PMID- 29223506
OWN - NLM
STAT- MEDLINE
DCOM- 20190131
LR  - 20220408
IS  - 1873-1449 (Electronic)
IS  - 1538-4721 (Linking)
VI  - 17
IP  - 2
DP  - 2018 Mar-Apr
TI  - Treatment planning considerations for permanent breast seed implant.
PG  - 456-464
LID - S1538-4721(17)30520-2 [pii]
LID - 10.1016/j.brachy.2017.11.002 [doi]
AB  - PURPOSE: To determine an optimal planning strategy for permanent breast seed 
      implant that minimizes dose heterogeneity without degrading coverage and 
      conformity. METHODS AND MATERIALS: A simple model was developed to investigate 
      planning strategies incorporating a range of (103)Pd seed activities, needle and 
      seed spacings, and implants in which seed positions are either restricted to or 
      permitted outside of spherical planning target volumes (PTVs). To address more 
      realistic target geometries, model parameters were used to retrospectively replan 
      a 10-patient cohort in MIM Symphony. RESULTS: We confirm that the current 
      clinical modified uniform implantation pattern provides the most favorable dose 
      distributions, given the resolution of the template grid and spacer length. We 
      show that needle and seed counts for replans with seed placement permitted 0.3 cm 
      outside of the PTV are most comparable to clinical preplans, but offer a 13 +/- 11% 
      average reduction in the V(PTV)150%. Replans produced with seed placement 0.5 cm 
      outside of the PTV provide the largest improvement in dose homogeneity, at the 
      cost of a slight increase in irradiated volume and an increase in the number of 
      needles and seeds. CONCLUSIONS: Implanting seeds beyond the PTV within a 
      0.3-0.5 cm margin, and optimizing seed activity on a per patient basis, allows 
      for improvement in dose homogeneity. However, these plans require higher needle 
      and seed counts and result in a small increase in irradiated volume. Before 
      planning recommendations can be made, the implications of these changes must be 
      investigated in the context of clinical outcome for permanent breast seed 
      implant.
CI  - Copyright (c) 2017 American Brachytherapy Society. Published by Elsevier Inc. All 
      rights reserved.
FAU - Frederick, Amy
AU  - Frederick A
AD  - Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, 
      Canada; Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta, 
      Canada. Electronic address: amy.frederick2@ucalgary.ca.
FAU - Meyer, Tyler
AU  - Meyer T
AD  - Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, 
      Canada; Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta, 
      Canada; Department of Oncology, Tom Baker Cancer Centre, Calgary, Alberta, 
      Canada.
FAU - Roumeliotis, Michael
AU  - Roumeliotis M
AD  - Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, 
      Canada; Department of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta, 
      Canada; Department of Oncology, Tom Baker Cancer Centre, Calgary, Alberta, 
      Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171206
PL  - United States
TA  - Brachytherapy
JT  - Brachytherapy
JID - 101137600
RN  - 0 (Radioisotopes)
RN  - 5TWQ1V240M (Palladium)
RN  - 68QTV136DF (Palladium-103)
SB  - IM
MH  - Brachytherapy/*methods
MH  - Breast Neoplasms/*radiotherapy
MH  - Female
MH  - Humans
MH  - Palladium
MH  - Radioisotopes
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Breast brachytherapy
OT  - Dosimetry
OT  - Forward planning
OT  - Pd-103
OT  - Permanent breast seed implant
OT  - Treatment planning
EDAT- 2017/12/11 06:00
MHDA- 2019/02/01 06:00
CRDT- 2017/12/11 06:00
PHST- 2017/07/25 00:00 [received]
PHST- 2017/10/07 00:00 [revised]
PHST- 2017/11/03 00:00 [accepted]
PHST- 2017/12/11 06:00 [pubmed]
PHST- 2019/02/01 06:00 [medline]
PHST- 2017/12/11 06:00 [entrez]
AID - S1538-4721(17)30520-2 [pii]
AID - 10.1016/j.brachy.2017.11.002 [doi]
PST - ppublish
SO  - Brachytherapy. 2018 Mar-Apr;17(2):456-464. doi: 10.1016/j.brachy.2017.11.002. 
      Epub 2017 Dec 6.