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Purpose <p>Breast edema is the most commonly observed toxicity during radiotherapy treatment. The advantage of surface-guided radiotherapy (SGRT) lies in its ability to set up patient positioning without radiation dose, identify position deviation, and control patient motion during treatment. In a previous study, the accuracy of setup positioning in cases of breast surface deformation was evaluated using deformable breast phantoms. However, the resulting equations were based on breast phantom models. The aim of this study was to investigate the accuracy of the mean translation error and mean rotation error equations in cases of shrinkage or extension of breast deformation during radiotherapy treatment.</p> Methods <p>For validation, the accuracy of the equation calculation was compared with measurement data from Catalyst HD™ software. Eight breast cancer patients who underwent conservative treatment by surgery and radiation therapy were evaluated. Breast surface deformation was analyzed using 3D Slicer by comparing surface differences between CT and four CBCT image datasets.</p> Results <p>The anterior-posterior view was most related to breast deformation because the breast swelled during radiotherapy treatment in this direction due to gravity. The difference in mean translation error and mean rotation error between the calculated equation and measurement was 2.10&#xa0;mm and 2.07°, respectively, which is within the acceptable threshold (5&#xa0;mm/3°).</p> Conclusions <p>Breast surface deformation in the superior-inferior direction showed the greatest influence on Catalyst HD™ system accuracy. The developed equations estimated deviations within 5&#xa0;mm and 3°, supporting its feasibility for position verification during treatment. Further validation in larger, diverse cohorts is recommended.</p>

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The Estimation of the accuracy of surface-guided radiotherapy with breast deformation

  • 期刊论文

  • 发表日期：

    2025年6月18日

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  • Boriphat Kadman,
  • Hironori Kojima,
  • Kimiya Noto,
  • Naoki Okada,
  • Naoki Isomura,
  • Haruna Yokoyama,
  • Supawitoo Sookpeng,
  • Akihiro Takemura

摘要

Purpose

Breast edema is the most commonly observed toxicity during radiotherapy treatment. The advantage of surface-guided radiotherapy (SGRT) lies in its ability to set up patient positioning without radiation dose, identify position deviation, and control patient motion during treatment. In a previous study, the accuracy of setup positioning in cases of breast surface deformation was evaluated using deformable breast phantoms. However, the resulting equations were based on breast phantom models. The aim of this study was to investigate the accuracy of the mean translation error and mean rotation error equations in cases of shrinkage or extension of breast deformation during radiotherapy treatment.

Methods

For validation, the accuracy of the equation calculation was compared with measurement data from Catalyst HD™ software. Eight breast cancer patients who underwent conservative treatment by surgery and radiation therapy were evaluated. Breast surface deformation was analyzed using 3D Slicer by comparing surface differences between CT and four CBCT image datasets.

Results

The anterior-posterior view was most related to breast deformation because the breast swelled during radiotherapy treatment in this direction due to gravity. The difference in mean translation error and mean rotation error between the calculated equation and measurement was 2.10 mm and 2.07°, respectively, which is within the acceptable threshold (5 mm/3°).

Conclusions

Breast surface deformation in the superior-inferior direction showed the greatest influence on Catalyst HD™ system accuracy. The developed equations estimated deviations within 5 mm and 3°, supporting its feasibility for position verification during treatment. Further validation in larger, diverse cohorts is recommended.