lima hospitals and clinics, where nurses and doctors battled to help the fire victims, many of them poor market traders. Peru and six other countries in the IAEA Latin America programme offer patients irradiated sterile human skin and bone from 37 tissue banks for transplant use. IAEA support of tissue banking began in 1983, since when the agency has contributed US $5,313,335 to the programme, resulting in the establishment of 66 tissue banks in the Asia Pacific region, seven in Africa, while the number is growing. Tissue grafts increase the odds for burn patients' survival by reducing the risk of infection. They are also used to treat victims of leprosy. A bone transplant can save a limb. The IAEA has helped develop a system - used in 28 countries - that disinfects tissue grafts in the final package with ionising radiation without damaging them, dramatically lowering the risk of contamination. Now medical authorities in the United States are considering adoption of similar irradiation techniques, following a number of cases of contamination of medical tissue used for transplant. The issue will be among items to be discussed in Vienna, December 2-4, at IAEA headquarters, at a meeting of

  20. Detection of irradiated spices using photo-stimulated luminescence technique (PSL)

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, Ros Anita Ahmad; Yasir, Muhamad Samudi [Faculty of Science and Technology, National University of Malaysia, Bangi, 43000 Kajang, Selangor (Malaysia); Othman, Zainon; Abdullah, Wan Saffiey Wan [Malaysian Nuclear Agency, Bangi 43000 Kajang, Selangor (Malaysia)

    2014-09-03

    Photo-stimulated luminescence (PSL) technique was applied to detect irradiated black pepper (Piper nigrum), cinnamon (Cinnamomum verum) and turmeric (Curcuma longa) after dark storage for 1 day, 3 and 6 months. Using screening and calibrated PSL, all samples were correctly discriminated between non-irradiated and spices irradiated with doses 1, 5 and 10 kGy. The PSL photon counts (PCs) of irradiated spices increased with increasing dose, with turmeric showing highest sensitivity index to irradiation compared to black pepper and cinnamon. The differences in response are possibly attributed to the varying quantity and quality of silicate minerals present in each spice sample. PSL signals of all irradiated samples reduced after 3 and 6 months storage. The results of this study provide a useful database on the applicability of PSL technique for the detection of Malaysian irradiated spices.

  1. Detection of irradiated spices using photo-stimulated luminescence technique (PSL)

    Science.gov (United States)

    Ramli, Ros Anita Ahmad; Yasir, Muhamad Samudi; Othman, Zainon; Abdullah, Wan Saffiey Wan

    2014-09-01

    Photo-stimulated luminescence (PSL) technique was applied to detect irradiated black pepper (Piper nigrum), cinnamon (Cinnamomum verum) and turmeric (Curcuma longa) after dark storage for 1 day, 3 and 6 months. Using screening and calibrated PSL, all samples were correctly discriminated between non-irradiated and spices irradiated with doses 1, 5 and 10 kGy. The PSL photon counts (PCs) of irradiated spices increased with increasing dose, with turmeric showing highest sensitivity index to irradiation compared to black pepper and cinnamon. The differences in response are possibly attributed to the varying quantity and quality of silicate minerals present in each spice sample. PSL signals of all irradiated samples reduced after 3 and 6 months storage. The results of this study provide a useful database on the applicability of PSL technique for the detection of Malaysian irradiated spices.

  2. Detection of irradiated spices using photo-stimulated luminescence technique (PSL)

    International Nuclear Information System (INIS)

    Ramli, Ros Anita Ahmad; Yasir, Muhamad Samudi; Othman, Zainon; Abdullah, Wan Saffiey Wan

    2014-01-01

    Photo-stimulated luminescence (PSL) technique was applied to detect irradiated black pepper (Piper nigrum), cinnamon (Cinnamomum verum) and turmeric (Curcuma longa) after dark storage for 1 day, 3 and 6 months. Using screening and calibrated PSL, all samples were correctly discriminated between non-irradiated and spices irradiated with doses 1, 5 and 10 kGy. The PSL photon counts (PCs) of irradiated spices increased with increasing dose, with turmeric showing highest sensitivity index to irradiation compared to black pepper and cinnamon. The differences in response are possibly attributed to the varying quantity and quality of silicate minerals present in each spice sample. PSL signals of all irradiated samples reduced after 3 and 6 months storage. The results of this study provide a useful database on the applicability of PSL technique for the detection of Malaysian irradiated spices

  3. Cone Beam Computed Tomography Guidance for Setup of Patients Receiving Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    White, Elizabeth A.; Cho, John; Vallis, Katherine A.; Sharpe, Michael B.; Lee, Grace B.Sc.; Blackburn, Helen; Nageeti, Tahani; McGibney, Carol; Jaffray, David A.

    2007-01-01

    Purpose: To evaluate the role of cone-beam CT (CBCT) guidance for setup error reduction and soft tissue visualization in accelerated partial breast irradiation (APBI). Methods and Materials: Twenty patients were recruited for the delivery of radiotherapy to the postoperative cavity (3850 cGy in 10 fractions over 5 days) using an APBI technique. Cone-beam CT data sets were acquired after an initial skin-mark setup and before treatment delivery. These were registered online using the ipsilateral lung and external contours. Corrections were executed for translations exceeding 3 mm. The random and systematic errors associated with setup using skin-marks and setup using CBCT guidance were calculated and compared. Results: A total of 315 CBCT data sets were analyzed. The systematic errors for the skin-mark setup were 2.7, 1.7, and 2.4 mm in the right-left, anterior-posterior, and superior-inferior directions, respectively. These were reduced to 0.8, 0.7, and 0.8 mm when CBCT guidance was used. The random errors were reduced from 2.4, 2.2, and 2.9 mm for skin-marks to 1.5, 1.5, and 1.6 mm for CBCT guidance in the right-left, anterior-posterior, and superior-inferior directions, respectively. Conclusion: A skin-mark setup for APBI patients is sufficient for current planning target volume margins for the population of patients studied here. Online CBCT guidance minimizes the occurrence of large random deviations, which may have a greater impact for the accelerated fractionation schedule used in APBI. It is also likely to permit a reduction in planning target volume margins and provide skin-line visualization and dosimetric evaluation of cardiac and lung volumes

  4. MO-A-BRD-06: In Vivo Cherenkov Video Imaging to Verify Whole Breast Irradiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, R; Glaser, A [Dartmouth College, Hanover, NH - New Hampshire (United States); Jarvis, L [Dartmouth-Hitchcock Medical Center, City Of Lebanon, New Hampshire (United States); Gladstone, D [Dartmouth-Hitchcock Medical Center, Hanover, City of Lebanon (Lebanon); Andreozzi, J; Hitchcock, W; Pogue, B [Dartmouth College, Hanover, NH (United States)

    2014-06-15

    Purpose: To show in vivo video imaging of Cherenkov emission (Cherenkoscopy) can be acquired in the clinical treatment room without affecting the normal process of external beam radiation therapy (EBRT). Applications of Cherenkoscopy, such as patient positioning, movement tracking, treatment monitoring and superficial dose estimation, were examined. Methods: In a phase 1 clinical trial, including 12 patients undergoing post-lumpectomy whole breast irradiation, Cherenkov emission was imaged with a time-gated ICCD camera synchronized to the radiation pulses, during 10 fractions of the treatment. Images from different treatment days were compared by calculating the 2-D correlations corresponding to the averaged image. An edge detection algorithm was utilized to highlight biological features, such as the blood vessels. Superficial dose deposited at the sampling depth were derived from the Eclipse treatment planning system (TPS) and compared with the Cherenkov images. Skin reactions were graded weekly according to the Common Toxicity Criteria and digital photographs were obtained for comparison. Results: Real time (fps = 4.8) imaging of Cherenkov emission was feasible and feasibility tests indicated that it could be improved to video rate (fps = 30) with system improvements. Dynamic field changes due to fast MLC motion were imaged in real time. The average 2-D correlation was about 0.99, suggesting the stability of this imaging technique and repeatability of patient positioning was outstanding. Edge enhanced images of blood vessels were observed, and could serve as unique biological markers for patient positioning and movement tracking (breathing). Small discrepancies exists between the Cherenkov images and the superficial dose predicted from the TPS but the former agreed better with actual skin reactions than did the latter. Conclusion: Real time Cherenkoscopy imaging during EBRT is a novel imaging tool that could be utilized for patient positioning, movement tracking

  5. Application of irradiation techniques to food and foodstuffs

    International Nuclear Information System (INIS)

    Kwon, Joong Ho; Byun, Myung Woo; Kim, Suc Won; Yang, Jae Seung; Cho, Han Ok

    1991-02-01

    A preservation study of dried fish, anchovies, has been conducted to determine the effect of gamma irradiation and laminated(nylon/polyethylene) film packaging on microbiological, physicochemical and organoleptic qualities of stored samples under room, refrigeration and freezing temperatures. Irradiation at less than 5 kGy and NY/PE-laminated film packaging are anticipated to be significantly effective for over 10 months in terms of improving the hygienic quality and extending the storage life of boiled-dried anchovies. In a survey participating 700 consumers, respondents preferred irradiated food to chemically-treated one. However, majority of respondents (55.7 %) was ignorant of the fact that the Korean government and international organizations concerned have approved the wholesomeness of irradiated food. Insufficiency of public information and understanding for irradiated food was indicated as a major cause for retardation of commercial utilization of food irradiation technology. In a response concerning perception and acceptance toward irradiated food, there was a significant difference between radiation worker and the general public. (Author)

  6. Postoperative irradiation of endometrial cancer by iridium afterloading technique

    International Nuclear Information System (INIS)

    Kucera, H.; Weghaupt, K.

    1988-01-01

    From 1981 to 1986 708 patients were operated and postoperativly treated by total hysterectomy, bilateral salpingo-oophorectomy and postoperative vaginal irradiation with high-dose-afterloading (iridium 192). A percutaneous irradiation (cobalt 60) was done in stage I cases only when myometrial infiltration was deep. Highly differentiated tumors with infiltration of the first and second thirth of the myometrium were treated by vaginal irradiation alone. Poorly differentiated tumors with infiltration of the second and third thirth of the myometrium were treated by vaginal and percutaneous irradiation. A group of 125 cases with good prognosis and with postoperative vaginal irradiation alone had the same five-year-survival of 83% as a group of 152 cases with bad prognosis treated by vaginal and percutaneous irrradiation. This result shows clearly the importance of additional irradiation of the pelvis in cases with bad prognosis factors. The incidence of radiation side effect in all 708 cases was: cystitis 4.6%, proctitis 5.2%, vaginal or rectal ulcera 1.4% and fistulas 0.2%. Cases with vaginal irradiation alone and with the optimal intravaginal fraction dose of 700 cGy (twice) had the lowest level of side effects: cystitis 3.8% proctitis 2.1%, vaginal necrosis 0.7%, no further severe complications. None of the patients with postoperative vaginal irradiation alone had a vaginal recurrence. The incidence of recurrences in 708 patients was 1.6%. All recurrence cases in stage I (0.7%) had bad prognosis factors and were treated with vaginal and percutaneous irradiation. (orig./MG) [de

  7. MO-DE-210-06: Development of a Supercompounded 3D Volumetric Ultrasound Image Guidance System for Prone Accelerated Partial Breast Irradiation (APBI)

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, T; Hrycushko, B; Zhao, B; Jiang, S; Gu, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: For early-stage breast cancer, accelerated partial breast irradiation (APBI) is a cost-effective breast-conserving treatment. Irradiation in a prone position can mitigate respiratory induced breast movement and achieve maximal sparing of heart and lung tissues. However, accurate dose delivery is challenging due to breast deformation and lumpectomy cavity shrinkage. We propose a 3D volumetric ultrasound (US) image guidance system for accurate prone APBI Methods: The designed system, set beneath the prone breast board, consists of a water container, an US scanner, and a two-layer breast immobilization cup. The outer layer of the breast cup forms the inner wall of water container while the inner layer is attached to patient breast directly to immobilization. The US transducer scans is attached to the outer-layer of breast cup at the dent of water container. Rotational US scans in a transverse plane are achieved by simultaneously rotating water container and transducer, and multiple transverse scanning forms a 3D scan. A supercompounding-technique-based volumetric US reconstruction algorithm is developed for 3D image reconstruction. The performance of the designed system is evaluated with two custom-made gelatin phantoms containing several cylindrical inserts filled in with water (11% reflection coefficient between materials). One phantom is designed for positioning evaluation while the other is for scaling assessment. Results: In the positioning evaluation phantom, the central distances between the inserts are 15, 20, 30 and 40 mm. The distances on reconstructed images differ by −0.19, −0.65, −0.11 and −1.67 mm, respectively. In the scaling evaluation phantom, inserts are 12.7, 19.05, 25.40 and 31.75 mm in diameter. Measured inserts’ sizes on images differed by 0.23, 0.19, −0.1 and 0.22 mm, respectively. Conclusion: The phantom evaluation results show that the developed 3D volumetric US system can accurately localize target position and determine

  8. Repair of chest wall defects after irradiation for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, L E

    1976-03-01

    A simple technique using a contralateral deltopectoral flap is described for the immediate repair of defects of the chest wall resulting from excision of radionecrosis or persistent tumour after radiotherapy. Successful use in 3 consecutive cases has shown that the deltopectoral flap may be rotated through a full 180/sup 0/ without compromise of blood supply and that primary healing may be obtained.

  9. A linac-based stereotactic irradiation technique of uveal melanoma

    International Nuclear Information System (INIS)

    Dieckmann, Karin; Bogner, Joachim; Georg, Dietmar; Zehetmayer, Martin; Kren, Gerhard; Poetter, Richard

    2001-01-01

    Purpose: To describe a stereotactic irradiation technique for uveal melanomas performed at a linac, based on a non-invasive eye fixation and eye monitoring system. Methods: For eye immobilization a light source system is integrated in a standard stereotactic mask system in front of the healthy eye: During treatment preparation (computed tomography/magnetic resonance imaging) as well as for treatment delivery, patients are instructed to gaze at the fixation light source. A mini-video camera monitors the pupil center position of the diseased eye. For treatment planning and beam delivery standard stereotactic radiotherapy equipment is used. If the pupil center deviation from a predefined 'zero-position' exceeds 1 mm (for more than 2 s), treatment delivery is interrupted. Between 1996 and 1999 60 patients with uveal melanomas, where (i) tumor height exceeded 7 mm, or (ii) tumor height was more than 3 mm, and the central tumor distance to the optic disc and/or the macula was less than 3 mm, have been treated. A total dose of 60 or 70 Gy has been given in 5 fractions within 10 days. Results: The repositioning accuracy in the mask system is 0.47±0.36 mm in rostral-occipital direction, 0.75±0.52 mm laterally, and 1.12±0.96 mm in vertical direction. An eye movement analysis performed for 23 patients shows a pupil center deviation from the 'zero' position<1 mm in 91% of all cases investigated. In a theoretical analysis, pupil center deviations are correlated with GTV 'movements'. For a pupil center deviation of 1 mm (rotation of the globe of 5 degree sign ) the GTV is still encompassed by the 80% isodose in 94%. Conclusion: For treatments of uveal melanomas, linac-based stereotactic radiotherapy combined with a non-invasive eye immobilization and monitoring system represents a feasible, accurate and reproducible method. Besides considerable technical requirements, the complexity of the treatment technique demands an interdisciplinary team continuously dedicated to this

  10. Impact of setup variability on incidental lung irradiation during tangential breast treatment

    International Nuclear Information System (INIS)

    Carter, Dennis L.; Marks, Lawrence B.; Bentel, Gunilla C.

    1997-01-01

    Purpose: This study aimed to determine the variability in treatment setup during a 5-week course of tangential breast treatment for patients immobilized in a customized hemibody cradle, to assess the relationship between the height of the lung shadow on the tangential port film and the percentage of lung volume irradiated, and to estimate the impact of setup variabilities on irradiated lung volume. Methods: One hundred seventy-two port films were reviewed from 20 patients who received tangential beam treatment for breast cancer. The height of the lung shadow at the central axis (CLD) on each port film was compared to the corresponding simulator film as an assessment of setup variability. A three-dimensional dose calculation was performed, and the percentage of total lung volume within the field was correlated with the CLD. The three-dimensional dose calculation was repeated for selected patients with the location of the treatment beams modified to reflect typical setup variations. Results: The CLD measured on the port films was within 3 mm of that prescribed on the simulator film in 43% (74 of 172) of the port films. The variation was 3-5 mm in 26%, 5-10 mm in 25%, and >10 mm in 6%. The height of the lung shadow correlated with the percentage of lung volume included in the radiation field (r 2 = 0.6). Typical variations in treatment setup resulted in ≤5% fluctuation in the absolute volume of ipsilateral lung irradiated. Conclusion: The current immobilization system used in our clinic provides a clinically acceptable reproducibility of patient setup. The height of the lung shadow is reasonably well correlated with the percentage of irradiated lung volume. During a typical 5-week course of radiotherapy, the ipsilateral irradiated lung volume fluctuates <5%

  11. Immunosuppression in irradiated breast cancer patients: In vitro effect of cyclooxygenase inhibitors

    International Nuclear Information System (INIS)

    Wasserman, J.; Blomgren, H.; Rotstein, S.; Petrini, B.; Hammarstroem, S.

    1989-01-01

    We have documented in previous studies that local irradiation therapy for breast cancer caused severe lymphopenia with reduction of both T and non-T lymphocytes. Non-T cells were relatively more depressed but recovered within six months. The recovery of T cells, on the other hand, remained incomplete 10-11 years after irradiation. Several lymphocyte functions were also severely impaired. An association was found between prognosis and postirradiation mitogen reactivity of lymphocytes from these patients. Mortality up to eight years after irradiation was significantly higher in patients with low postirradiation phytohemagglutinin and PPD reactivity. The radiation induced decrease in mitogenic response seemed mainly to be caused by immunosuppressive monocytes, which suggests that the underlying mechanism might be mediated by increased production of prostaglandins by monocytes. For this reason we examined the effect of some cyclooxygenase products on different lymphocyte functions and found that prostaglandins A2, D2, and E2 inhibited phytohemagglutinin response in vitro. Natural killer cell activity was also reduced by prostaglandins D2 and E2. The next step was to examine various inhibitors of cyclooxygenase in respect to their capacity to revert irradiation-induced suppression of in vitro mitogen response in lymphocytes from breast cancer patients. It was demonstrated that Diclofenac Na (Voltaren), Meclofenamic acid, Indomethacin, and lysin-mono-acetylsalicylate (Aspisol) could enhance mitogen responses both before and after radiation therapy. This effect was most pronounced at completion of irradiation. On a molar basis, Diclofenac Na was most effective followed by Indomethacin, Meclofenamic acid, and lysin-monoacetylsalicylate

  12. Immunosuppression in irradiated breast cancer patients: In vitro effect of cyclooxygenase inhibitors

    Energy Technology Data Exchange (ETDEWEB)

    Wasserman, J.; Blomgren, H.; Rotstein, S.; Petrini, B.; Hammarstroem, S.

    1989-01-01

    We have documented in previous studies that local irradiation therapy for breast cancer caused severe lymphopenia with reduction of both T and non-T lymphocytes. Non-T cells were relatively more depressed but recovered within six months. The recovery of T cells, on the other hand, remained incomplete 10-11 years after irradiation. Several lymphocyte functions were also severely impaired. An association was found between prognosis and postirradiation mitogen reactivity of lymphocytes from these patients. Mortality up to eight years after irradiation was significantly higher in patients with low postirradiation phytohemagglutinin and PPD reactivity. The radiation induced decrease in mitogenic response seemed mainly to be caused by immunosuppressive monocytes, which suggests that the underlying mechanism might be mediated by increased production of prostaglandins by monocytes. For this reason we examined the effect of some cyclooxygenase products on different lymphocyte functions and found that prostaglandins A2, D2, and E2 inhibited phytohemagglutinin response in vitro. Natural killer cell activity was also reduced by prostaglandins D2 and E2. The next step was to examine various inhibitors of cyclooxygenase in respect to their capacity to revert irradiation-induced suppression of in vitro mitogen response in lymphocytes from breast cancer patients. It was demonstrated that Diclofenac Na (Voltaren), Meclofenamic acid, Indomethacin, and lysin-mono-acetylsalicylate (Aspisol) could enhance mitogen responses both before and after radiation therapy. This effect was most pronounced at completion of irradiation. On a molar basis, Diclofenac Na was most effective followed by Indomethacin, Meclofenamic acid, and lysin-monoacetylsalicylate.

  13. Microbiology, sensory evaluation and shelf life of irradiated chicken breast fillets stored in air or vacuum

    Directory of Open Access Journals (Sweden)

    Samira Pirola Santos Mantilla

    2011-06-01

    Full Text Available This work investigated the effects of different packaging methods (air and vacuum combined with irradiation (0.0, 2.0 and 3.0 kGy on the preservation of chicken breast fillets stored at 1ºC for up to 18 days by sensorial test, determination of pH and bacterial growth. The findings indicated that the post-irradiation lag phase increased with the dose, leading to an extension in shelf-life. Vacuum-packed samples irradiated at 3.0 kGy exhibited the longest shelf life. Among the analyzed bacteria, coliforms and Listeria spp. were most sensitive to gamma radiation. All the fillets acquired more attractive coloration and better overall impression with irradiation. The combined use of vacuum packaging and irradiation (3.0 kGy reduced the microbial populations without causing change in pH and yielded a significant shelf-life extension of refrigerated fillets, besides improving its appearance.

  14. Clinical implementation of a new HDR brachytherapy device for partial breast irradiation

    International Nuclear Information System (INIS)

    Scanderbeg, Daniel J.; Yashar, Catheryn; Rice, Roger; Pawlicki, Todd

    2009-01-01

    Purpose: To present the clinical implementation of a new HDR device for partial breast irradiation, the Strut-Adjusted Volume Implant (SAVI), at the University of California, San Diego. Methods and materials: The SAVI device has multiple peripheral struts that can be differentially loaded with the HDR source. Planning criteria used for evaluation of the treatment plans included the following dose volume histogram (DVH) criteria: V90 >90%, V150 <50 cc and V200 <20 cc. Results: SAVI has been used on 20 patients to date at UC San Diego. In each case, the dose was modulated according to patient-specific anatomy to cover the tumor bed, while sparing normal tissues. The dosimetric data show that we can achieve greater than 90% coverage with respect to V90 (median of 95.3%) and also keep a low V150 and V200 dose at 24.5 and 11.2 cc, respectively. Complete treatment can be done within a 30-min time slot, which includes implant verification, setup, and irradiation time as well as wound dressing. Conclusion: SAVI has been implemented at UC San Diego for accelerated partial breast irradiation with excellent tumor bed conformance and minimal normal tissue exposure. Patient positioning is the key to identifying any inter-fraction device motion. Device asymmetry or tissue conformance has been shown to resolve itself 24 h after the device implantation. The device can be implemented into an existing HDR program with minimal effort

  15. Tumourectomy and irradiation - an increasing by appeciated method of treating early breast cancer

    International Nuclear Information System (INIS)

    Deffebach, R.R.; Goodman, R.L.; Miller, L.

    1981-01-01

    The authors give a general view at the treatment concepts for breast cancer in the USA which are being changed. Their explanations show that the 5 years-survival statistics are the same after radical irradiation and tumourectomy as after radical mastectomy and postradiation. 10 years' investigations show the same result. The authors emphasize that the regionary relapse rate is higher with mastectomy alone than with radical irradiation and are of the opinion that the proof of an improved total survival time must be provided by the treatment method with the lower local control rate. The cosmetical and functional results of primary breast irradiation are excellent in 90% of the cases and the side reactions in this procedure are minimal. The key of the treatment is the tumour biopsy without immediate mastectomy in order to first manifest the histological diagnose of the cancer. This is followed by the classification of the stages of the disease and then a discussion with the patient and her family concerning the alternatives of the treatment. (orig./MG) [de

  16. Development of PIE techniques for irradiated LWR pressure vessel steels

    International Nuclear Information System (INIS)

    Nishi, Masahiro; Kizaki, Minoru; Sukegawa, Tomohide

    1999-01-01

    For the evaluation of safety and integrity of light water reactors (LWRs), various post irradiation examinations (PIEs) of reactor pressure vessel (RPV) steels and fuel claddings have been carried out in the Research Hot Laboratory (RHL). In recent years, the instrumented Charpy impact testing machine was remodeled aiming at the improvement of accuracy and reliability. By this remodeling, absorbed energy and other useful information on impact properties can be delivered from the force-displacement curve for the evaluation of neutron irradiation embrittlement behavior of LWR-RPV steels at one-time striking. In addition, two advanced PIE technologies are now under development. One is the remote machining of mechanical test pieces from actual irradiated pressure vessel steels. The other is development of low-cycle and high-cycle fatigue test technology in order to clarify the post-irradiation fatigue characteristics of structural and fuel cladding materials. (author)

  17. The irradiation lung volume in tangential fields for the treatment of a breast

    International Nuclear Information System (INIS)

    Oh, Y. T.; Kim, J. R.; Kang, H. J.; Sohn, J. H.; Kang, S. H.; Chun, M. S.

    1997-01-01

    Radiation pneumonitis is one of the complications caused by radiation therapy that includes a portion of the lung tissue. The severity of radiation induced pulmonary dysfunction depends on the irradiated lung volume, total dose, dose rate and underlying pulmonary function. The lung volume was measured for 25 patients with breast cancer irradiated with tangential field from Jan. 1995 to Aug. 1996. Parameters that can predict the irradiated lung volume included; (1) the perpendicular distance from the posterior tangential edge to the posterior part of the anterior chest wall at the center of the field (CLD); (2) the maximum perpendicular distance from the posterior tangential field edge to the posterior part of the anterior chest wall (MLD); (3) the greatest perpendicular distance from the posterior tangential edge to the posterior part of anterior chest wall on CT image at the center of the longitudinal field (GPD); (4) the length of the longitudinal field (L). The irradiated lung volume(RV), the entire both lung volume(EV) and the ipsilateral lung volume(IV) were measured using dose volume histogram. The RV is 61-279cc, the RV/EV is 2.9-13.0% and the RV/EN is 4.9-29.6%. The CLD, the MLD and the GPD are 1.9-3.3cm and 1.4-3.1cm respectively. The significant relations between the irradiated lung volume such as RV, RV/EV, RV/IV and parameters such as CLD, MLD, GPD, L, CLD x L, MLD x L and GPD x L are not found with little variances in parameters. The RV/IV of the left breast irradiation is significances. The significant relationship between the irradiated lung volume and predictors is not found with little variation on parameters. The irradiated lung volume in the tangential field is less than 10% of entire lung volume when CLD is less than 3cm. The RV/IV of the left tangential field is larger than that of the right but there was no significant differences in RV/EVs. Symptomatic radiation pneumonitis has not occurred during minimum 6 months follow up. (author)

  18. Accelerated partial breast irradiation with external beam radiotherapy. First results of the German phase 2 trial

    Energy Technology Data Exchange (ETDEWEB)

    Ott, Oliver J.; Strnad, Vratislav; Stillkrieg, Wilhelm; Fietkau, Rainer [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Uter, Wolfgang [University Erlangen-Nuremberg, Dept. of Medical Informatics, Biometry and Epidemiology, Erlangen (Germany); Beckmann, Matthias W. [University Hospital Erlangen, Dept. of Gynecology, Erlangen (Germany)

    2017-01-15

    To evaluate the feasibility and efficacy of external beam three-dimensional (3D) conformal accelerated partial breast irradiation (APBI) for selected patients with early breast cancer. Between 2011 and 2016, 72 patients were recruited for this prospective phase 2 trial. Patients were eligible for APBI if they had histologically confirmed breast cancer or pure ductal carcinoma in situ (DCIS), a tumor diameter ≤3 cm, clear resection margins ≥2 mm, no axillary lymph node involvement, no distant metastases, tumor bed clips, and were aged ≥50 years. Patients were excluded if mammography showed a multicentric invasive growth pattern, or if they had residual diffuse microcalcifications postoperatively, an extensive intraductal component, or vessel invasion. Patients received 3D conformal external beam APBI with a total dose of 38 Gy in 10 fractions in 1-2 weeks. The trial had been registered at the German Clinical Trials Register, DRKS-ID: DRKS00004417. Median follow-up was 25.5 months (range 1-61 months). Local control was maintained in 71 of 72 patients. The 3-year local recurrence rate was 2.1% (95% confidence interval, CI: 0-6.1%). Early toxicity (grade 1 radiodermatitis) was seen in 34.7% (25/72). Late side effects ≥ grade 3 did not occur. Cosmetic results were rated as excellent/good in 96.7% (59/61). APBI with external beam radiotherapy techniques is feasible with low toxicity and, according to the results of the present and other studies, on the way to becoming a standard treatment option for a selected subgroup of patients. (orig.) [German] Untersuchung der Vertraeglichkeit und Sicherheit der externen, 3-D-konformalen akzelerierten Teilbrustbestrahlung (APBI) fuer ausgewaehlte Patientinnen mit einem fruehen Mammakarzinom. Von 2011 bis 2016 wurden 72 Patientinnen in diese prospektive Phase-2-Studie eingebracht. Einschlusskriterien waren ein histologisch gesichertes Mammakarzinom oder DCIS, ein Tumordurchmesser ≤ 3 cm, tumorfreie Resektionsraender ≥ 2

  19. Detection of Irradiated Tubers (Ginger and Potato) Using Photostimulated Luminescence Technique (PSL)

    International Nuclear Information System (INIS)

    Ros Anita Ahmad Ramli; Zainon Othman; Wan Saffiey Wan Abdullah; Foziah Ali; Zainab Harun

    2016-01-01

    Photo-stimulated luminescence (PSL) measurement was conducted to detect irradiated gingers (Zingiber officinale Roscoe) and potatoes (Solanum tuberosum) after dark storage for 1 week, 3 and 6 months. Using screening and calibrated PSL, all the samples were correctly distinguished between non-irradiated and irradiated samples at doses 50, 150 and 500 Gy based on photon count values. The PSL signal stability of irradiated samples (150 and 500 Gy) appeared to fade upon 6 months storage but remained well above upper threshold values of 5000 photon counts/ 60 s (PCs) for irradiated gingers and potatoes. The PCs of irradiated tubers showed a general trend of increase with the increase in doses up to 500 Gy. Samples showed highest intensity after irradiation. The differences in intensity to irradiation are possibly attributed to the varying quantity and quality of silicate minerals present in each tuber sample. Tubers irradiated at doses higher than 150 Gy, showed sensitivity index ratio of less than 10. Sensitivity Index was suggested for irradiated samples at doses slightly above 150 Gy. Irradiated samples at doses less than 150 Gy should be subjected for further investigation using thermoluminescence (TL) analysis. The results of this study provide a useful database on the applicability of PSL technique for the detection of Malaysian irradiated tubers. (author)

  20. The detection of irradiated foods using the Direct Epifluorescent Filter Technique

    International Nuclear Information System (INIS)

    Betts, R.P.; Bankes, P.; Stringer, M.F.; Farr, L.

    1988-01-01

    A method was evaluated which has the potential to detect a food sample which has been irradiated. The technique will give an indication of the total number of viable micro-organisms present before irradiation. It is based on the comparison of an aerobic plate count (APC) with a count obtained using the Direct Epifluorescent Filter Technique (DEFT). When the APC of an irradiated sample was compared with the DEFT count on the same sample, the APC was considerably lower than that obtained by DEFT. The count of orange fluorescing cells after irradiation, however, correlated well with an APC of the same sample before irradiation. For the samples examined the DEFT count determined the viable microbial population in the sample before irradiation. The difference between the APC and the DEFT count gave the number of organisms rendered non-viable by the process. (author)

  1. Fat necrosis in women with early-stage breast cancer treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy

    International Nuclear Information System (INIS)

    Budrukkar, Ashwini; Jagtap, Vikas; Kembhavi, Seema; Munshi, Anusheel; Jalali, Rakesh; Seth, Tanuja; Parmar, Vani; Raj Upreti, Ritu; Badwe, Rajendra; Sarin, Rajiv

    2012-01-01

    Purpose: To report the incidence of clinical, pathological and radiological fat necrosis (FN) in women treated with accelerated partial breast irradiation (APBI) using interstitial brachytherapy (BRT) for early-stage breast cancer and to study certain variables associated with it. Methods and materials: Between May 2000 and August 2008, 171 women were treated with APBI using high dose rate (HDR) BRT. Patients were treated to a dose of 34 Gy/10 fractions/1 week with two fractions/day after intraoperative/postoperative placement of catheters. Results: At a median follow up of 48 months (SD: 28) 20 women developed FN with median time to detection being 24 months (range: 4–62 months, SD: 20). Actuarial 5 and 7 year FN rate was 18% and 23%, respectively. Grade 1 FN was seen in 4, grade 2 in 8 and grade 4 in 8 women. Additional investigations such as aspiration/biopsy were done in 9 patients. Volume of excision was the only significant factor affecting FN (p = 0.04). Conclusions: Actuarial FN rate of 18% at 5 years in our study was comparable to other reported series of FN. Median time of detection of FN was 24 months. Higher volume of excision resulted in an increased incidence of fat necrosis.

  2. [Does nodal irradiation (clavicular and internal mammary chains) increase the toxicity of adjuvant breast radiotherapy?].

    Science.gov (United States)

    Riou, O; Bourgier, C; Fenoglietto, P; Azria, D

    2015-06-01

    Treatment volume is a major risk factor of radiation-induced toxicity. As nodal irradiation increases treatment volume, radiation toxicity should be greater. Nevertheless, scientific randomised data do not support this fact. However, a radiation-induced toxicity is possible outside tangential fields in the nodal volumes not related to breast-only treatment. Treatment should not be adapted only to the disease but personalized to the individual risk of toxicity for each patient. Copyright © 2015 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  3. Estrogen enhanced cell-cell signalling in breast cancer cells exposed to targeted irradiation

    International Nuclear Information System (INIS)

    Shao, Chunlin; Folkard, Melvyn; Held, Kathryn D; Prise, Kevin M

    2008-01-01

    Radiation-induced bystander responses, where cells respond to their neighbours being irradiated are being extensively studied. Although evidence shows that bystander responses can be induced in many types of cells, it is not known whether there is a radiation-induced bystander effect in breast cancer cells, where the radiosensitivity may be dependent on the role of the cellular estrogen receptor (ER). This study investigated radiation-induced bystander responses in estrogen receptor-positive MCF-7 and estrogen receptor-negative MDA-MB-231 breast cancer cells. The influence of estrogen and anti-estrogen treatments on the bystander response was determined by individually irradiating a fraction of cells within the population with a precise number of helium-3 using a charged particle microbeam. Damage was scored as chromosomal damage measured as micronucleus formation. A bystander response measured as increased yield of micronucleated cells was triggered in both MCF-7 and MDA-MB-231 cells. The contribution of the bystander response to total cell damage in MCF-7 cells was higher than that in MDA-MB-231 cells although the radiosensitivity of MDA-MB-231 was higher than MCF-7. Treatment of cells with 17β-estradiol (E2) increased the radiosensitivity and the bystander response in MCF-7 cells, and the effect was diminished by anti-estrogen tamoxifen (TAM). E2 also increased the level of intracellular reactive oxygen species (ROS) in MCF-7 cells in the absence of radiation. In contrast, E2 and TAM had no influence on the bystander response and ROS levels in MDA-MB-231 cells. Moreover, the treatment of MCF-7 cells with antioxidants eliminated both the E2-induced ROS increase and E2-enhanced bystander response triggered by the microbeam irradiation, which indicates that ROS are involved in the E2-enhanced bystander micronuclei formation after microbeam irradiation. The observation of bystander responses in breast tumour cells may offer new potential targets for radiation

  4. Breast

    International Nuclear Information System (INIS)

    Ribeiro, G.G.

    1985-01-01

    The treatment of malignant disease of the breast arouses more controversy and emotion than that of any other form of malignant disease. Many clinical trials have been carried out and others are still in progress. In addition, research work continues in regard to other aspects of the disease, such as epidemiology, population screening, and endocrine factors; yet little is really known about the true biological nature of carcinoma of the breast. A vast amount of literature has accumulated on the treatment of ''operable'' carcinoma of the breast, but it is not proposed to discuss here the merits or demerits of the various suggested treatments. Instead this chapter will be confined to the practical management of carcinoma of the breast as seen from the point of view of radiotherapist. For this reason greater attention will be paid to the radiotherapy techniques as practised at the Christie Hospital

  5. CT simulation technique for craniospinal irradiation in supine position

    International Nuclear Information System (INIS)

    Lee, Suk; Kim, Yong Bae; Chu, Sung Sil; Suh, Chang Ok; Kwon, Soo Il

    2002-01-01

    In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetric image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was performed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. CSI in the supine position was successfully performed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The difference between the DRRs and the portal films were less than 3 mm in the vertebral contour. CSI in the supine position is feasible in patients who cannot lie on

  6. CT simulation technique for craniospinal irradiation in supine position

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Suk; Kim, Yong Bae; Chu, Sung Sil; Suh, Chang Ok [Yonsei Cancer Center, College of Medicine, Yonsei University, Seoul (Korea, Republic of); Kwon, Soo Il [Kyonggi University, Seoul (Korea, Republic of)

    2002-06-15

    In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetric image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was performed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. CSI in the supine position was successfully performed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The difference between the DRRs and the portal films were less than 3 mm in the vertebral contour. CSI in the supine position is feasible in patients who cannot

  7. Designed-seamless irradiation technique for extended whole mediastinal proton-beam irradiation for esophageal cancer

    Directory of Open Access Journals (Sweden)

    Okonogi Noriyuki

    2012-10-01

    Full Text Available Abstract Background Proton-beam therapy (PBT provides therapeutic advantages over conformal x-ray therapy in sparing organs at risk when treating esophageal cancer because of the fundamental physical dose distribution of the proton-beam. However, cases with extended esophageal lesions are difficult to treat with conventional PBT with a single isocentric field, as the length of the planning target volume (PTV is longer than the available PBT field size in many facilities. In this study, the feasibility of a practical technique to effectively match PBT fields for esophageal cancer with a larger regional field beyond the available PBT field size was investigated. Methods Twenty esophageal cancer patients with a larger regional field than the available PBT single-field size (15 cm in our facility were analyzed. The PTV was divided into two sections to be covered by a single PBT field. Subsequently, each PTV isocenter was aligned in a cranial-caudal (CC axis to rule out any influence by the movement of the treatment couch in anterior-posterior and left-right directions. To obtain the appropriate dose distributions, a designed-seamless irradiation technique (D-SLIT was proposed. This technique requires the following two adjustments: (A blocking a part of the PTV by multi-leaf collimator(s (MLCs; and (B fine-tuning the isocenter distance by the half-width of the MLC leaf (2.5 mm in our facility. After these steps, the inferior border of the cranial field was designed to match the superior border of the caudal field. Dose distributions along the CC axis around the field junction were evaluated by the treatment-planning system. Dose profiles were validated with imaging plates in all cases. Results The average and standard deviation of minimum dose, maximum dose, and dose range between maximum and minimum doses around the field junction by the treatment-planning system were 95.9 ± 3.2%, 105.3 ± 4.1%, and 9.4 ± 5.2%. The dose profile validated by the

  8. Safety and toxicology assessment of chicken breast for high-dose irradiation

    International Nuclear Information System (INIS)

    Zhu Jiating; Feng Min; Yan Jianmin; Yang Ping; Wang Dening; Gao Meixu; Ha Yiming; Liu Chunquan

    2011-01-01

    Feeding wholesomeness tests of irradiated chicken breast were studied by using acute oral toxicology, Ames, micronucleus of born marrow cell, sperm shape abnormality in mice and 30 d feeding test. The LD 50 of all the rats and mice were more than 10 g/kg · BW, which means that the pet foods belonged to actually non-toxic grade; ames test, and the tests of micronucleus of born marrow cell, sampan shape abnormality in mice were all negative results; 30 d feeding test in rats demonstrated that it had no distinctive effects on routine blood, body weight and biochemical index. It is concluded that pet foods irradiated up to 25 kGy high dose were no safety and toxicology problems. (authors)

  9. A Fuzzy PROMETHEE Approach for Breast Cancer Treatment Techniques

    Directory of Open Access Journals (Sweden)

    Dilber Uzun Ozsahin

    2018-05-01

    Full Text Available Breast tumor is a growth that occur in the healthy breast tissue, whereby abnormal cells undergo division in an uncontrolled manner. It comes in different types and stages and the ability to metastasize and infect distant tissues. Several studies have showed that one in eight women in the US have develop breast cancer during their life time. Therefore, early diagnosis and treatment is widely approved as being essential to effectively alleviate the disease. The aim of this study is to comparatively analyze certain breast cancer treatment procedures which include surgery, hormone therapy, chemotherapy, and radiation therapy. Fuzzy PROMETHEE (preference ranking organization method for enrichment of evaluations a multi-criteria decision-making process was used to evaluate the treatments on factors that include side effects, overall survival rate, cost of treatment and treatment time.

  10. Refractive index dispersion of swift heavy ion irradiated BFO thin films using Surface Plasmon Resonance technique

    International Nuclear Information System (INIS)

    Paliwal, Ayushi; Sharma, Savita; Tomar, Monika; Singh, Fouran; Gupta, Vinay

    2016-01-01

    Highlights: • Investigated the optical properties of BiFeO_3 (BFO) thin films after irradiation using SPR. • Otto configuration has been used to excite the surface plasmons using gold metal thin film. • BFO thin films were prepared by sol–gel spin coating technique. • Examined the refractive index dispersion of pristine and irradiated BFO thin film. - Abstract: Swift heavy ion irradiation (SHI) is an effective technique to induce defects for possible modifications in the material properties. There is growing interest in studying the optical properties of multiferroic BiFeO_3 (BFO) thin films for optoelectronic applications. In the present work, BFO thin films were prepared by sol–gel spin coating technique and were irradiated using the 15 UD Pelletron accelerator with 100 MeV Au"9"+ ions at a fluence of 1 × 10"1"2 ions cm"−"2. The as-grown films became rough and porous on ion irradiation. Surface Plasmon Resonance (SPR) technique has been identified as a highly sensitive and powerful technique for studying the optical properties of a dielectric material. Optical properties of BFO thin films, before and after irradiation were studied using SPR technique in Otto configuration. Refractive index is found to be decreasing from 2.27 to 2.14 on ion irradiation at a wavelength of 633 nm. Refractive index dispersion of BFO thin film (from 405 nm to 633 nm) before and after ion radiation was examined.

  11. Refractive index dispersion of swift heavy ion irradiated BFO thin films using Surface Plasmon Resonance technique

    Energy Technology Data Exchange (ETDEWEB)

    Paliwal, Ayushi [Department of Physics and Astrophysics, University of Delhi, Delhi 110007 (India); Sharma, Savita [Department of Applied Physics, Delhi Technological University, Delhi (India); Tomar, Monika [Physics Department, Miranda House, University of Delhi, Delhi 110007 (India); Singh, Fouran [Inter University Accelerator Centre, Aruna Asaf Ali Marg, New Delhi 110075 (India); Gupta, Vinay, E-mail: drguptavinay@gmail.com [Department of Physics and Astrophysics, University of Delhi, Delhi 110007 (India)

    2016-07-15

    Highlights: • Investigated the optical properties of BiFeO{sub 3} (BFO) thin films after irradiation using SPR. • Otto configuration has been used to excite the surface plasmons using gold metal thin film. • BFO thin films were prepared by sol–gel spin coating technique. • Examined the refractive index dispersion of pristine and irradiated BFO thin film. - Abstract: Swift heavy ion irradiation (SHI) is an effective technique to induce defects for possible modifications in the material properties. There is growing interest in studying the optical properties of multiferroic BiFeO{sub 3} (BFO) thin films for optoelectronic applications. In the present work, BFO thin films were prepared by sol–gel spin coating technique and were irradiated using the 15 UD Pelletron accelerator with 100 MeV Au{sup 9+} ions at a fluence of 1 × 10{sup 12} ions cm{sup −2}. The as-grown films became rough and porous on ion irradiation. Surface Plasmon Resonance (SPR) technique has been identified as a highly sensitive and powerful technique for studying the optical properties of a dielectric material. Optical properties of BFO thin films, before and after irradiation were studied using SPR technique in Otto configuration. Refractive index is found to be decreasing from 2.27 to 2.14 on ion irradiation at a wavelength of 633 nm. Refractive index dispersion of BFO thin film (from 405 nm to 633 nm) before and after ion radiation was examined.

  12. Re-irradiation and hyperthermia after surgery for recurrent breast cancer

    International Nuclear Information System (INIS)

    Linthorst, Marianne; Geel, Albert N. van; Baaijens, Margreet; Ameziane, Ali; Ghidey, Wendim; Rhoon, Gerard C. van; Zee, Jacoba van der

    2013-01-01

    Purpose: Evaluation of efficacy and side effects of combined re-irradiation and hyperthermia electively or for subclinical disease in the management of locoregional recurrent breast cancer. Methods and materials: Records of 198 patients with recurrent breast cancer treated with re-irradiation and hyperthermia from 1993 to 2010 were reviewed. Prior treatments included surgery (100%), radiotherapy (100%), chemotherapy (42%), and hormonal therapy (57%). Ninety-one patients were treated for microscopic residual disease following resection or systemic therapy and 107 patients were treated electively for areas at high risk for local recurrences. All patients were re-irradiated to 28–36 Gy (median 32) and treated with 3–8 hyperthermia treatments (mean 4.36). Forty percent of the patients received concurrent hormonal therapy. Patient and tumor characteristics predictive for actuarial local control (LC) and toxicity were studied in univariate and multivariate analysis. Results: The median follow-up was 42 months. Three and 5 year LC-rates were 83% and 78%. Mean of T90 (tenth percentile of temperature distribution), maximum and average temperatures were 39.8 °C, 43.6 °C, and 41.2 °C, respectively. Mean of the cumulative equivalent minutes (CEM43) at T90 was 4.58 min. Number of previous chemotherapy and surgical procedures were most predictive for LC. Cumulative incidence of grade 3 and 4 late toxicity at 5 years was 11.9%. The number of thermometry sensors and depth of treatment volume were associated with acute hyperthermia toxicity. Conclusions: The combination of re-irradiation and hyperthermia results in a high LC-rate with acceptable toxicity

  13. Characterization of irradiated fuel rods using pulsed eddy current techniques

    International Nuclear Information System (INIS)

    Martin, M.R.; Francis, W.C.

    1975-11-01

    A number of irradiated fuel rods and unfueled zircaloy cladding tubes (''water tubes'') were obtained from the Saxton reactor through arrangements with the Westinghouse Electric Corporation for use in subsequent irradiation effects and fuel behavior programs. A comprehensive nondestructive and corroborative destructive characterization program was undertaken on these fuel rods and tubes by ANC to provide baseline data on their characteristics prior to further testing and for comparison against post-post data. This report deals primarily with one portion of the NDT program performed remotely in the hot cells. The portion of interest in this paper is the pulsed eddy current inspection used in the nondestructive phase of the work. 6 references

  14. Detection of Irradiated Food using Photostimulated Luminescence (PSL) Technique

    International Nuclear Information System (INIS)

    Foziah Ali; Ros Anita Ahmad Ramli; Zainab Harun; Zainon Othman

    2015-01-01

    The Photostimulated luminescence (PSL) method may in principles be applied to detect irradiation of any foods which contain mineral debris, especially silicates mineral and bio inorganic materials such as calcite, which originate from shells or skeleton. These materials store energy in charge carriers trapped at structural interstitial or impurities site. When exposed to ionizing radiation optical stimulation of minerals release charges carriers. In PSL measurements, whole samples or a mixture of organic and inorganic materials can be used. The finding of this study will be useful to facilitate control of food irradiation application in Malaysia. (author)

  15. Transumbilical breast augmentation (TUBA): patient selection, technique, and clinical experience.

    Science.gov (United States)

    Pound, E C; Pound, E C

    2001-07-01

    The TUBA procedure offers another approach to placing inflatable breast implants in the subglandular or submuscular position. It is an easy procedure to learn and to perform, using only a few relatively inexpensive specialized instruments. It also can be modified to use preexisting scars on the abdomen as the access point. The authors believe that complications seem to occur less with TUBA patients than with patients having breast augmentation by other approaches, an observation shared by other plastic surgeons offering the TUBA procedure. Limitations include the fact that only inflatable implants can be used. Also, with increasing distance from the breast, there is less control over manipulation of the pocket. Fortunately, the authors have not found this to be a problem in achieving symmetry. Furthermore, bleeding tends to be minimal with this approach. Nevertheless, should technical difficulties arise, conversion to a standard breast incision is an easy back-up option and should be discussed with the patient before surgery. Interest in the TUBA approach to breast augmentation continues to grow. Patients appreciate the lack of scarring on the breast and the short recovery that allows them to resume their normal lifestyle quickly. The authors' caseload has increased considerably over the past 8 years through word-of-mouth advertising from satisfied patients. Other plastic surgeons who offer this approach agree that patient demand for this operation continues to grow dramatically in their practices.

  16. In vivo dosimetry with MOSFETs and GAFCHROMIC films during electron IORT for Accelerated Partial Breast Irradiation.

    Science.gov (United States)

    Petoukhova, Anna; Rüssel, Iris; Nijst-Brouwers, Julienne; van Wingerden, Ko; van Egmond, Jaap; Jacobs, Daphne; Marinelli, Andreas; van der Sijp, Joost; Koper, Peter; Struikmans, Henk

    2017-12-01

    The purpose of this study was to compare the delivered dose to the expected intraoperative radiation therapy (IORT) dose with in vivo dosimetry. For IORT using electrons in accelerated partial breast irradiation, this is especially relevant since a high dose is delivered in a single fraction. For 47 of breast cancer patients, in vivo dosimetry was performed with MOSFETs and/or GAFCHROMIC EBT2 films. A total dose of 23.33 Gy at d max was given directly after completing the lumpectomy procedure with electron beams generated with an IORT dedicated mobile accelerator. A protection disk was used to shield the thoracic wall. The results of in vivo MOSFET dosimetry for 27 patients and GAFROMIC film dosimetry for 20 patients were analysed. The entry dose for the breast tissue, measured with MOSFETs, (mean value 22.3 Gy, SD 3.4%) agreed within 1.7% with the expected dose (mean value 21.9 Gy). The dose in breast tissue, measured with GAFCHROMIC films (mean value 23.50 Gy) was on average within 0.7% (SD = 3.7%, range -5.5% to 5.6%) of the prescribed dose of 23.33 Gy. The dose measured with MOSFETs and GAFROMIC EBT2 films agreed well with the expected dose. For both methods, the dose to the thoracic wall, lungs and heart for left sided patents was lower than 2.5 Gy even when 12 MeV was applied. The positioning time of GAFCHROMIC films is negligible and based on our results we recommend its use as a standard tool for patient quality assurance during breast cancer IORT. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Adaptive Replanning to Account for Lumpectomy Cavity Change in Sequential Boost After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiaojian [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Qiao, Qiao [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Radiotherapy, First Hospital of China Medical University, Shenyang (China); DeVries, Anthony [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, Wenhui [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Radiotherapy, Yunnan Tumor Hospital, Kunming (China); Currey, Adam; Kelly, Tracy; Bergom, Carmen; Wilson, J. Frank [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, X. Allen, E-mail: ali@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)

    2014-12-01

    Purpose: To evaluate the efficiency of standard image-guided radiation therapy (IGRT) to account for lumpectomy cavity (LC) variation during whole-breast irradiation (WBI) and propose an adaptive strategy to improve dosimetry if IGRT fails to address the interfraction LC variations. Methods and Materials: Daily diagnostic-quality CT data acquired during IGRT in the boost stage using an in-room CT for 19 breast cancer patients treated with sequential boost after WBI in the prone position were retrospectively analyzed. Contours of the LC, treated breast, ipsilateral lung, and heart were generated by populating contours from planning CTs to boost fraction CTs using an auto-segmentation tool with manual editing. Three plans were generated on each fraction CT: (1) a repositioning plan by applying the original boost plan with the shift determined by IGRT; (2) an adaptive plan by modifying the original plan according to a fraction CT; and (3) a reoptimization plan by a full-scale optimization. Results: Significant variations were observed in LC. The change in LC volume at the first boost fraction ranged from a 70% decrease to a 50% increase of that on the planning CT. The adaptive and reoptimization plans were comparable. Compared with the repositioning plans, the adaptive plans led to an improvement in target coverage for an increased LC case (1 of 19, 7.5% increase in planning target volume evaluation volume V{sub 95%}), and breast tissue sparing for an LC decrease larger than 35% (3 of 19, 7.5% decrease in breast evaluation volume V{sub 50%}; P=.008). Conclusion: Significant changes in LC shape and volume at the time of boost that deviate from the original plan for WBI with sequential boost can be addressed by adaptive replanning at the first boost fraction.

  18. Left-sided breast cancer irradiation using rotational and fixed-field radiotherapy

    International Nuclear Information System (INIS)

    Qi, X. Sharon; Liu, Tian X.; Liu, Arthur K.; Newman, Francis; Rabinovitch, Rachel; Kavanagh, Brian; Hu, Y. Angie

    2014-01-01

    The 3-dimensional conformal radiotherapy (3DCRT) technique is the standard for breast cancer radiotherapy. During treatment planning, not only the coverage of the planning target volume (PTV) but also the minimization of the dose to critical structures, such as the lung, heart, and contralateral breast tissue, need to be considered. Because of the complexity and variations of patient anatomy, more advanced radiotherapy techniques are sometimes desired to better meet the planning goals. In this study, we evaluated external-beam radiation treatment techniques for left breast cancer using various delivery platforms: fixed-field including TomoDirect (TD), static intensity-modulated radiotherapy (sIMRT), and rotational radiotherapy including Elekta volumetric-modulated arc therapy (VMAT) and tomotherapy helical (TH). A total of 10 patients with left-sided breast cancer who did or did not have positive lymph nodes and were previously treated with 3DCRT/sIMRT to the entire breast were selected, their treatment was planned with Monaco VMAT, TD, and TH. Dosimetric parameters including PTV coverage, organ-at-risk (OAR) sparing, dose-volume histograms, and target minimum/maximum/mean doses were evaluated. It is found that for plans providing comparable PTV coverage, the Elekta VMAT plans were generally more inhomogeneous than the TH and TD plans. For the cases with regional node involvement, the average mean doses administered to the heart were 9.2 (± 5.2) and 8.8 (± 3.0) Gy in the VMAT and TH plans compared with 11.9 (± 6.4) and 11.8 (± 9.2) Gy for the 3DCRT and TD plans, respectively, with slightly higher doses given to the contralateral lung or breast or both. On average, the total monitor units for VMAT plans are 11.6% of those TH plans. Our studies have shown that VMAT and TH plans offer certain dosimetric advantages over fixed-field IMRT plans for advanced breast cancer requiring regional nodal treatment. However, for early-stage breast cancer fixed

  19. Techniques used by United Kingdom consultant plastic surgeons to select implant size for primary breast augmentation.

    Science.gov (United States)

    Holmes, W J M; Timmons, M J; Kauser, S

    2015-10-01

    Techniques used to estimate implant size for primary breast augmentation have evolved since the 1970s. Currently no consensus exists on the optimal method to select implant size for primary breast augmentation. In 2013 we asked United Kingdom consultant plastic surgeons who were full members of BAPRAS or BAAPS what was their technique for implant size selection for primary aesthetic breast augmentation. We also asked what was the range of implant sizes they commonly used. The answers to question one were grouped into four categories: experience, measurements, pre-operative external sizers and intra-operative sizers. The response rate was 46% (164/358). Overall, 95% (153/159) of all respondents performed some form of pre-operative assessment, the others relied on "experience" only. The most common technique for pre-operative assessment was by external sizers (74%). Measurements were used by 57% of respondents and 3% used intra-operative sizers only. A combination of measurements and sizers was used by 34% of respondents. The most common measurements were breast base (68%), breast tissue compliance (19%), breast height (15%), and chest diameter (9%). The median implant size commonly used in primary breast augmentation was 300cc. Pre-operative external sizers are the most common technique used by UK consultant plastic surgeons to select implant size for primary breast augmentation. We discuss the above findings in relation to the evolution of pre-operative planning techniques for breast augmentation. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Intensity modulated radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Riou, O.; Fenoglietto, P.; Lemanski, C.; Azria, D.

    2012-01-01

    Intensity modulated radiotherapy (IMRT) is a technique allowing dose escalation and normal tissue sparing for various cancer types. For breast cancer, the main goals when using IMRT were to improve dose homogeneity within the breast and to enhance coverage of complex target volumes. Nonetheless, better heart and lung protections are achievable with IMRT as compared to standard irradiation for difficult cases. Three prospective randomized controlled trials of IMRT versus standard treatment showed that a better breast homogeneity can translate into better overall cosmetic results. Dosimetric and clinical studies seem to indicate a benefit of IMRT for lymph nodes irradiation, bilateral treatment, left breast and chest wall radiotherapy, or accelerated partial breast irradiation. The multiple technical IMRT solutions available tend to indicate a widespread use for breast irradiation. Nevertheless, indications for breast IMRT should be personalized and selected according to the expected benefit for each individual. (authors)

  1. Incidental dose to coronary arteries is higher in prone than in supine whole breast irradiation. A dosimetric comparison in adjuvant radiotherapy of early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wuerschmidt, Florian; Stoltenberg, Solveigh; Kretschmer, Matthias; Petersen, Cordula

    2014-06-15

    Sparing of normal lung is best achieved in prone whole breast irradiation (WBI). However, exposure of the heart and coronary arteries might increase due to anterior movement of the heart in prone WBI. Treatment plans of 46 patients with large breasts irradiated for mammary cancer after breast-conserving surgery were retrospectively analyzed. The average treated breast volume of right-sided breasts (n = 33) was 1,804 ccm and 1,500 ccm for left-sided breasts (n = 13). The majority had invasive cancer (96 %) of which 61 % were pT1 and 39 % pT2 tumors. All patients received radiation therapy to the breast only. For three-dimensional (3D) treatment planning, all patients underwent a noncontrast-enhanced CT in the supine position with a wingboard and a second CT in the prone position using a prone breastboard. Nontarget volumes of the lung, heart, and coronary arteries were contoured. A total dose of 50.4 Gy was prescribed to the breast only. Differences were calculated for each patient and compared using the Wilcoxon signed-rank test. Treatment of left-sided breasts resulted in similar average mean heart doses in prone versus supine WBI (4.16 vs. 4.01 Gy; p = 0.70). The left anterior descending artery (LAD) had significantly higher dose exposure in left versus right WBI independent of position. Prone WBI always resulted in significantly higher exposures of the right circumflex artery (RCA) and LAD as compared to supine WBI. In left WBI, the mean LADprone was 33.5 Gy vs. LADsupine of 25.6 Gy (p = 0.0051). The V20prone of the LAD was 73.6 % vs. V20supine 50.4 % (p = 0.0006). The heart dose is not different between supine and prone WBI. However, in left WBI the incidental dose to the LAD with clinically relevant doses can be significantly higher in prone WBI. This is discussed controversially in the literature as it might depend on contouring and treatment techniques. We recommend contouring of LAD if patients are treated in prone WBI and evaluation of alternative

  2. Development status of post irradiation examination techniques at the JMTR Hot Laboratory

    International Nuclear Information System (INIS)

    Ohmi, M.; Ohsawa, K.; Nakagawa, T.; Umino, A.; Shimizu, M.; Satoh, H.; Oyamada, R.

    1992-01-01

    Hot laboratory at Oarai Research Establishment was founded to examine the objects mainly irradiated at JMTR (Japan Materials Testing Reactor) and has been operated since 1971. A wide variety of post-irradiation examinations (PIE) is available using the hot laboratory. Continuous efforts are made to develop new PIE techniques to accommodate the user's requirements. The following are main techniques recently developed in the hot laboratory; 1. Remote capsule assembly including remote weld of irradiated objects for reirradiation in JMTR. 2. Fracture toughness tests of reactor component materials. 3. Creep tests of heat resistance alloys in high temperature conditions. 4. Tests of irradiation assisted stress corrosion cracking (IASCC). 5. Examination techniques of miniaturized test specimens. This report describes an outline of the hot laboratory with main emphasis on the new PIE techniques. (author)

  3. Analysis of interfraction and intrafraction variation during tangential breast irradiation with an electronic portal imaging device

    International Nuclear Information System (INIS)

    Smith, Ryan P.; Bloch, Peter; Harris, Eleanor E.; McDonough, James; Sarkar, Abhirup; Kassaee, Alireza; Avery, Steven; Solin, Lawrence J.

    2005-01-01

    Purpose: To evaluate the daily setup variation and the anatomic movement of the heart and lungs during breast irradiation with tangential photon beams, as measured with an electronic portal imaging device. Methods and materials: Analysis of 1,709 portal images determined changes in the radiation field during a treatment course in 8 patients. Values obtained for every image included central lung distance (CLD) and area of lung and heart within the irradiated field. The data from these measurements were used to evaluate variation from setup between treatment days and motion due to respiration and/or patient movement during treatment delivery. Results: The effect of respiratory motion and movement during treatment was minimal: the maximum range in CLD for any patient on any day was 0.25 cm. The variation caused by day-to-day setup variation was greater, with CLD values for patients ranging from 0.59 cm to 2.94 cm. Similar findings were found for heart and lung areas. Conclusions: There is very little change in CLD and corresponding lung and heart area during individual radiation treatment fractions in breast tangential fields, compared with a relatively greater amount of variation that occurs between days

  4. Chloroquine Engages the Immune System to Eradicate Irradiated Breast Tumors in Mice

    International Nuclear Information System (INIS)

    Ratikan, Josephine Anna; Sayre, James William; Schaue, Dörthe

    2013-01-01

    Purpose: This study used chloroquine to direct radiation-induced tumor cell death pathways to harness the antitumor activity of the immune system. Methods and Materials: Chloroquine given immediately after tumor irradiation increased the cure rate of MCaK breast cancer in C3H mice. Chloroquine blocked radiation-induced autophagy and drove MCaK cells into a more rapid apoptotic and more immunogenic form of cell death. Results: Chloroquine treatment made irradiated tumor vaccines superior at inducing strong interferon gamma-associated immune responses in vivo and protecting mice from further tumor challenge. In vitro, chloroquine slowed antigen uptake and degradation by dendritic cells, although T-cell stimulation was unaffected. Conclusions: This study illustrates a novel approach to improve the efficacy of breast cancer radiation therapy by blocking endosomal pathways, which enhances radiation-induced cell death within the field and drives antitumor immunity to assist therapeutic cure. The study illuminates and merges seemingly disparate concepts regarding the importance of autophagy in cancer therapy

  5. Investigation of conformal and intensity-modulated radiation therapy techniques to determine the absorbed fetal dose in pregnant patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Öğretici, Akın, E-mail: akinogretici@gmail.com; Akbaş, Uğur; Köksal, Canan; Bilge, Hatice

    2016-07-01

    The aim of this research was to investigate the fetal doses of pregnant patients undergoing conformal radiotherapy or intensity-modulated radiation therapy (IMRT) for breast cancers. An Alderson Rando phantom was chosen to simulate a pregnant patient with breast cancer who is receiving radiation therapy. This phantom was irradiated using the Varian Clinac DBX 600 system (Varian Medical System, Palo Alto, CA) linear accelerator, according to the standard treatment plans of both three-dimensional conformal radiation therapy (3-D CRT) and IMRT techniques. Thermoluminescent dosimeters were used to measure the irradiated phantom's virtually designated uterus area. Thermoluminescent dosimeter measurements (in the phantom) revealed that the mean cumulative fetal dose for 3-D CRT is 1.39 cGy and for IMRT it is 8.48 cGy, for a pregnant breast cancer woman who received radiation treatment of 50 Gy. The fetal dose was confirmed to increase by 70% for 3-D CRT and 40% for IMRT, if it is closer to the irradiated field by 5 cm. The mean fetal dose from 3-D CRT is 1.39 cGy and IMRT is 8.48 cGy, consistent with theoretic calculations. The IMRT technique causes the fetal dose to be 5 times more than that of 3-D CRT. Theoretic knowledge concerning the increase in the peripheral doses as the measurements approached the beam was also practically proven.

  6. Air-electron stream interactions during magnetic resonance IGRT. Skin irradiation outside the treatment field during accelerated partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Min [Seoul National University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of); Seoul National University Hospital, Biomedical Research Institute, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Advanced Institutes of Convergence Technology, Robotics Research Laboratory for Extreme Environments, Suwon (Korea, Republic of); Shin, Kyung Hwan; Wu, Hong-Gyun [Seoul National University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of); Seoul National University Hospital, Biomedical Research Institute, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiation Oncology, Seoul (Korea, Republic of); Kim, Jung-in; Park, So-Yeon; Kim, Jin Ho [Seoul National University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of); Seoul National University Hospital, Biomedical Research Institute, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Jeon, Seung Hyuck [Seoul National University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of); Choi, Noorie [Seoul National University College of Medicine, Department of Radiation Oncology, Seoul (Korea, Republic of)

    2018-01-15

    To investigate and to prevent irradiation outside the treatment field caused by an electron stream in the air generated by the magnetic field during magnetic resonance image-guided accelerated partial breast irradiation (APBI). In all, 20 patients who received APBI with a magnetic resonance image-guided radiation therapy (MR-IGRT) system were prospectively studied. The prescription dose was 38.5 Gy in 10 fractions of 3.85 Gy and delivered with a tri-cobalt system (the ViewRay system). For each patient, primary plans were delivered for the first five fractions and modified plans with different gantry angles from those of the primary plan (in-treatment plans) were delivered for the remaining five fractions to reduce the skin dose. A 1 cm thick bolus was placed in front of the patient's jaw, ipsilateral shoulder, and arm to shield them from the electron stream. Radiochromic EBT3 films were attached to the front (towards the breast) and back (towards the head) of the bolus during treatment. Correlations between the measured values and the tumor locations, treatment times, and tumor sizes were investigated. For a single fraction delivery, the average areas of the measured isodoses of 14% (0.54 Gy), 12% (0.46 Gy), and 10% (0.39 Gy) at the front of the boluses were as large as 3, 10.4, and 21.4 cm{sup 2}, respectively, whereas no significant dose could be measured at the back of the boluses. Statistically significant but weak correlations were observed between the measured values and the treatment times. During radiotherapy for breast cancer with an MR-IGRT system, the patient must be shielded from electron streams in the air generated by the interaction of the magnetic field with the beams of the three-cobalt treatment unit to avoid unwanted irradiation of the skin outside the treatment field. (orig.) [German] Beim Einsatz eines Magnetresonanztomographie(MRT)-gefuehrten Bestrahlungsgeraets kann durch die Wechselwirkung von Magnetfeld und Strahlenquelle unerwuenscht

  7. Impact of MLC leaf width on the quality of the dose distribution in partial breast irradiation

    International Nuclear Information System (INIS)

    Height, Felicity J.; Kron, Tomas; Willis, David; Chua, Boon H.

    2012-01-01

    Partial-breast irradiation (PBI) aims to limit the target volume for radiotherapy in women with early breast cancer after partial mastectomy to the region at highest risk of local recurrence, the tumor bed. Multileaf collimators are used to achieve conformal radiation beam portals required for PBI. Narrower leaf widths are generally assumed to allow more conformal shaping of beam portals around irregularly shaped target volumes. The aim was to compare 5-mm and 10-mm leaf widths for patients previously treated using PBI and assess subsequent planning target volume (PTV) coverage and organ at risk (OAR) doses for 16 patients. Several plans (5-mm leaf width or 10-mm leaf width) were generated for each patient using the original treated plan as the basis for attempts at further optimization. Alternating between different leaf widths found no significant difference in terms of overall PTV coverage and OAR doses between treatment plans. Optimization of the original treated plan allowed a small decrease in ipsilateral breast dose, which was offset by a lower PTV minimum. No significant dosimetric difference was found to support an advantage of 5-mm over 10-mm leaf width in this setting.

  8. Long-term outcome of accelerated partial breast irradiation using a multilumen balloon applicator in a patient with existing breast implants.

    Science.gov (United States)

    Akhtari, Mani; Nitsch, Paige L; Bass, Barbara L; Teh, Bin S

    2015-01-01

    Accelerated partial breast irradiation is now an accepted component of breast-conserving therapy. However, data regarding long-term outcomes of patients treated with multilumen catheter systems who have existing breast implants are limited. We report the treatment and outcome of our patient who had existing bilateral silicone subpectoral implants at the time of presentation. Ultrasound-guided core needle biopsy of the right breast showed infiltrating mucinous carcinoma. Right breast lumpectomy revealed an 8 mm area of infiltrating ductal carcinoma with mucinous features and nuclear grade 1. A 4-5 cm Contura (Bard Biopsy Systems, Tempe, AZ) device was placed, and she was treated over the course of 5 days twice daily to a dose of 34 Gy using a high-dose-rate iridium-192 source. The planning target volume for evaluation was 73.9 cc. The percentage of the planning target volume for evaluation receiving 90%, 95%, and 100% of the prescribed dose was 99.9%, 99.3%, and 97.8%, respectively. The total implant volume was 234.5 cc and received a mean dose of 15.4 Gy and a maximum dose of 72.8 Gy. The percentage of implant volume receiving 50%, 75%, 100%, and 200% of the prescribed dose was 31.1%, 16.5%, 8.6%, 2.0%, and 0%, respectively. Maximum skin dose was 97% of the prescribed dose. With a followup of nearly 5 years, she continues to be cancer free with minimal late toxicities and good to excellent cosmetic outcome. Accelerated partial breast irradiation using a multilumen balloon applicator in patients with existing breast implants can safely be performed with excellent long-term cosmetic outcome. Further studies are needed to establish the absolute dosimetric tolerance of breast implants. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  9. Small Punch Test Techniques for Irradiated Materials in Hot Cell

    International Nuclear Information System (INIS)

    Kim, Do Sik; Ahn, S. B.; Oh, W. H.; Yoo, B. O.; Choo, Y. S.

    2006-06-01

    Detailed procedures of the small punch test including the apparatus, the definition of small punch-related parameters, and the interpretation of results were presented. The testing machine should have a capability of the compressive loading and unloading at a given deflection level. The small punch specimen holder consists of an upper and lower die and clamping screws. The clamped specimen is deformed by using ball or spherical head punch. Two type of specimens with a circular and a square shape were used. The irradiated small punch specimen is made from the undamaged portion of the broken CVN bars or prepared by the irradiation of the specimen fabricated from the fresh materials. The heating and cooling devices should have the capability of the temperature control within ±2 .deg. C for the target value during the test. Based on the load-deflection data obtained from the small punch test. the empirical correlation between the small punch related parameters and a tensile properties such as 0.2% yield strength and ultimate tensile strength, fracture toughness, ductile-brittle transition temperature and creep properties determined from the standard test method is established and used to evaluate the mechanical properties of an irradiated materials. In addition, from the quantitative fractographic assessment of small punch test specimens, the relationship between the small punch energy and the quantity of ductile crack growth is obtained. Analytical formulations demonstrated good agreement with experimental load-deflection curves

  10. A review of the surgical management of breast cancer: plastic reconstructive techniques and timing implications.

    Science.gov (United States)

    Rosson, Gedge D; Magarakis, Michael; Shridharani, Sachin M; Stapleton, Sahael M; Jacobs, Lisa K; Manahan, Michele A; Flores, Jaime I

    2010-07-01

    The oncologic management of breast cancer has evolved over the past several decades from radical mastectomy to modern-day preservation of chest and breast structures. The increased rate of mastectomies over recent years made breast reconstruction an integral part of the breast cancer management. Plastic surgery now offers patients a wide variety of reconstruction options from primary closure of the skin flaps to performance of microvascular and autologous tissue transplantation. Well-coordinated partnerships between surgical oncologists, plastic surgeons, and patients address concerns of tumor control, cosmesis, and patients' wishes. The gamut of breast reconstruction options is reviewed, particularly noting state-of-the-art techniques, as well as the advantages and disadvantages of various timing modalities.

  11. Accelerated partial breast irradiation using once-daily fractionation: analysis of 312 cases with four years median follow-up

    Directory of Open Access Journals (Sweden)

    Shaikh Arif Y

    2012-02-01

    Full Text Available Abstract Background There are limited data on accelerated partial breast irradiation (APBI using external beam techniques. Moreover, there are recent reports of increased fibrosis and unacceptable cosmesis with APBI using external beam with BID fractionation. We adopted a once daily regimen of APBI with fractionation similar to that shown to be effective in a Canadian randomized trial of whole breast irradiation. It is unclear whether patients with DCIS or invasive lobular carcinoma (ILC are suitable for APBI. Methods The retrospective cohort included 310 patients with 312 tumors of T1-T2N0-N1micM0 invasive ductal carcinoma (IDC, ILC, or Tis (DCIS treated with APBI via external beam. Most patients were treated using IMRT with 16 daily fractions of 270 cGy to a dose of 4320 cGy. The target volume included the lumpectomy cavity plus 1.0 cm to account for microscopic disease and an additional 0.5 to 1.0 cm for setup uncertainty and breathing motion. Ipsilateral breast failure (IBF was pathologically confirmed as a local failure (LF or an elsewhere failure (EF. Results Median follow-up was 49 months. Among the 312 cases, 213 were IDC, 31 ILC, and 68 DCIS. Median tumor size was 1.0 cm. There were 9 IBFs (2.9% including 5 LFs and 4 EFs. The IBF rates among patients with IDC, ILC, and DCIS were 2.4%, 3.2%, and 4.4%, respectively, with no significant difference between histologies. When patients were analyzed by the ASTRO APBI consensus statement risk groups, 32% of treated cases were considered suitable, 50% cautionary, and 18% unsuitable. The IBF rates among suitable, cautionary, and unsuitable patients were 4.0%, 2.6%, and 1.8%, respectively, with no significant difference between risk groups. Acute skin reactions were rare and long-term cosmetic outcome was very good to excellent. Conclusions External beam APBI with once daily fractionation has a low rate of IBF consistent with other published APBI studies. The ASTRO risk stratification did not

  12. Fractionation for Whole Breast Irradiation: An American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline

    International Nuclear Information System (INIS)

    Smith, Benjamin D.; Bentzen, Soren M.; Correa, Candace R.; Hahn, Carol A.; Hardenbergh, Patricia H.; Ibbott, Geoffrey S.; McCormick, Beryl; McQueen, Julie R.; Pierce, Lori J.; Powell, Simon N.; Recht, Abram; Taghian, Alphonse G.; Vicini, Frank A.; White, Julia R.; Haffty, Bruce G.

    2011-01-01

    Purpose: In patients with early-stage breast cancer treated with breast-conserving surgery, randomized trials have found little difference in local control and survival outcomes between patients treated with conventionally fractionated (CF-) whole breast irradiation (WBI) and those receiving hypofractionated (HF)-WBI. However, it remains controversial whether these results apply to all subgroups of patients. We therefore developed an evidence-based guideline to provide direction for clinical practice. Methods and Materials: A task force authorized by the American Society for Radiation Oncology weighed evidence from a systematic literature review and produced the recommendations contained herein. Results: The majority of patients in randomized trials were aged 50 years or older, had disease Stage pT1-2 pN0, did not receive chemotherapy, and were treated with a radiation dose homogeneity within ±7% in the central axis plane. Such patients experienced equivalent outcomes with either HF-WBI or CF-WBI. Patients not meeting these criteria were relatively underrepresented, and few of the trials reported subgroup analyses. For patients not receiving a radiation boost, the task force favored a dose schedule of 42.5 Gy in 16 fractions when HF-WBI is planned. The task force also recommended that the heart should be excluded from the primary treatment fields (when HF-WBI is used) due to lingering uncertainty regarding late effects of HF-WBI on cardiac function. The task force could not agree on the appropriateness of a tumor bed boost in patients treated with HF-WBI. Conclusion: Data were sufficient to support the use of HF-WBI for patients with early-stage breast cancer who met all the aforementioned criteria. For other patients, the task force could not reach agreement either for or against the use of HF-WBI, which nevertheless should not be interpreted as a contraindication to its use.

  13. Intensity modulated radiotherapy with fixed collimator jaws for locoregional left-sided breast cancer irradiation.

    Science.gov (United States)

    Wang, Juanqi; Yang, Zhaozhi; Hu, Weigang; Chen, Zhi; Yu, Xiaoli; Guo, Xiaomao

    2017-05-16

    The purpose of this study is to evaluate the intensity modulated radiotherapy (IMRT) with the fixed collimator jaws technique (FJT) for the left breast and regional lymph node. The targeted breast tissue and the lymph nodes, and the normal tissues were contoured for 16 left-sided breast cancer patients previously treated with radiotherapy after lumpectomy. For each patient, treatment plans using different planning techniques, i.e., volumetric modulated arc therapy (VMAT), tangential IMRT (tangential-IMRT), and IMRT with FJT (FJT-IMRT) were developed for dosimetric comparisons. A dose of 50Gy was prescribed to the planning target volume. The dose-volume histograms were generated, and the paired t-test was used to analyze the dose differences. FJT-IMRT had similar mean heart volume receiving 30Gy (V30 Gy) with tangential-IMRT (1.5% and 1.6%, p = 0.41), but inferior to the VMAT (0.8%, p < 0.001). In the average heart mean dose comparison, FJT-IMRT had the lowest value, and it was 0.6Gy lower than that for the VMAT plans (p < 0.01). A significant dose increase in the contralateral breast and lung was observed in VMAT plans. Compared with tangential-IMRT and VMAT plans, FJT-IMRT reduced the mean dose of thyroid, humeral head and cervical esophageal by 47.6% (p < 0.01) and 45.7% (p < 0.01), 74.3% (p =< 0.01) and 73% (p =< 0.01), and 26.7% (p =< 0.01) and 29.2% (p =< 0.01). In conclusion, compared with tangential-IMRT and VMAT, FJT-IMRT plan has the lowest thyroid, humeral head and cervical esophageal mean dose and it can be a reasonable treatment option for a certain subgroup of patients, such as young left-breast cancer patients and/or patients with previous thyroid disease.

  14. Trialed production of low protein irradiated natural rubber latex in factory scale by gamma irradiation technique

    International Nuclear Information System (INIS)

    Utama, Marga; Herwinarni, S.; Halik, H.M.; Siswanto; Suharyanto; Syamsu, Y.; Handoko, B.

    2006-01-01

    Four tons fresh field natural rubber latex (FNRL) with total solid content 30% were added with 2 phr (part hundred ratio of rubber) normal butyl acrylate (nBA) then irradiated by gamma rays at 25 kGy. The irradiated FNRL was centrifuged, then the properties of irradiated centrifuged natural rubber latex (INRL) and its film were measured before and after storage for 5 months. It is found that the INRL is stable latex during storage in 5 months, with lowest protein, and free nitrosamine content. The tensile strength of INRL film was 24-27 MPa, and modulus 600% was 1,5-2,0 MPa, elongation at break was 900%, and hardness was 27-29 Shore A, while the extractable protein content less than 100 μg/g. (author)

  15. Investigation of neutron irradiated reactor vessel steels using post-irradiation annealing techniques

    Energy Technology Data Exchange (ETDEWEB)

    Nakata, Hayato; Fukuya, Koji [Institute of Nuclear Safety System Inc., Mihama, Fukui (Japan)

    2001-09-01

    The matrix damage is known to be a major factor that contributes to embrittlement and hardening of irradiated reactor vessel steels, and is assumed to be composed of the point defect clusters. However field emission gun scanning transmission electron microscopy (FEGSTEM) and atom probe (AP) could not detect any evidence of the matrix damage. In this study, post irradiation annealing experiments combining positron annihilation lineshape analysis (PALA) and hardness experiments were applied to an actual surveillance test specimen and a sample of reactor vessel steel irradiated in a material test reactor (MTR), in order to investigate the matrix damage recovery behavior and its contribution to hardening. It was confirmed that higher fluence increased the hardness and the volume fraction of open volume defects and that higher flux decreased the thermal stability of matrix damage and the effect on hardening. The contribution of matrix damage to hardening could be estimated to be below 30%. (author)

  16. Liposuction-assisted four pedicle-based breast reduction (LAFPBR): A new safer technique of breast reduction for elderly patients.

    Science.gov (United States)

    La Padula, Simone; Hersant, Barbara; Noel, Warren; Meningaud, Jean Paul

    2018-05-01

    As older people increasingly care for their body image and remain active longer, the demand for reduction mammaplasty is increasing in this population. Only a few studies of reduction mammaplasty have specifically focussed on the outcomes in elderly women. We developed a new breast reduction technique: the Liposuction-Assisted Four Pedicle-Based Breast Reduction (LAFPBR) that is especially indicated for elderly patients. The aim of this paper was to describe the LAFPBR technique and to determine whether it could be considered a safer option for elderly patients compared to the superomedial pedicle (SMP) technique. A retrospective study included sixty-two women aged 60 years and over who underwent bilateral breast reduction mammaplasty. Thirty-one patients underwent LAFPBR and 31 patients were operated using the SMP technique. Complications and patient satisfaction in both groups were analysed. Patient satisfaction was measured using a validated questionnaire: the client satisfaction questionnaire 8 (CSQ-8). The LAFPBR technique required less operating time, and avoided significant blood loss. Six minor complications were observed in SMP patients. No LAFPBR women developed a procedure-related complication. Patient satisfaction was high with a mean score of 29.65 in LAFPBR patients and 28.68 in SMP patients. The LAFPBR is an easy procedure that appears safer than SMP and results in a high satisfaction rate in elderly women. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source

    Energy Technology Data Exchange (ETDEWEB)

    White, Shane A.; Landry, Guillaume; Reniers, Brigitte, E-mail: brigitte.reniers@maastro.nl [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN (Netherlands); Fonseca, Gabriel Paiva [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN, The Netherlands and Instituto de Pesquisas Energéticas e Nucleares – IPEN-CNEN/SP, São Paulo CP 11049, 05422-970 (Brazil); Holt, Randy; Rusch, Thomas [Xoft, A Subsidiary of iCAD, Sunnyvale, California 94085-4115 (United States); Beaulieu, Luc [Centre Hospitalier Universitaire de Québec Université Laval, Radio-Oncologie et Centre de Recherche en Cancérologie de l’Université Laval, Québec, Québec G1R 2J6 Canada (Canada); Verhaegen, Frank [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN, The Netherlands and Department of Oncology, McGill University, Montreal, Quebec H3G 1A4 (Canada)

    2014-06-15

    Purpose: The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy (<50 kV) brachytherapy system used in accelerated partial breast irradiation (APBI). Breast tissue is a heterogeneous tissue in terms of density and composition. Dosimetric calculations of seven APBI patients treated with Axxent were made using a model-based Monte Carlo platform for a number of tissue models and dose reporting methods and compared to TG-43 based plans. Methods: A model of the Axxent source, the S700, was created and validated against experimental data. CT scans of the patients were used to create realistic multi-tissue/heterogeneous models with breast tissue segmented using a published technique. Alternative water models were used to isolate the influence of tissue heterogeneity and backscatter on the dose distribution. Dose calculations were performed using Geant4 according to the original treatment parameters. The effect of the Axxent balloon applicator used in APBI which could not be modeled in the CT-based model, was modeled using a novel technique that utilizes CAD-based geometries. These techniques were validated experimentally. Results were calculated using two dose reporting methods, dose to water (D{sub w,m}) and dose to medium (D{sub m,m}), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. Results: All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D{sub 90} to PTV was reduced by between ∼4% and ∼40%, depending on the

  18. Optimal application of the Contura multilumen balloon breast brachytherapy catheter vacuum port to deliver accelerated partial breast irradiation.

    Science.gov (United States)

    Tokita, Kenneth M; Cuttino, Laurie W; Vicini, Frank A; Arthur, Douglas W; Todor, Dorin A; Julian, Thomas B; Lyden, Maureen R

    2011-01-01

    The impact of using the Contura multilumen balloon (MLB) (SenoRx, Inc., Irvine, CA) breast brachytherapy catheter's vacuum port in patients treated with accelerated partial breast irradiation (APBI) was analyzed. Data from 32 patients at two sites were reviewed. Variables analyzed included the seroma fluid (SF):air volume around the MLB before and after vacuum port use and on its ability to improve (1) the eligibility of patients for APBI and (2) dose coverage of the planning target volume for evaluation (PTV_EVAL) in eligible patients. The median SF/air volume before vacuum removal was 6.8 cc vs. 0.8 cc after vacuum removal (median reduction in SF/air volume was 90.5%). Before vacuum port use, the median SF/air volume expressed as percentage of the PTV_EVAL was 7.8% (range, 1.9-26.6) in all patients. After application of the vacuum, this was reduced to 1.2%. Before vacuum port use, 10 (31.3%) patients were not considered acceptable candidates for APBI because the SF/air volume:PTV_EVAL ratio (SF:PTV) was greater than 10% (range, 10.1-26.6%; median, 15.2%). After vacuum port use, the median SF:PTV ratio was 1.6% for a median reduction of 91.5%. In addition, the percentage of the prescribed dose covering greater than or equal to 90% of the PTV_EVAL proportionally increased a median of 8% (range, 3-10%) in eligible patients. Use of the Contura MLB vacuum port significantly improved the conformity of the target tissue to the balloon surface, leading to reproducible dose delivery and increased target volume coverage. In addition, application of the vacuum allowed the safe treatment of unacceptable patients with APBI. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  19. Use of electron spin resonance technique for identifying of irradiated foods

    International Nuclear Information System (INIS)

    El-Shiemy, S.M.E

    2008-01-01

    The present investigation was carried out to establish the electron spin resonance (ESR) technique for identifying of some irradiated foodstuffs, i.e. dried fruits (fig and raisin), nuts (almond and pistachio) and spices (fennel and thyme). Gamma rays were used as follows: 0, 1, 3 and 5 kGy were given for dried fruits, while 0, 2, 4 and 6 kGy were given for nuts. In addition, 0, 5, 10 and 15 kGy were given for spices. All treatments were stored at room temperature (25±2 degree C) for six months to study the possibility of detecting its irradiation treatment by ESR spectroscopy. The obtained results indicated that ESR signal intensities of all irradiated samples were markedly increased correspondingly with irradiation dose as a result of free radicals generated by gamma irradiation. So, all irradiated samples under investigation could be differentiated from unirradiated ones immediately after irradiation treatment. The decay that occur in free radicals which responsible of ESR signals during storage periods at ambient temperature showed a significant minimize in ESR signal intensities of irradiated samples. Therefore, after six months of ambient storage the detection was easily possible for irradiated dried fig with dose ≥ 3 kGy and for all irradiated raisin and pistachio (shell). Also, it was possible for irradiated fennel with dose ≥ 10 kGy and for irradiated thyme with dose ≥15 kGy. In contrast, the identification of all irradiated samples of almond (shell as well as edible part) and pistachio (edible part) was impossible after six months of ambient storage.

  20. Use of electron spin resonance technique for identifying of irradiated foods

    Energy Technology Data Exchange (ETDEWEB)

    El-Shiemy, S M E

    2008-07-01

    The present investigation was carried out to establish the electron spin resonance (ESR) technique for identifying of some irradiated foodstuffs, i.e. dried fruits (fig and raisin), nuts (almond and pistachio) and spices (fennel and thyme). Gamma rays were used as follows: 0, 1, 3 and 5 kGy were given for dried fruits, while 0, 2, 4 and 6 kGy were given for nuts. In addition, 0, 5, 10 and 15 kGy were given for spices. All treatments were stored at room temperature (25{+-}2 degree C) for six months to study the possibility of detecting its irradiation treatment by ESR spectroscopy. The obtained results indicated that ESR signal intensities of all irradiated samples were markedly increased correspondingly with irradiation dose as a result of free radicals generated by gamma irradiation. So, all irradiated samples under investigation could be differentiated from unirradiated ones immediately after irradiation treatment. The decay that occur in free radicals which responsible of ESR signals during storage periods at ambient temperature showed a significant minimize in ESR signal intensities of irradiated samples. Therefore, after six months of ambient storage the detection was easily possible for irradiated dried fig with dose {>=} 3 kGy and for all irradiated raisin and pistachio (shell). Also, it was possible for irradiated fennel with dose {>=} 10 kGy and for irradiated thyme with dose {>=}15 kGy. In contrast, the identification of all irradiated samples of almond (shell as well as edible part) and pistachio (edible part) was impossible after six months of ambient storage.

  1. Mammographically detected ductal carcinoma in situ of the breast treated with breast-conserving surgery and definitive breast irradiation: long-term outcome and prognostic significance of patient age and margin status

    International Nuclear Information System (INIS)

    Solin, Lawrence J.; Fourquet, Alain; Vicini, Frank A.; Haffty, Bruce; Taylor, Marie; McCormick, Beryl; McNeese, Marsha; Pierce, Lori J.; Landmann, Christine; Olivotto, Ivo A.; Borger, Jacques; Kim, Jung-Soo; Rochefordiere, Anne de la; Schultz, Delray J.

    2001-01-01

    Purpose: This study was performed to determine the long-term outcome for women with mammographically detected ductal carcinoma in situ (DCIS; intraductal carcinoma) of the breast treated with breast-conserving surgery followed by definitive breast irradiation. Methods and Materials: An analysis was performed of 422 mammographically detected intraductal breast carcinomas in 418 women from 11 institutions in North America and Europe. All patients were treated with breast-conserving surgery followed by definitive breast irradiation. The median follow-up time was 9.4 years (mean, 9.4 years; range, 0.1-19.8 years). Results: The 15-year overall survival rate was 92%, and the 15-year cause-specific survival rate was 98%. The 15-year rate of freedom from distant metastases was 94%. There were 48 local failures in the treated breast, and the 15-year rate of any local failure was 16%. The median time to local failure was 5.0 years (mean, 5.7 years; range, 1.0-15.2 years). Patient age at the time of treatment and final pathology margin status from the primary tumor excision were both significantly associated with local failure. The 10-year rate of local failure was 31% for patient age ≤ 39 years, 13% for age 40-49 years, 8% for age 50-59 years, and 6% for age ≥ 60 years (p=0.0001). The 10-year rate of local failure was 24% when the margins of resection were positive, 9% when the margins of resection were negative, 7% when the margins of resection were close, and 12% when the margins of resection were unknown (p=0.030). Patient age ≤ 39 years and positive margins of resection were both independently associated with an increased risk of local failure (p=0.0006 and p=0.023, respectively) in the multivariable Cox regression model. Conclusions: The 15-year results from the present study demonstrated high rates of overall survival, cause-specific survival, and freedom from distant metastases following the treatment of mammographically detected ductal carcinoma in situ of the

  2. Digital image analysis in breast pathology-from image processing techniques to artificial intelligence.

    Science.gov (United States)

    Robertson, Stephanie; Azizpour, Hossein; Smith, Kevin; Hartman, Johan

    2018-04-01

    Breast cancer is the most common malignant disease in women worldwide. In recent decades, earlier diagnosis and better adjuvant therapy have substantially improved patient outcome. Diagnosis by histopathology has proven to be instrumental to guide breast cancer treatment, but new challenges have emerged as our increasing understanding of cancer over the years has revealed its complex nature. As patient demand for personalized breast cancer therapy grows, we face an urgent need for more precise biomarker assessment and more accurate histopathologic breast cancer diagnosis to make better therapy decisions. The digitization of pathology data has opened the door to faster, more reproducible, and more precise diagnoses through computerized image analysis. Software to assist diagnostic breast pathology through image processing techniques have been around for years. But recent breakthroughs in artificial intelligence (AI) promise to fundamentally change the way we detect and treat breast cancer in the near future. Machine learning, a subfield of AI that applies statistical methods to learn from data, has seen an explosion of interest in recent years because of its ability to recognize patterns in data with less need for human instruction. One technique in particular, known as deep learning, has produced groundbreaking results in many important problems including image classification and speech recognition. In this review, we will cover the use of AI and deep learning in diagnostic breast pathology, and other recent developments in digital image analysis. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Lung and heart dose volume analyses with CT simulator in tangential field irradiation of breast cancer

    International Nuclear Information System (INIS)

    Das, Indra J.; Cheng, Elizabeth C.; Fowble, Barbara

    1997-01-01

    Objective: Radiation pneumonitis and cardiac effects are directly related to the irradiated lung and heart volumes in the treatment fields. The central lung distance (CLD) from a tangential breast radiograph is shown to be a significant indicator of ipsilateral irradiated lung volume based on empirically derived functions which accuracy depends on the actual measured volume in treatment position. A simple and accurate linear relationship with CLD and retrospective analysis of the pattern of dose volume of lung and heart is presented with actual volume data from a CT simulator in the treatment of breast cancer. Materials and Methods: The heart and lung volumes in the tangential treatment fields were analyzed in 45 consecutive (22 left and 23 right breast) patients referred for CT simulation of the cone down treatment. All patients in this study were immobilized and placed on an inclined breast board in actual treatment setup. Both arms were stretched over head uniformly to avoid collision with the scanner aperture. Radiopaque marks were placed on the medial and lateral borders of the tangential fields. All patients were scanned in spiral mode with slice width and thickness of 3 mm each, respectively. The lung and heart structures as well as irradiated areas were delineated on each slice and respective volumes were accurately measured. The treatment beam parameters were recorded and the digitally reconstructed radiographs (DRRs) were generated for the CLD and analysis. Results: Table 1 shows the volume statistics of patients in this study. There is a large variation in the lung and heart volumes among patients. Due to differences in the shape of right and left lungs the percent irradiated volume (PIV) are different. The PIV data have shown to correlate with CLD with 2nd and 3rd degree polynomials; however, in this study a simple straight line regression is used to provide better confidence than the higher order polynomial. The regression lines for the left and right

  4. Dosimetric validation of planning system Eclipse 10 in partial breast irradiation treatments with IMRT; Validacion dosimetrica del sistema de planeacion Eclipse 10 en tratamientos de irradiacion parcial de mama con IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Velazquez T, J. J.; Gutierrez M, J. G.; Ortiz A, C. S.; Chagoya G, A.; Gutierrez C, J. G., E-mail: jvelaesfm@gmail.com [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamentos de Fisica Medica y Radioterapia, Av. Cuauhtemoc 330, 03020 Mexico D. F. (Mexico)

    2015-10-15

    Partial breast irradiation is a new type of external radiation therapy to treat breast cancer in early clinical stages. Consist of administering to the channel surgical high doses of radiation in few treatment sessions. In this paper the dose calculations of the planning system Eclipse version 10 for a treatment of partial breast irradiation with X-rays beams (6 MV) intensity modulated were compared against the measurements made with OSL dosimeters and radio-chromic dye film. An anthropomorphic mannequin was used in which OSL dosimeters were collocated near the surface, an inside the radio-chromic dye film one plate; with this latest one dimensional dose distribution was measured. Previously dosimeters were calibrated irradiating them with a beam of X-rays 6 MV under the conditions specified in the IAEA-398 protocol. The OSL dosimeters were read in the Micro star Landauer equipment, the radio-chromic dye films were read with a scanner Epson 10000-Xl and analyzed with FilmCal and PTW Verisoft programs. The differences between measured and calculated dose were as follows: 3.6±1% for the OSL dosimeter and 96.3±1% of the analyzed points approved the gamma index criterion (3%, 3m m) when comparing the matrices of calculated dose and measured with the radio-chromic dye film. These results confirm the good dosimetric performance of planning system used under specific conditions used in the partial breast irradiation technique. (Author)

  5. Development of examination technique for oxide layer thickness measurement of irradiated fuel rods

    International Nuclear Information System (INIS)

    Koo, D. S.; Park, S. W.; Kim, J. H.; Seo, H. S.; Min, D. K.; Kim, E. K.; Chun, Y. B.; Bang, K. S.

    1999-06-01

    Technique for oxide layer thickness measurement of irradiated fuel rods was developed to measure oxide layer thickness and study characteristic of fuel rods. Oxide layer thickness of irradiated fuels were measured, analyzed. Outer oxide layer thickness of 3 cycle-irradiated fuel rods were 20 - 30 μm, inner oxide layer thickness 0 - 10 μm and inner oxide layer thickness on cracked cladding about 30 μm. Oxide layer thickness of 4 cycle-irradiated fuel rods were about 2 times as thick as those of 1 cycle-irradiated fuel rods. Oxide layer on lower region of irradiated fuel rods was thin and oxide layer from lower region to upper region indicated gradual increase in thickness. Oxide layer thickness from 2500 to 3000 mm showed maximum and oxide layer thickness from 3000 to top region of irradiated fuel rods showed decreasing trend. Inner oxide layer thicknesses of 4 cycle-irradiated fuel rod were about 8 μm at 750 - 3500 mm from the bottom end of fuel rod. Outer oxide layer thickness were about 8 μm at 750 - 1000 mm from the bottom end of fuel rod. These indicated gradual increase up to upper region from the bottom end of fuel rod. These indicated gradual increase up to upper region from the bottom end of fuel. Oxide layer thickness technique will apply safety evaluation and study of reactor fuels. (author). 6 refs., 14 figs

  6. Internal Mammary Lymph Node Irradiation Contributes to Heart Dose in Breast Cancer

    International Nuclear Information System (INIS)

    Chargari, Cyrus; Castadot, Pierre; MacDermed, Dhara; Vandekerkhove, Christophe; Bourgois, Nicolas; Van Houtte, Paul; Magne, Nicolas

    2010-01-01

    We assessed the impact of internal mammary chain radiotherapy (IMC RT) to the radiation dose received by the heart in terms of heart dose-volume histogram (DVH). Thirty-six consecutive breast cancer patients presenting with indications for IMC RT were enrolled in a prospective study. The IMC was treated by a standard conformal RT technique (50 Gy). For each patient, a cardiac DVH was generated by taking into account the sole contribution of IMC RT. Cardiac HDV were compared according to breast cancer laterality and the type of previous surgical procedure, simple mastectomy or breast conservative therapy (BCT). The contribution of IMC RT to the heart dose was significantly greater for patients with left-sided versus right-sided tumors (13.8% and 12.8% for left-sided tumors versus 3.9% and 4.2% for right-sided tumors in the BCT group and the mastectomy group, respectively; p < 0.0001). There was no statistically significant difference in IMC contribution depending on the initial surgical procedure. IMC RT contributes to cardiac dose for both left-sided and right-sided breast cancers, although the relative contribution is greater in patients with left-sided tumors.

  7. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

    International Nuclear Information System (INIS)

    Pashtan, Itai M.; Recht, Abram; Ancukiewicz, Marek; Brachtel, Elena; Abi-Raad, Rita F.; D'Alessandro, Helen A.; Levy, Antonin; Wo, Jennifer Y.; Hirsch, Ariel E.; Kachnic, Lisa A.; Goldberg, Saveli; Specht, Michelle; Gadd, Michelle; Smith, Barbara L.; Powell, Simon N.; Taghian, Alphonse G.

    2012-01-01

    Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.

  8. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Pashtan, Itai M. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Recht, Abram [Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Ancukiewicz, Marek [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Brachtel, Elena [Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts (United States); Abi-Raad, Rita F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); D' Alessandro, Helen A. [Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts (United States); Levy, Antonin; Wo, Jennifer Y. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Hirsch, Ariel E. [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States); Kachnic, Lisa A. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Goldberg, Saveli [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle; Gadd, Michelle; Smith, Barbara L. [Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Powell, Simon N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2012-11-01

    Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.

  9. Alternated Prone and Supine Whole-Breast Irradiation Using IMRT: Setup Precision, Respiratory Movement and Treatment Time

    International Nuclear Information System (INIS)

    Veldeman, Liv; De Gersem, Werner; Speleers, Bruno; Truyens, Bart; Van Greveling, Annick; Van den Broecke, Rudy; De Neve, Wilfried

    2012-01-01

    Purpose: The objective of this study was to compare setup precision, respiration-related breast movement and treatment time between prone and supine positions for whole-breast irradiation. Methods and Materials: Ten patients with early-stage breast carcinoma after breast-conserving surgery were treated with prone and supine whole breast-irradiation in a daily alternating schedule. Setup precision was monitored using cone-beam computed tomography (CBCT) imaging. Respiration-related breast movement in the vertical direction was assessed by magnetic sensors. The time needed for patient setup and for the CBCT procedure, the beam time, and the length of the whole treatment slot were also recorded. Results: Random and systematic errors were not significantly different between positions in individual patients for each of the three axes (left-right, longitudinal, and vertical). Respiration-related movement was smaller in prone position, but about 80% of observations showed amplitudes <1 mm in both positions. Treatment slots were longer in prone position (21.2 ± 2.5 min) than in supine position (19.4 ± 0.8 min; p = 0.044). Conclusion: Comparison of setup precision between prone and supine position in the same patient showed no significant differences in random and systematic errors. Respiratory movement was smaller in prone position. The longer treatment slots in prone position can probably be attributed to the higher repositioning need.

  10. Alternated prone and supine whole-breast irradiation using IMRT: setup precision, respiratory movement and treatment time.

    Science.gov (United States)

    Veldeman, Liv; De Gersem, Werner; Speleers, Bruno; Truyens, Bart; Van Greveling, Annick; Van den Broecke, Rudy; De Neve, Wilfried

    2012-04-01

    The objective of this study was to compare setup precision, respiration-related breast movement and treatment time between prone and supine positions for whole-breast irradiation. Ten patients with early-stage breast carcinoma after breast-conserving surgery were treated with prone and supine whole breast-irradiation in a daily alternating schedule. Setup precision was monitored using cone-beam computed tomography (CBCT) imaging. Respiration-related breast movement in the vertical direction was assessed by magnetic sensors. The time needed for patient setup and for the CBCT procedure, the beam time, and the length of the whole treatment slot were also recorded. Random and systematic errors were not significantly different between positions in individual patients for each of the three axes (left-right, longitudinal, and vertical). Respiration-related movement was smaller in prone position, but about 80% of observations showed amplitudes movement was smaller in prone position. The longer treatment slots in prone position can probably be attributed to the higher repositioning need. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Field in field technique in two-dimensional planning for whole brain irradiation; Tecnica field in field em planejamentos bidimensionais para irradiacao de cerebro total

    Energy Technology Data Exchange (ETDEWEB)

    Castro, A.L.S.; Campos, T.P.R., E-mail: radioterapia.andre@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (Brazil). Departamento de Engenharia Nuclear

    2016-11-01

    Radiotherapy is the most used clinical method used for brain metastases treatment, the most frequent secondary tumors provided by breast, lung and melanomas as primary origin. The protocols often use high daily doses and, depending on the irradiation technique there is high probability of complications in health tissues. In order to minimize adverse effects, it is important the dosimetric analysis of three-dimensional radiotherapy planning through tomographic images or, concerning to the 2D simulations, by the application of techniques that optimize dose distribution by increasing the homogeneity. The study aimed to compare the 2D and 3D conformal planning for total brain irradiation in a individual equivalent situation and evaluate the progress of these planning applying the field in field technique. The methodology consisted of simulating a two-dimensional planning, reproduce it on a set of tomographic images and compare it with the conformal plan for two fields and four fields (field in field). The results showed no significant difference between 2D and 3D planning for whole brain irradiation, and the field in field technique significantly improved the dose distribution in brain volume compared with two fields for the proposal situation. As conclusion, the two-dimensional plane for the four fields described was viable for whole brain irradiation in the treatment of brain metastases at the proposal situation. (author)

  12. Development of small scale mechanical testing techniques on ion beam irradiated 304 SS

    International Nuclear Information System (INIS)

    Reichardt, A.; Abad, M.D.; Hosemann, P.; Lupinacci, A.; Kacher, J.; Minor, A.; Jiao, Z; Chou, P.

    2015-01-01

    Austenitic stainless steels are widely used for structural components in light water reactors, however uncertainty in their susceptibility to irradiation assisted stress corrosion cracking (IASCC) has made long term performance predictions difficult. In addition, the testing of reactor irradiated materials has proven challenging due to the long irradiation times required, limited sample availability, and unwanted activation. To address these problems, we apply recently developed techniques in nano-indentation and micro-compression testing to small volume samples of 10 dpa proton-beam irradiated 304 stainless steel. Cross sectional nano-indentation was performed on both proton beam irradiated and non-irradiated samples at temperatures ranging from 22 to 300 C. degrees to determine the effects of irradiation and operating temperature on hardening. Micro-compression tests using 2 μm x 2 μm x 5 μm focused-ion beam milled pillars were then performed in situ in an electron microscope to allow for a more accurate look at stress-strain behavior along with real-time observations of localized mechanical deformation. Large sudden slip events and significant increase in yield strength are observed in irradiated micro-compression samples at room temperature. Elevated temperature nano-indentation results reveal the possibility of thermally-activated changes in deformation mechanism for irradiated specimens. Since the deformation mechanism information provided by micro-compression testing can provide valuable information about IASCC susceptibility, future work will involve ex situ micro-compression tests at reactor operating temperature

  13. Results of adjuvant therapy in postmastectomy breast patients irradiated at the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw between 1985 and 1994

    International Nuclear Information System (INIS)

    Galecki, J.; Grudzien-Kowalska, M.; Zalucki, W.; Hicer-Grzenkiewicz, J.; Dyttus-Cebulok, K.; Jonska, J.

    2004-01-01

    Between the years 1985 and 1994 at the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw two radiotherapy techniques were used in the case of postmastectomy breast cancer patients. In technique 'A', in order to limit cardiotoxicity, peripheral nodes only were irradiated, in technique 'B' the chest wall was additionally treated. Usually technique 'B' was chosen in more advanced cases, but generally the selection of the technique was left to the discretion of the attending physician.To estimate disease free survival (DFS) and overall survival (OS) with regard to prognostic factors, to evaluate locoregional failures as related to the radiotherapy technique and to assess early and late morbidity. The retrospective analysis included 507 postmastectomy patients consecutively irradiated for breast cancer in stage IA - III B. Median age was 57 years. Median follow-up was 10 years. The incidence of patients with pN1 stage was 90% and with pN0 10%. We applied a total dose of 50 Gy in 25 fractions, over 5 weeks, with Co 60 to the supraclavicular area, axillary and internal mammary nodes. The chest wall was irradiated with electrons to a total dose of 46 Gy at 90% isodose in 23 fractions over 5 weeks. Three-dimensional treatment planning of the chest wall was used. Technique 'A' and 'B' were used in 62% and 38% of patients, respectively. Simultaneously with radiotherapy 67% of patients received chemotherapy (CMF), and/or hormonotherapy (tamoxifen). In 33% of patients no systemic treatment was administered. We analysed the influence of the following prognostic factors: age and hormonal status, additional diseases, duration of symptoms before treatment, breast laterality, T-stage, breast tumour location, carcinoma type, tumour grade, nodal index, extranodal extension and vascular invasion on disease free survival (DFS) and overall survival (OS); in a univariate analysis with the Kaplan-Meier method and in a multivariate analysis with the Cox

  14. Predictors of Local Recurrence Following Accelerated Partial Breast Irradiation: A Pooled Analysis

    International Nuclear Information System (INIS)

    Shah, Chirag; Wilkinson, John Ben; Lyden, Maureen; Beitsch, Peter; Vicini, Frank A.

    2012-01-01

    Purpose: To analyze a pooled set of nearly 2,000 patients treated on the American Society of Breast Surgeons (ASBS) Mammosite Registry Trial and at William Beaumont Hospital (WBH) to identify factors associated with local recurrence following accelerated partial breast irradiation (APBI). Methods and Materials: A total of 1,961 women underwent partial breast irradiation between April 1993 and November 2010 as part of the ASBS Registry Trial or at WBH. Rates of ipsilateral breast tumor recurrence (IBTR), regional recurrence (RR), distant metastases (DM), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS) were analyzed for each group and for the pooled cohort. Clinical, pathologic, and treatment-related variables were analyzed including age, tumor stage/size, estrogen receptor status, surgical margins, and lymph node status to determine their association with IBTR. Results: The two groups weres similar, but WBH patients were more frequently node positive, had positive margins, and were less likely to be within the American Society for Radiation Oncology-unsuitable group. At 5 years, the rates of IBTR, RR, DM, DFS, CSS, and OS for the pooled group of patients were 2.9%, 0.5%, 2.4%, 89.1%, 98.5%, and 91.8%, respectively. The 5-year rate of true recurrence/marginal miss was 0.8%. Univariate analysis of IBTR found that negative estrogen receptor status (odds ratio [OR], 2.83, 95% confidence interval 1.55–5.13, p = 0.0007) was the only factor significantly associated with IBTR, while a trend was seen for age less than 50 (OR 1.80, 95% confidence interval 0.90–3.58, p = 0.10). Conclusions: Excellent 5-year outcomes were seen following APBI in over 1,900 patients. Estrogen receptor negativity was the only factor associated with IBTR, while a trend for age less than 50 was noted. Significant differences in factors associated with IBTR were noted between cohorts, suggesting that factors driving IBTR may be predicated based on the risk

  15. Validity of PRV margins around lung and heart during left breast irradiation

    International Nuclear Information System (INIS)

    Stefanovski, Zoran

    2010-01-01

    Planning organ at risk volumes (PRV) has a minor use in radiotherapy treatment planning. During left breast irradiation two critical volumes are of special importance the lung and the heart. The aim of this study was to evaluate the changes in volume doses after adding appropriate margins around these organs at risk and compare them with the effect that the systematic positioning error has on the volume doses. Methods: Treatment plans for 44 patients with left breast cancer were analyzed. Two changes for each plan were made, and dose-volume histogram values for hearts and lungs volumes were recorded. In the first case margins of 5 mm to hearts and lungs were added. Volumes that were enclosed by 30% isodose for hearts and volumes that were enclosed by 20% isodose of lungs were recorded. In the second case plans were made with a systematic error of 5 mm employed, depicting a translation of isocenter posterior and to the right. In this second case, monitor units were taken from the original plan. The critical volumes for hearts and lungs were recorded as in the first case. Results: Our policy for breast cancer irradiation demands that the lung volume receiving 20 Gy should be kept under 25% of the whole left-lung volume, and no more than 10% of the heart volume should receive more than 30 Gy. The first case simulation showed that 23% of the patients have a heart overdose while 11% of them have a lung overdose according to the criteria above. Simulation of the second kind showed that the systematic error in isocenter positioning of 5 mm gives bigger a volume of the heart (in average 0.69% of heart volume) to be enclosed in critical isodose than in PRV case. For the lung the situation was opposite; namely in PRV case the lung volume that is encompassed with critical isodose is greater (in average 1.47% of lung volume) than in a case of displaced isocenter. Conclusions: Adding PRV margins around the heart and the lung does not give straightforward and unambiguous result

  16. Impact of setup variability on incidental lung irradiation during tangential breast treatment

    International Nuclear Information System (INIS)

    Carter, D.C.; Marks, L.B.; Bentel, G.B.

    1995-01-01

    Purpose: 1) To determine the variability in treatment setup during a 5 week course of tangential breast treatment. 2) To assess the relationship between the height of the lung shadow at the central axis (Central Lung Distance: CLD) on the tangential port film and the percent of total lung volume included within the tangential fields (to verify the previously reported result from Bornstein, et al, IJROBP 18:181, 90). 3) To determine the impact of the variabilities in treatment setup on the volume of lung that is incidentally included within the radiation fields. Methods: 1) 172 port films of tangential breast/chest wall fields were reviewed from 20 patients who received tangential beam treatment for breast cancer. All patients were immobilized in customized hemibody foam cradles during simulation and treatment. The CLD (height of the lung shadow at the central axis) seen on each of the port films was compared to the corresponding simulator film (correcting for differences in magnification) as an assessment of setup variability. Both inter and intrapatient differences were considered. 2) A three-dimensional dose calculation (reflecting lung density) was performed, and the percent of total lung volume within the field was compared to the CLD. 3) The three-dimensional dose calculation was repeated for selected patients with the location of the treatment beams modified to reflect typical setup variations, in order to assess the impact of this variability on the volume of lung irradiated. Results: 1) The CLD measured on the port films was within 3 mm of that prescribed on the simulator film in 43% ((74(172))) of the port films. The variation was 3-5 mm in 26 %, 5-10 mm in 25 % and > 10 mm in 6 %. The data are shown in Figure 1. 2) There was an excellent correlation found between the height of the lung shadow and the percent of total lung volume seen within the radiation field, (Figure 2), thus verifying the concept previously reported by Bornstein. 3) A 1 cm setup

  17. Comparison of a new noncoplanar intensity-modulated radiation therapy technique for craniospinal irradiation with 3 coplanar techniques

    DEFF Research Database (Denmark)

    Hansen, Anders T; Lukacova, Slavka; Lassen-Ramshad, Yasmin A.

    2015-01-01

    When standard conformal x-ray technique for craniospinal irradiation is used, it is a challenge to achieve satisfactory dose coverage of the target including the area of the cribriform plate, while sparing organs at risk. We present a new intensity-modulated radiation therapy (IMRT), noncoplanar...... patient using the noncoplanar IMRT-based technique, a coplanar IMRT-based technique, and a coplanar volumetric-modulated arch therapy (VMAT) technique. Dosimetry data for all patients were compared with the corresponding data from the conventional treatment plans. The new noncoplanar IMRT technique...... substantially reduced the mean dose to organs at risk compared with the standard radiation technique. The 2 other coplanar techniques also reduced the mean dose to some of the critical organs. However, this reduction was not as substantial as the reduction obtained by the noncoplanar technique. Furthermore...

  18. Detection of irradiated poultry products using the direct epifluorescence filter technique

    International Nuclear Information System (INIS)

    Copin, M.P.; Bourgeois, C.

    1992-01-01

    Food irradiation has developed during the last few years. Nevertheless this development would be larger if there was a recognized method to detect whether a foodstuff had been irradiated. BETTS et al. (1988) suggested a method based on the comparison of an aerobic plate count (APC) with a count obtained using the Direct Epifluorescence Filter Technique (DEFT). They showed that the APC of an irradiated product was considerably lower than that obtained by the DEFT; in this case the DEFT count gave an indication of the number of viable microbial population in the product before irradiation; the APC of a non irradiated product was very well correlated with the DEFT count. In the present work both methods were tested on deep frozen mechanically deboned chicken meat (MDCM) and fresh chicken meat. The fluorochrome used for the DEFT was acridine orange; the mesophilic microflora was counted on 'Plate Count Agar'. According to the results obtained with the deep frozen MDCM, aerobic plate counts and DEFT counts are very similar during 100 days of storage when the product has not been irradiated; if it has been irradiated the difference between the two counts is high (about two logarithmic units). With this method it is thus possible to detect an irradiated product and to know the number of viable microbial cells in the irradiated product before the treatment. The method was tested on fresh chicken meat stored at 4 deg C. At the beginning of the storage period, it is possible to detect irradiated products, but at the end the method fails. In the latter case, irradiation can be detected, but it would be impossible to say that a product had not been irradiated. This method is potentially applicable to deep frozen products, more than to fresh products

  19. Comparison of elective inguinal node irradiation techniques in anal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  20. Comparison of elective inguinal node irradiation techniques in anal cancer

    International Nuclear Information System (INIS)

    Cha, Ji Hye; Seong, Jin Sil; Keum, Ki Chang; Lee, Chang Geol; Koom, Woong Sub

    2011-01-01

    To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.

  1. The technique of craniospinal irradiation of paediatric patients in supine position

    International Nuclear Information System (INIS)

    Slampa, P.; Seneklova, Z.; Simicek, J.; Soumarova, R.; Burkon, P.; Burianova, L.

    2001-01-01

    Background. Postoperative radiation therapy has significant impact on local control and overall survival of paediatric patients with brain tumours but an irradiated volume is often a controversial issue. Our aim was to describe a new technique of craniospinal irradiation as a postoperative treatment in patients with the risk of relapse of brain tumours as well as to estimate the side effects of such craniospinal irradiation. Patients and methods. In the last 4 years, 17 paediatric patients under 15 years of age with medulloblastoma (8) ependymoma (6) and glioblastoma (3) received postoperative craniospinal axis radiotherapy by a new technique developed in our departments. This technique is based on irradiation in supine position with the use of asymmetric jaws of the linear accelerator. Results. Radiotherapy was well tolerated and dose-reduction was not needed in any case. Skin reactions were mild in all patients. The gastrointestinal and haematological toxicity was mild to moderate (WHO grade I-II). Conclusion. The proposed new technique of craniospinal irradiation is advantageous in terms of side effects and could be recommended to be widely used. Craniospinal irradiation in supine position is an alternative method to the treatment in prone position. The evaluation of the effectiveness was limited by a short follow-up interval. (author)

  2. Imaging techniques in the diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Mueller, T.; Stotzka, R.; Neiber, H.J.; Eppler, W.; Gemmeke, H.

    2000-01-01

    Breast cancer is a frequent cause for death of women in the western world. Detection of anomalies in early pathological stages and immediate treatment are essential for successful cure. Early stages of breast cancer are indicated by the occurance of microcalcifications. Their shape and spatial arrangement are of high diagnostic value. The process of recognition and three-dimensional reconstruction of clustered microcalcifications requires a good expert knowledge and a high abstract imagination capability. Therefore, it is useful to detect calcifications automatically in mammograms and present their spatial relationship in an animated 3D-model. This automatic process is done in a mammography workstation with the objective not to replace a medical doctor but to provide a second expert opinion. This will lead to a more reliable diagnosis. (orig.)

  3. Refrigerated poultry breast fillets packed in modified atmosphere and irradiated: bacteriological evaluation, shelf life and sensory acceptance

    Directory of Open Access Journals (Sweden)

    Samira Pirola Santos Mantilla

    2012-12-01

    Full Text Available In the present study the effects on shelf life and sensory acceptance of gamma-irradiated refrigerated poultry breast fillets subjected to modified atmosphere packaging (80% CO2/20% N2 or vacuum were investigated. After irradiation with 2 kGy, sensory acceptance tests and monitoring of bacterial growth were performed in order to determine the sanitary quality of the samples. It has been found that irradiation, used in combination with modified atmosphere packaging, can double the shelf life of refrigerated poultry breast fillets by reducing the populations of aerobic mesophilic and psychrotrophic bacteria, enterobacteria, coliforms, Listeria spp. and Aeromonas spp., without significantly modifying its color or its overall appearance, the lactic acid bacteria being the most resistant to exposure to radiation and carbon dioxide.

  4. Trace elemental correlation study in malignant and normal breast tissue by PIXE technique

    International Nuclear Information System (INIS)

    Raju, G.J. Naga; Sarita, P.; Kumar, M. Ravi; Murty, G.A.V. Ramana; Reddy, B. Seetharami; Lakshminarayana, S.; Vijayan, V.; Lakshmi, P.V.B. Rama; Gavarasana, Satyanarayana; Reddy, S. Bhuloka

    2006-01-01

    Particle induced X-ray emission technique was used to study the variations in trace elemental concentrations between normal and malignant human breast tissue specimens and to understand the effects of altered homeostasis of these elements in the etiology of breast cancer. A 3 MeV proton beam was used to excite the biological samples of normal and malignant breast tissues. The elements Cl, K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Br, Rb and Sr were identified and their relative concentrations were estimated. Almost all the elements were found to be elevated (p < 0.05, Wilcoxon signed-ranks test) in the cancerous tissues when compared with normal tissues. The excess levels of trace elements observed in the cancerous breast tissues could either be a cause or a consequence of breast cancer. Regarding their role in the initiation or promotion of breast cancer, one possible interpretation is that the elevated levels of Cu, Fe and Cr could have led to the formation of free radicals or other reactive oxygen species (ROS) that adversely affect DNA thereby causing breast cancer, which is mainly attributed to genetic abnormalities. Moreover, since Cu and Fe are required for angiogenesis, elevated concentrations of these elements are likely to promote breast cancer by increasing the blood supply for tumor growth. On the other hand elevated concentrations of elements in breast cancer tissues might also be a consequence of the cancer. This can be understood in terms of the biochemical and histological differences between normal and cancerous breast tissues. Tumors, characterized by unregulated multiplication of cells, need an ever-increasing supply of essential nutrients including trace elements. This probably results in an increased vascularity of malignant tissues, which in turn leads to enhancement of elemental concentrations in tumors

  5. Irradiation mutation techniques combined with biotechnology for soybean breeding

    International Nuclear Information System (INIS)

    Wang Lianzheng; Wang Lan; Zhao Rongjuan; Pei Yanlong; Fu Yuqing; Yan Qingshang; Li Qiang

    2001-01-01

    By using 60 Co γ-irradiation to 30 adapted Chinese cultivars of soybean and selection of high yield, good quality, early maturity resistance to diseases and insects, several lines have been evaluated as good lines over the control, Zhonghuang 4, an important soybean variety in Beijing area. After 10 generations of individual selection, 5 high yield mutants are obtained and l ∼ 2 mutants from these mutants will be released in 2001. 3 mutants selected have the crude oil content of over 22.00%. The crude oil content of 397-2 is 23.52% and the crude protein content of 348-4 is 47.67%. 30 lines were evaluated for their genetic transformation ability and Heinong 35 has been identified as very suitable material for genetic transformation. (authors)

  6. A New Technique for Whole Craniospinal Irradiation (WCSI)

    International Nuclear Information System (INIS)

    Chang, Hye Sook

    1991-01-01

    To irradiate the entire neuroaxis, bilateral parallel opposed brain fields and direct posterior spinal field have been utilized and radiation dose at the junction between abutting fields has been extensilvely studied. And several workable methods were reported to achieve uniform dose at a desired depth at the junction between abutting fields whose central axis are coplanar. But the dose distribution at the junction of orthogonal fields has been a persistent problem in radiation oncology. Author describes a new method to solve the junction problem between abutting fields whose central axis are orthogonal. Author utilized split beam/collimator rotation or collimator/couch rotation to avoid hot or cold spots that may arise from beam divergence. Author achieved accurate and homogeneous dose distribution by matching the 50% isodose line at the junction between orthogonal central axis beam fields

  7. Material irradiation techniques used in corrosion and wear analysis

    International Nuclear Information System (INIS)

    Tenreiro, Claudio

    1996-01-01

    Full text: Nuclear physics methods, applied to material analysis are discussed and some application examples are given. Experiments have been performed to study corrosion du to the presence of humidity and sulfur compounds. The use of resonant reactors allows the determination of depth profiles of H and S from structures located in particularly contaminated areas. The method provides a non destructive and quick way of estimating the effect of such elements in different types of structures, such as the ones used in high voltage transmission lines. Also the wear out rates in mechanical engine components having a difficult direct access, have been evaluated by proton activation analysis. The evaluation of the advantages of this method is being done. The effect of irradiation damage on superconducting high temperature ceramics was analyzed by the interaction of energetic alpha particles with high T c YBaCuO samples

  8. Irradiation of dates: insect disinfestation, microbial and chemical assessments, and use of thermoluminescence technique

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kahtani, Hassan A.; Abu-Tarboush, Hamza M.; Ahmed, Mohamed A.; Bajaber, Adnan S. [Food Science and Nutrition Department, College of Agriculture, King Saud University, Riyadh (Saudi Arabia); Al-Dryhim, Yousif N.; Adam, El-Shami E. [Plant Protection Department, College of Agriculture, King Saud University, Riyadh (Saudi Arabia); El-Mojaddidi, Mohamed A. [King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia)

    1998-08-01

    Irradiation of dates (Khalas variety) at 0.9 kGy was sufficient to eliminate single insect infestation (Oryzaephilus surinamensis) and mixed infestation (O. surinamensis and Tribolium castaneum), whereas 0.3 kGy was effective only in controlling single infestation. Sensory properties were not affected but irradiation contributed to some reduction in microbial counts immediately after irradiation and counts remained low till the end of 6 months storage period. All sugars were significantly reduced immediately after irradiation but they increased gradually with increasing storage time. Thermoluminescence (TL) technique was useful in discriminating between irradiated and unirradiated dates during the entire storage period but was less sensitive as far as the dose estimation is concerned.

  9. Irradiation of dates: insect disinfestation, microbial and chemical assessments, and use of thermoluminescence technique

    International Nuclear Information System (INIS)

    Al-Kahtani, Hassan A.; Abu-Tarboush, Hamza M.; Ahmed, Mohamed A.; Bajaber, Adnan S.; Al-Dryhim, Yousif N.; Adam, El-Shami E.; El-Mojaddidi, Mohamed A.

    1998-01-01

    Irradiation of dates (Khalas variety) at 0.9 kGy was sufficient to eliminate single insect infestation (Oryzaephilus surinamensis) and mixed infestation (O. surinamensis and Tribolium castaneum), whereas 0.3 kGy was effective only in controlling single infestation. Sensory properties were not affected but irradiation contributed to some reduction in microbial counts immediately after irradiation and counts remained low till the end of 6 months storage period. All sugars were significantly reduced immediately after irradiation but they increased gradually with increasing storage time. Thermoluminescence (TL) technique was useful in discriminating between irradiated and unirradiated dates during the entire storage period but was less sensitive as far as the dose estimation is concerned

  10. Treatment of early stage breast cancer by limited surgery and radical irradiation

    International Nuclear Information System (INIS)

    Chu, A.M.; Cope, O.; Russo, R.; Wang, C.C.; Schulz, M.D.; Wang, C.; Rodkey, G.

    1980-01-01

    Eighty-five female patients with early stage breast cancer, i.e., Stage I and II were treated by limited surgery followed by radical radiation therapy at Massachusetts General Hospital between January, 1956 and December, 1974. Patients included those who were medically inoperable or who refused mastectomy. The 5-year survival rate was 83% and 76% for Stage I and II, respectively. The corresponding disease free survival (absolute) was 67% and 42%. Although the number of patients so treated is small, there was no significant difference in survival from the results of the radical mastectomy series at the same institution. No major complications were encountered. Seventeen of eighty-five patients developed minor problems; mostly fibrosis and minimal arm lymphedema stemmming from older orthovoltage equipment and treatment techniques. With the current availability of megavoltage equipment, improvements in techniques and dosimetry, complications should decrease. Combined limited surgery and radical radiation therapy should be considered in those patients where a radical mastectomy is not feasible because of psychological or medical problems. Since this procedure results in a cosmetically acceptable breast, radical radiation in early stage breast cancer seems a reasonable alternative to radical mastectomy

  11. Modification of the radiological technique of Parma for reduction of irradiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Stampfel, G.; Ionesco-Farco, F.

    1982-04-01

    A modified radiological technique to demonstrate the temporo-mandibular joint is presented. An ordinary X-ray tube put on the skin is directed 10/sup 0/ dorso-ventrally and 10/sup 0/ caudo-cranially to the temporo-mandibular joint. The irradiation skin dose applied is ten times smaller than by using the conventional contact technique.

  12. A New Technique for SET Pulse Width Measurement in Chains of Inverters Using Pulsed Laser Irradiation

    International Nuclear Information System (INIS)

    Ferlet-Cavrois, V.; Fel, N.; Gaillardin, M.; Baggio, J.; Girard, S.; Flament, O.; Paillet, P.; McMorrow, D.; Melinger, J. S.; Kobayashi, D.; Hirose, K.; Saito, H.; Pouget, V.; Essely, F.; Schwank, J. R.; Flores, R. S.; Dodd, P. E.; Shaneyfelt, M. R.

    2009-01-01

    A new technique is developed to measure precisely and accurately the width of propagating voltage transients induced by irradiation of inverter chains. The technique is based on measurement of the supply current in a detection inverter, and permits a direct determination of the transient width with a 50 GHz bandwidth. (authors)

  13. Enhancing breast projection in autologous reconstruction using the St Andrew's coning technique and 3D volumetric analysis.

    Science.gov (United States)

    Chae, Michael P; Rozen, Warren Matthew; Patel, Nakul Gamanlal; Hunter-Smith, David J; Ramakrishnan, Venkat

    2017-12-01

    An increasing number of women undergo mastectomy for breast cancer and post-mastectomy autologous breast reconstruction has been shown to significantly improve the psychosexual wellbeing of the patients. A goal of treatment is to achieve symmetry and projection to match the native breast, and/or the contralateral breast in the case of a unilateral reconstruction. Autologous reconstruction, particularly with the deep inferior epigastric artery perforator (DIEP) flap, is particularly advantageous as it can be manipulated to mimic the shape and turgor of the native breast. However, very few techniques of shaping the breast conus when insetting the DIEP flap to enhance aesthetic outcome have been reported to date. With the aide of three-dimension (3D) photography and 3D-printed mirrored image of the contralateral breast as a guide intraoperatively, we describe our St Andrew's coning technique to create a personalized flap projection. We report a prospective case series of 3 delayed unilateral breast reconstructions where symmetrization procedure to the contralateral breast was not indicated. Using a commercial 3D scanner (VECTRA XR, Canfield Scientific), the breast region was imaged. The mirrored image was 3D-printed in-house using a desktop 3D printer. In all cases, projection of the breast mound was able to be safely achieved, with a demonstrated central volume (or 'cone') able to be highlighted on imaging and a 3D printed breast. A 3D print of the contralateral breast was able to be used intraoperatively to guide the operative approach. The St Andrew's coning technique is a useful aesthetic maneuver for achieving breast projection during DIEP flap breast reconstruction, with 3D imaging techniques able to assist in perioperative assessment of breast volume.

  14. Irradiation techniques for the release of bound heavy metals in natural waters and blood

    International Nuclear Information System (INIS)

    Batley, G.E.; Farrar, Y.J.

    1978-01-01

    Irradiation techniques are compared with conventional acid digestion procedures for the release of bound heavy metals in natural waters and in blood, before their determination by anodic stripping voltammetry. Ultra-violet irradiation of acidified water with a 550-W mercury vapour lamp releases bound zinc, cadmium, lead and copper after 4 h. The same results can be achieved with a 30 Mrad dose of high-energy γ-irradiation. These techniques are also effective for the release of metals in whole blood and blood plasma, where sample volumes as small as 200 μl are adequate in analyses for zinc, copper and lead. By comparison with acid digestion and solvent extraction methods, irradiation treatments offer the advantages of minimum sample manipulation and negligible reagent blanks. (Auth.)

  15. Irradiation of head-and-neck tumors with intensity modulated radiotherapy (IMRT). Comparison between two IMRT techniques with 3D conformal irradiation

    International Nuclear Information System (INIS)

    Heeger, Jonas

    2013-01-01

    For 12 patients with inoperable head-neck carcinoma that were treated with 3D conformal irradiation techniques additional irradiation plans using IMRT were developed. It was shown that the IMRT techniques are superior to the 3D conformal technique. The new rapid arc technique is unclear with respect to the critical organs (parotid glands, spinal canal and mandibles) but is significantly advantageous for the other normal tissue with respect to conformity (steeper dose gradients) and thus radiation dose reduction. The resulting lower irradiation time and the reduced radiation exposure being important for the treatment economy and patients' comfort should favor the more planning intensive rapid arc technique.

  16. SU-F-T-650: The Comparison of Robotic Partial Breast Stereotactic Irradiation Using MLC Vs. Iris Cone

    Energy Technology Data Exchange (ETDEWEB)

    Ding, C; Timmerman, R; Jiang, S; Rahimi, A [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: To evaluate the dosimetric impact on treatment planning for partial breast stereotactic irradiation using Cyberknife with MLC versus Iris Cone. Methods: Ten patients whom underwent lumpectomy for DCIS or stage I invasive non-lobular epithelial breast cancer were included in this study. All patients were previously treated on the Cyberknife using Iris cone with the prescription dose of 37.5Gy in 5 fractions covering at least 95% of PTV on our phase I SBRT 5 fraction partial breast irradiation trial. Retrospectively, treatment planning was performed and compared using the new Cyberknife M6 MLC system for each patient. Using the same contours and critical organ constraints for both MLC and Iris cone plans, the dose on target and critical organs were analyzed accordingly. Results: Dose to critical organs such as ipsilateral lung, contralateral lung, heart, skin, ipsilateral breast, and rib were analyzed, as well as conformity index and high dose spillage of the target area. In 9 of 10 patients, the MLC plans had less total ipsilateral breast volume encompassing the 50% prescription isodose (mean:22.3±8.2% MLC vs. 31.6±8.0 Iris, p=0.00014) .The MLC plans mean estimated treatment delivery time was significantly less than the Iris plans (51±3.9min vs. 56.2±9min, p=0.03) Both MLC and Iris cone plans were able to meet all dose constraints and there was no statistical difference between those dose constraints. Conclusion: Both MLC and Iris Cone can deliver conformal dose to a partial breast target and satisfy the dose constraints of critical organs. The new Cyberknife with MLC can deliver a more conformal dose in the lower dose region and spare more ipsilateral breast tissue to the 50% prescription isodose. The treatment time for partial breast SBRT plans was also reduced using MLC. Project receives research support from Accuray Inc.

  17. Refractive index dispersion of swift heavy ion irradiated BFO thin films using Surface Plasmon Resonance technique

    Science.gov (United States)

    Paliwal, Ayushi; Sharma, Savita; Tomar, Monika; Singh, Fouran; Gupta, Vinay

    2016-07-01

    Swift heavy ion irradiation (SHI) is an effective technique to induce defects for possible modifications in the material properties. There is growing interest in studying the optical properties of multiferroic BiFeO3 (BFO) thin films for optoelectronic applications. In the present work, BFO thin films were prepared by sol-gel spin coating technique and were irradiated using the 15 UD Pelletron accelerator with 100 MeV Au9+ ions at a fluence of 1 × 1012 ions cm-2. The as-grown films became rough and porous on ion irradiation. Surface Plasmon Resonance (SPR) technique has been identified as a highly sensitive and powerful technique for studying the optical properties of a dielectric material. Optical properties of BFO thin films, before and after irradiation were studied using SPR technique in Otto configuration. Refractive index is found to be decreasing from 2.27 to 2.14 on ion irradiation at a wavelength of 633 nm. Refractive index dispersion of BFO thin film (from 405 nm to 633 nm) before and after ion radiation was examined.

  18. Dosimetric comparison of treatment planning systems in irradiation of breast with tangential fields

    International Nuclear Information System (INIS)

    Cheng, C.-W.; Das, Indra J.; Tang, Walter; Chang Sha; Tsai, J.-S.; Ceberg, Crister; Gaspie, Barbara de; Singh, Rajinder; Fein, Douglas A.; Fowble, Barbara

    1997-01-01

    Purpose: The objectives of this study are: (1) to investigate the dosimetric differences of the different treatment planning systems (TPS) in breast irradiation with tangential fields, and (2) to study the effect of beam characteristics on dose distributions in tangential breast irradiation with 6 MV linear accelerators from different manufacturers. Methods and Materials: Nine commercial and two university-based TPS are evaluated in this study. The computed tomographic scan of three representative patients, labeled as 'small', 'medium' and 'large' based on their respective chest wall separations in the central axis plane (CAX) were used. For each patient, the tangential fields were set up in each TPS. The CAX distribution was optimized separately with lung correction, for each TPS based on the same set of optimization conditions. The isodose distributions in two other off-axis planes, one 6 cm cephalic and the other 6 cm caudal to the CAX plane were also computed. To investigate the effect of beam characteristics on dose distributions, a three-dimensional TPS was used to calculate the isodose distributions for three different linear accelerators, the Varian Clinac 6/100, the Siemens MD2 and the Philips SL/7 for the three patients. In addition, dose distributions obtained with 6 MV X-rays from two different accelerators, the Varian Clinac 6/100 and the Varian 2100C, were compared. Results: For all TPS, the dose distributions in all three planes agreed qualitatively to within ± 5% for the 'small' and the 'medium' patients. For the 'large' patient, all TPS agreed to within ± 4% on the CAX plane. The isodose distributions in the caudal plane differed by ± 5% among all TPS. In the cephalic plane in which the patient separation is much larger than that in the CAX plane, six TPS correctly calculated the dose distribution showing a cold spot in the center of the breast contour. The other five TPS showed that the center of the breast received adequate dose. Isodose

  19. Dosimetric effects of an air cavity for the SAVI partial breast irradiation applicator

    Energy Technology Data Exchange (ETDEWEB)

    Richardson, Susan L.; Pino, Ramiro [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Department of Radiation Oncology, Methodist Hospital, Houston, Texas 77030 and Texas Cancer Clinic, San Antonio, Texas 78240 (United States)

    2010-08-15

    Purpose: To investigate the dosimetric effect of the air inside the SAVI partial breast irradiation device. Methods: The authors have investigated how the air inside the SAVI partial breast irradiation device changes the delivered dose from the homogeneously calculated dose. Measurements were made with the device filled with air and water to allow comparison to a homogenous dose calculation done by the treatment planning system. Measurements were made with an ion chamber, TLDs, and film. Monte Carlo (MC) simulations of the experiment were done using the EGSnrc suite. The MC model was validated by comparing the water-filled calculations to those from a commercial treatment planning system. Results: The magnitude of the dosimetric effect depends on the size of the cavity, the arrangement of sources, and the relative dwell times. For a simple case using only the central catheter of the largest device, MC results indicate that the dose at the prescription point 1 cm away from the air-water boundary is about 9% higher than the homogeneous calculation. Independent measurements in a water phantom with a similar air cavity gave comparable results. MC simulation of a realistic multidwell position plan showed discrepancies of about 5% on average at the prescription point for the largest device. Conclusions: The dosimetric effect of the air cavity is in the range of 3%-9%. Unless a heterogeneous dose calculation algorithm is used, users should be aware of the possibility of small treatment planning dose errors for this device and make modifications to the treatment delivery, if necessary.

  20. Correlation between atopic manifestation and lung toxicity following chest irradiation for breast cancer

    International Nuclear Information System (INIS)

    Hirota, Saeko; Shimizu, Tadafumi; Kubota, Satoshi

    2007-01-01

    The purpose of this study was to identify the impact of atopic manifestations on the occurrence of the lung toxicity following chest irradiation for breast cancer. Collection of 1,173 patients who had undergone radiotherapy on their 1,177 chest walls or postsurgical mammary glands at 9 institutions including ours. They received treatment consecutively from December 1980 through October 2005, with which we formed the basis of this analysis. Patients with any of the following medical history were defined as having atopic manifestations (n=111): asthma, allergic rhinitis, atopic dermatitis, contact dermatitis, and allergy to food or drug. Of them, patients who were observed for at least 6 months or who suffered from lung toxicity at any time, were classified as Group A (n=85). On the other hand, patients in our institute who were observed for at least 6 months or who suffered from lung toxicity at any time regardless of atopic manifestations, were classified as Group B (n=113), and patients without any atopic manifestation were classified as Group C (n=92). Grade 3 or higher lung toxicity in National Cancer Institute, Common Toxicity Criteria for Adverse Events (NCI-CTCAE) (v 3.0), occurred in 8.2%, id est (i.e.) 7 cases, of Group A, 2.7% of Group B, and 1.1% of Group C (p=0.0293 Group C against Group A). Three cases were classified as classical pneumonitis, and the other 4 sporadic pneumonitis such as Cryptogenic Organizing Pneumonia and Chronic Eosinophilic Pneumonia. Both of the histologically proven COP and CEP patients showed atopic manifestations in our institute. The detail clinical features are described in the main text. Having atopic manifestations suggests that there may be risk of lung toxicity following chest irradiation for breast cancer. (author)

  1. Development of heavy-ion irradiation technique for single-event in semiconductor devices

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Norio; Akutsu, Takao; Matsuda, Sumio [National Space Development Agency of Japan, Tsukuba, Ibaraki (Japan). Tsukuba Space Center; Naitoh, Ichiro; Itoh, Hisayoshi; Agematsu, Takashi; Kamiya, Tomihiro; Nashiyama, Isamu

    1997-03-01

    Heavy-ion irradiation technique has been developed for the evaluation of single-event effects on semiconductor devices. For the uniform irradiation of high energy heavy ions to device samples, we have designed and installed a magnetic beam-scanning system in a JAERI cyclotron beam course. It was found that scanned area was approximately 4 x 2 centimeters and that the deviation of ion fluence from the average value was less than 7%. (author)

  2. The evaluation of the irradiation of medical team in critical X-ray diagnostic techniques

    Energy Technology Data Exchange (ETDEWEB)

    Markovic, S; Pavlovic, R [Inst. of Nuclear Science Vinca, Belgrade (Yugoslavia). Radiation and Environmental Protection Lab.; Boreli, F [Fac. of Electrical Engineering, Belgrade (Yugoslavia)

    1996-12-31

    A good realized assessment of the irradiation for any exposed group of population serves as the base for the radiation protection measures (emergency radiation preparedness, radiation protection optimization etc.). This is especially important, by the radiation protection point of view, in contrast X-ray diagnostic techniques - angiographies. This paper presents the way for the realization of the medical team irradiation assessment, based on originally derived simple equations for the scattered radiation field around patient. (author) 1 fig., 3 figs.

  3. The application of irradiation techniques for food preservation and processing improvement

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Myung Woo; Cho, Han Ok; Jo, Sung Ki; Yook, Hong Sun; Kwon, Oh Jin; Yang, Jae Seung; Kim, Sung; Im, Sung Il

    1997-09-01

    This project has intended to develop alternative techniques to be used in food industry for food processing and utilization by safe irradiation methods. For improvement of rheology and processing in corn starch by irradiation, the production of modified starch with low viscosity as well as with excellent viscosity stability became feasible by the control of gamma irradiation dose levels and the amount of added inorganic peroxides to starch. Also, this project was developed the improvement methods of hygienic quality and long-term storage of dried red pepper by gamma irradiation. And, in Korean medicinal plants, 10 kGy gamma irradiation was effective for improving sanitary quality and increasing extraction yield of major components. For the sanitization of health and convenience foods, gamma irradiation was more effective than ozone treatment in decontamination of microorganisms, with minimal effect on the physicochemical properties analysed. In evaluation of wholesomeness, gamma-irradiated the Korean medicinal plants could be safe on the genotoxic point of view. And, thirteen groups of irradiated foods approved for human consumption from Korea Ministry of Health and Welfare. (author). 81 refs., 74 tabs.

  4. The application of irradiation techniques for food preservation and processing improvement

    International Nuclear Information System (INIS)

    Byun, Myung Woo; Cho, Han Ok; Jo, Sung Ki; Yook, Hong Sun; Kwon, Oh Jin; Yang, Jae Seung; Kim, Sung; Im, Sung Il.

    1997-09-01

    This project has intended to develop alternative techniques to be used in food industry for food processing and utilization by safe irradiation methods. For improvement of rheology and processing in corn starch by irradiation, the production of modified starch with low viscosity as well as with excellent viscosity stability became feasible by the control of gamma irradiation dose levels and the amount of added inorganic peroxides to starch. Also, this project was developed the improvement methods of hygienic quality and long-term storage of dried red pepper by gamma irradiation. And, in Korean medicinal plants, 10 kGy gamma irradiation was effective for improving sanitary quality and increasing extraction yield of major components. For the sanitization of health and convenience foods, gamma irradiation was more effective than ozone treatment in decontamination of microorganisms, with minimal effect on the physicochemical properties analysed. In evaluation of wholesomeness, gamma-irradiated the Korean medicinal plants could be safe on the genotoxic point of view. And, thirteen groups of irradiated foods approved for human consumption from Korea Ministry of Health and Welfare. (author). 81 refs., 74 tabs

  5. Proton beam radiotherapy as part of comprehensive regional nodal irradiation for locally advanced breast cancer.

    Science.gov (United States)

    Verma, Vivek; Iftekaruddin, Zaid; Badar, Nida; Hartsell, William; Han-Chih Chang, John; Gondi, Vinai; Pankuch, Mark; Gao, Ming; Schmidt, Stacey; Kaplan, Darren; McGee, Lisa

    2017-05-01

    This study evaluates acute toxicity outcomes in breast cancer patients treated with adjuvant proton beam therapy (PBT). From 2011 to 2016, 91 patients (93 cancers) were treated with adjuvant PBT targeting the intact breast/chest wall and comprehensive regional nodes including the axilla, supraclavicular fossa, and internal mammary lymph nodes. Toxicity was recorded weekly during treatment, one month following treatment, and then every 6months according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Charts were retrospectively reviewed to verify toxicities, patient parameters, disease and treatment characteristics, and disease-related outcomes. Median follow-up was 15.5months. Median PBT dose was 50.4 Gray relative biological effectiveness (GyRBE), with subsequent boost as clinically indicated (N=61, median 10 GyRBE). Chemotherapy, when administered, was given adjuvantly (N=42) or neoadjuvantly (N=46). Grades 1, 2, and 3 dermatitis occurred in 23%, 72%, and 5%, respectively. Eight percent required treatment breaks owing to dermatitis. Median time to resolution of dermatitis was 32days. Grades 1, 2, and 3 esophagitis developed in 31%, 33%, and 0%, respectively. PBT displays acceptable toxicity in the setting of comprehensive regional nodal irradiation. Copyright © 2017. Published by Elsevier B.V.

  6. Autologous Fat Grafting Reduces Pain in Irradiated Breast: A Review of Our Experience

    Directory of Open Access Journals (Sweden)

    Fabio Caviggioli

    2016-01-01

    Full Text Available Introduction. Pain syndromes affect women after conservative and radical breast oncological procedures. Radiation therapy influences their development. We report autologous fat grafting therapeutical role in treating chronic pain in irradiated patients. Materials and Methods. From February 2006 to November 2014, we collect a total of 209 patients who meet the definition of “Postmastectomy Pain Syndrome” (PMPS and had undergone mastectomy with axillary dissection (113 patients or quadrantectomy (96 patients. Both procedures were followed by radiotherapy. We performed fat grafting following Coleman’s procedure. Mean amount of adipose tissue injected was 52 cc (±8.9 cc per breast. Seventy-eight in 209 patients were not treated surgically and were considered as control group. Data were gathered through preoperative and postoperative VAS questionnaires; analgesic drug intake was recorded. Results. The follow-up was at 12 months (range 11.7–13.5 months. In 120 treated patients we detected pain decrease (mean ± SD point reduction, 3.19 ± 2.86. Forty-eight in 59 patients stopped their analgesic drug therapy. Controls reported a mean ± SD decrease of pain of 1.14 ± 2.72. Results showed that pain decreased significantly in patients treated (p<0.005, Wilcoxon rank-sum test. Conclusion. Our 8-year experience confirms fat grafting effectiveness in decreasing neuropathic pain.

  7. Brachytherapy Partial Breast Irradiation: Analyzing Effect of Source Configurations on Dose Metrics Relevant to Toxicity

    International Nuclear Information System (INIS)

    Cormack, Robert A.; Devlin, Phillip M.

    2008-01-01

    Purpose: Recently, the use of partial breast irradiation (PBI) for patients with early-stage breast cancer with low-risk factors has increased. The volume of the high-dose regions has been correlated with toxicity in interstitial treatment. Although no such associations have been made in applicator-based experience, new applicators are being developed that use complex noncentered source configurations. This work studied the effect of noncentered source placements on the volume of the high-dose regions around a spherical applicator. Methods and Materials: Many applicator configurations were numerically simulated for a range of inflation radii. For each configuration, a dose homogeneity index was used as a dose metric to measure the volume of the high-dose region. Results: All multisource configurations examined resulted in an increase of the high-dose region compared with a single-center source. The resulting decrease in the prescription dose homogeneity index was more pronounced for sources further from the center of the applicator, and the effect was reduced as the number of dwell locations was increased. Conclusion: The geometries of particular applicators were not considered to achieve a more general result. On the basis of the calculations of this work, it would appear that treatment using noncentered dwell locations will lead to an increase in the volume of the high-dose regions

  8. Comparison of classic simulation and virtual simulation in breast irradiation: prospective study on 14 patients

    International Nuclear Information System (INIS)

    Bauduceau, O.; Pons, P.; Romero, L.; Fayolle, M.; Campana, F.; Bollet, M.

    2005-01-01

    Purpose. - To compare conventional 2D simulation and virtual simulation on 14 patients with breast cancer. Patients and methods. - Patients were simulated for treatment using standard procedure. They subsequently underwent CT scan in the treatment position. The CTV was defined as breast tissue. The PTV was obtained by adding a 3D margin of 1 cm around CTV. Organs at risk (lungs and heart) were outlined. Ballistics and dose distribution obtained with the two planning methods were compared. Results. - With conventional simulation, 95% of CTV received 95% of the dose prescribed. Virtual simulation significantly improved dosimetric coverage of PTV without increasing irradiation volume of lung and heart. In 2D simulation, using three slices allowed optimisation by adjusting wedge angle. The five-slice plan was a much better predictor of the maximum dose regions when compared to the three-slice plan. Using entire CT data did not give any benefit. Conclusion. - Variations in CTV delineation and PTV definition limit interest of virtual simulation. In classic simulation, a 5 CT slice-plan can be used to optimise dose distribution. (author)

  9. Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

    International Nuclear Information System (INIS)

    Goddu, S. Murty; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran; Jeswani, Sam; Powell, Simon N.; Low, Daniel A.

    2009-01-01

    Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 ± 1.3 Gy vs. 27.9 ± 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 ± 1.8 Gy vs. 37.5 ± 26.9 Gy). The mean percentage of the left lung volume receiving ≥20 Gy in the tomotherapy plans decreased from 32.6% ± 4.1% to 17.6% ± 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving ≥5 Gy for the total lung increased from 25.2% ± 4.2% for the three-dimensional technique to 46.9% ± 8.4% for the tomotherapy plan. The mean volume receiving ≥35 Gy for the heart decreased from 5.6% ± 4.8% to 2.2% ± 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 ± 3.4 Gy to 12.2 ± 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses

  10. Food irradiation dosimetry by opti-chromic technique

    International Nuclear Information System (INIS)

    Liu, Z.J.; Radak, B.B.; McLaughlin, W.L.

    1985-01-01

    The measurement of gamma-radiation quantities, e.g., absorbed dose in materials such as water, plastics, foodstuffs, is a convenient means of quality assurance in radiation processing. A new dosimetry system, called the “Opti-Chromic” dosimeter, is commercially available in large batches for use as a routine measurement system in the absorbed dose range 10 to 2 x 10 4 Gy. This dose range covers most food irradiation applications. A statistical evaluation was made of the reproducibility of this dosimeter for measuring doses appropriate for the disinfestation and shelf-life extension of many foods, namely 10 to 2 x 10 3 Gy. In addition, the small dosimeters were used to map absorbed dose distributions in boxes of foods having four different bulk densities (grapefruit, lemons, peanuts, and wheat bran). It is demonstrated that the dosimeters are rugged and stable enough to be used over a wide temperature and humidity range, and, in fact, can be placed in such environments as the inside of citrus fruits without adverse effects on their ability to give satisfactory dose assessment. (author)

  11. Food irradiation dosimetry by opti-chromic technique

    International Nuclear Information System (INIS)

    Liu Zhan-Jun; McLaughlin, W.L.

    1985-01-01

    The measurement of gamma-radiation quantities, e.g., absorbed dose in materials such as water, plastics, foodstuffs, is a convenient means of quality assurance in radiation processing. A new dosimetry system, called the 'Opti-Chromic' dosimeter, is commercially available in large batches for use as a routine measurement system in the absorbed dose range 10 to 2 x 10 4 Gy. This dose range covers most food irradiation applications. A statistical evaluation was made of the reproducibility of this dosimeter for measuring doses appropriate for the disinfestation and shelf-life extension of many foods, namely 10 to 2 x 10 3 Gy. In addition, the small dosimeters were used to map absorbed dose distributions in boxes of foods having four different bulk densities (grapefruit, lemons, peanuts, and wheat bran). It is demonstrated that the dosimeters are rugged and stable enough to be used over a wide temperature and humidity range, and, in fact, can be placed in such environments as the inside of citrus fruits without adverse effects on their ability to give satisfactory dose assessment. (author)

  12. Physicochemical Study of Irradiated polypropylene/Organo :Modified Montmorillonite Composites by Using Electron Beam Irradiation Technique

    International Nuclear Information System (INIS)

    Hassan, M.S.

    2008-01-01

    Polypropylene/ Organo modified montmorillonite composites (PP/ OMMT) were prepared by melt blending with a twin screw extruder. The thermal properties by thermo gravimetric analysis (TGA), the dispersion of OMMT of macromolecules by X-ray diffraction (XRD), mechanical properties and the morphology by scanning electron microscopy (SEM) were investigated. The effect of electron beam irradiation on these properties was also studied. The results showed an intercalation between the silicate layers and the PP polymer matrix. The (PP/ OMMT) composites exhibit higher thermal stability and lower mechanical properties than pure polypropylene

  13. Long-Term Results of a Highly Performing Conformal Electron Therapy Technique for Chest Wall Irradiation After Mastectomy

    Energy Technology Data Exchange (ETDEWEB)

    Grellier Adedjouma, Noemie, E-mail: grellier.noemie@gmail.com [Department of Radiation Oncology, Institut Curie, Paris (France); Chevrier, Marion [Department of Biostatistics, Institut Curie, Paris (France); Fourquet, Alain; Costa, Emilie; Xu, Haoping [Department of Radiation Oncology, Institut Curie, Paris (France); Berger, Frederique [Department of Biostatistics, Institut Curie, Paris (France); Campana, Francois [Department of Radiation Oncology, Institut Curie, Paris (France); Laki, Fatima [Department of Surgical Oncology, Institut Curie, Paris (France); Beuzeboc, Philippe [Department of Medical Oncology, Institut Curie, Paris (France); Lefeuvre, Delphine [Department of Biostatistics, Institut Curie, Paris (France); Fournier-Bidoz, Nathalie; Kirova, Youlia M. [Department of Radiation Oncology, Institut Curie, Paris (France)

    2017-05-01

    Purpose: To evaluate locoregional control and survival after mastectomy, as well as toxicity, in patients irradiated by a previously described postmastectomy highly conformal electron beam radiation therapy technique (PMERT). Methods and Materials: We included all women irradiated by postmastectomy electron beam radiation therapy for nonmetastatic breast cancer between 2007 and 2011 in our department. Acute and late toxicities were retrospectively assessed using Common Terminology Criteria for Adverse Events version 3.0 criteria. Results: Among the 796 women included, 10.1% were triple-negative, 18.8% HER2-positive, and 24.6% received neoadjuvant chemotherapy (CT). Multifocal lesions were observed in 51.3% of women, and 64.6% had at least 1 involved lymph node (LN). Internal mammary chain, supraclavicular, infraclavicular, and axillary LNs were treated in 85.6%, 88.3%, 77.9%, and 14.9% of cases, respectively. With a median follow-up of 64 months (range, 6-102 months), 5-year locoregional recurrence–free survival and overall survival were 90% (95% confidence interval 88.1%-92.4%) and 90.9% (95% confidence interval 88.9%-93%), respectively. Early skin toxicity was scored as grade 1 in 58.5% of patients, grade 2 in 35.9%, and grade 3 in 4.5%. Concomitant CT was associated with increased grade 3 toxicity (P<.001). At long-term follow-up, 29.8% of patients presented temporary or permanent hyperpigmentation or telangiectasia or fibrosis (grade 1: 23.6%; grade 2: 5.2%; grade 3: 1%), with higher rates among smokers (P=.06); 274 patients (34.4%) underwent breast reconstruction. Only 24 patients (3%) had early esophagitis of grade 1. Only 3 patients developed ischemic heart disease: all had been treated by anthracycline-based CT with or without trastuzumab, all had been irradiated to the left chest wall and LN, and all presented numerous cardiovascular risk factors (2-4 factors). Conclusions: This study demonstrated the good efficacy of this technique in terms of

  14. Development of high resolution x-ray CT technique for irradiated fuel assembly

    Energy Technology Data Exchange (ETDEWEB)

    Ishimi, Akihiro; Katsuyama, Kozo; Maeda, Koji; Asaga, Takeo [Japan Atomic Energy Agency, Oarai Research and Development Center, Oarai, Ibaraki (Japan)

    2012-03-15

    High X-ray CT technique was developed to observe the irradiation performance of FBR fuel assembly and MOX fuel. In this technique, the high energy X-ray pulse (12MeV) was used synchronizing detection system with the X-ray pulse to reduce the effect of the gamma ray emissions from the irradiated fuel assembly. In this study, this technique was upgraded to obtain high resolution X-ray CT image. In this upgrading, the collimator which had slit width of 0.1 mm and X-ray detector of a highly sensitive silicon semiconductor detector (100 channels) was introduced in the X-ray CT system. As a result of these developments, high resolution X-ray CT images could be obtained