Abstract
In this paper a method of breast cancer treatment planning using virtual simulation implemented at the Department of Human Oncology at the University of Wisconsin is described. All patients in this procedure are placed in a custom vacuum mold in treatment position with both arms up to avoid collision with the CT scanner aperture. For all patients a CT scan of 5‐mm‐slice thickness is acquired. The ipsilateral and contralateral breast, the ipsilateral lung and the heart are delineated and a three‐dimensional plan is generated that tries to minimize the dose to the ipsilateral lung and heart while ensuring adequate coverage of the affected breast. Digitally reconstructed radiographs are used to verify the patient setup on the treatment machine. © 2000 American College of Medical Physics. PACS number(s): 87.53.–j
Highlights
In 1997, approximately 181,600 new cases of breast cancer were diagnosed in the United States
In this paper we describe a technique for virtual simulation and three-dimensional3Dtreatment planning, that employs the PINNACLE3 3D Treatment Planning SystemADAC Laboratories, Milpitas, CA, used in our clinic for breast-conserving radiotherapy
Besides making conventional simulation unnecessary, the application of 3D treatment planning allows us to be more precise about including within the treatment beams all tissues at risk for cancer recurrence
Summary
In 1997, approximately 181,600 new cases of breast cancer were diagnosed in the United States. There were only 43,900 deaths that year, indicating that the majority of patients with breast cancer are treated successfully with long-term survival This high survival rate may be attributed in part to annual mammography as a screening tool for middle-aged and elderly women. Image segmentation allows the planner to take critical anatomical structures explicitly into account through volume rendering in the 3D beam’s-eye-view display, and shape the blocks such that the critical organs are avoided as far as possible, while ensuring adequate coverage of the breast This is in contrast to conventional simulation, where the blocks are shaped by either following the chest wall as imaged on the simulation film or using a rotatable half beam block to approximate the chest wallsee, for example, Refs. In the technique we employ the breast lies in the inferior half of the treatment field and a supraclavicular field can be matched in the superior half of the treatment field if therapeutically indicated
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