Department of Radiation Oncology, University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA.
Int J Radiat Oncol Biol Phys. 2010 Nov 15;78(4):1127-34. doi: 10.1016/j.ijrobp.2009.09.025. Epub 2010 Mar 19.
To determine, whether the presence of gold fiducial markers would improve the inter- and intraphysician accuracy in the delineation of the surgical cavity compared with a matched group of patients who did not receive gold fiducial markers in the setting of accelerated partial-breast irradiation (APBI).
Planning CT images of 22 lumpectomy cavities were reviewed in a cohort of 22 patients; 11 patients received four to six gold fiducial markers placed at the time of surgery. Three physicians categorized the seroma cavity according to cavity visualization score criteria and delineated each of the 22 seroma cavities and the clinical target volume. Distance between centers of mass, percentage overlap, and average surface distance for all patients were assessed.
The mean seroma volume was 36.9 cm(3) and 34.2 cm(3) for fiducial patients and non-fiducial patients, respectively (p = ns). Fiducial markers improved the mean cavity visualization score, to 3.6 ± 1.0 from 2.5 ± 1.3 (p < 0.05). The mean distance between centers of mass, average surface distance, and percentage overlap for the seroma and clinical target volume were significantly improved in the fiducial marker patients as compared with the non-fiducial marker patients (p < 0.001).
The placement of gold fiducial markers placed at the time of lumpectomy improves interphysician identification and delineation of the seroma cavity and clinical target volume. This has implications in radiotherapy treatment planning for accelerated partial-breast irradiation and for boost after whole-breast irradiation.
在加速部分乳房照射 (APBI) 中，与未接受金基准标记物的匹配患者组相比，确定金基准标记物的存在是否会提高外科腔的医师间和医师内准确性。
在 22 例患者的队列中，回顾了 22 例乳房切除术腔的计划 CT 图像；其中 11 例患者在手术时放置了 4 至 6 个金基准标记物。三位医生根据腔可视化评分标准对浆液腔进行分类，并对所有 22 个浆液腔和临床靶区进行了勾画。评估了所有患者的质心之间的距离、重叠百分比和平均表面距离。
有基准标记物患者的平均浆液体积为 36.9cm³，无基准标记物患者的平均浆液体积为 34.2cm³（p=ns）。基准标记物将平均腔可视化评分从 2.5±1.3 提高到 3.6±1.0（p<0.05）。与无基准标记物患者相比，有基准标记物患者的质心之间的距离、平均表面距离和浆液腔及临床靶区的重叠百分比均有显著改善（p<0.001）。
在乳房切除术时放置金基准标记物可提高医师间识别和勾画浆液腔和临床靶区的能力。这对加速部分乳房照射的放射治疗计划和全乳房照射后的加量照射有影响。
