MR-guided breast radiotherapy: feasibility and magnetic-field impact on skin dose

作者：van Heijst Tristan C F^*; den Hartogh Mariska D; Lagendijk Jan J W; van den Bongard H J G Desiree; van Asselen Bram

来源：Physics in Medicine and Biology, 2013, 58(17): 5917-5930.

DOI：10.1088/0031-9155/58/17/5917

The UMC Utrecht MRI/linac (MRL) design provides image guidance with high soft-tissue contrast, directly during radiotherapy (RT). Breast cancer patients are a potential group to benefit from better guidance in the MRL. However, due to the electron return effect, the skin dose can be increased in presence of a magnetic field. Since large skin areas are generally involved in breast RT, the purpose of this study is to investigate the effects on the skin dose, for whole-breast irradiation (WBI) and accelerated partial-breast irradiation (APBI). In ten patients with early-stage breast cancer, targets and organs at risk (OARs) were delineated on postoperative CT scans co-registered with MRI. The OARs included the skin, comprising the first 5 mm of ipsilateral-breast tissue, plus extensions. Three intensity-modulated RT techniques were considered (2 x WBI, 1 x APBI). Individual beam geometries were used for all patients. Specially developed MRL treatment-planning software was used. Acceptable plans were generated for 0 T, 0.35 T and 1.5 T, using a class solution. The skin dose was augmented in WBI in the presence of a magnetic field, which is a potential drawback, whereas in APBI the induced effects were negligible. This opens possibilities for developing MR-guided partial-breast treatments in the MRL.

• 出版日期2013-9-7