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Tumour bed localisation after oncoplastic breast conservative surgery: a comparative contouring study

Abstract:
Purpose To investigate the modalities of tumour bed (TB) localisation of target volume delineation [clinically computed tomography (CT), ultrasound (US) compared with surgical clips-guided] and the impact of their differences in delineated TB volumes. Material and methods In total, 27 patients who underwent oncoplastic breast conservative surgery with surgical clips insertion (at least three) were included. CT and US imaging for TB localisation were done 3–4 weeks post-operatively in the same treatment position. TB was delineated four times, guided by surgical clips, clinical data, CT (seroma) and US. A plan was done for each TB delineated. The four delineated volumes were compared regarding the volumetric differences, the geographical miss index (GMI) and the overlap index. Results Comparing the four modalities, median TB volume was for clinical (60.7), CT (60.8) and US (49.3) cm 3 , in comparison with 59.7 cm 3 for clips, p =0.05. Median of GMI (represented the tissue at risk of recurrence and not had been treated) was for clinical (61.8), CT (45) and US (62.4)%, with significant difference of p =0.02. Median of normal tissue index (normal tissue has been included unnecessarily) was for clinical (59.5), CT (49.6) and US (62.3)%, p =0.17. Overlap index with clips-guided was for clinical (0.36), CT (0.42) and US (0.35) with significance of p =0.04. Median superior/inferior direction was 0.72, −0.03 and −0.2 cm for clinical, CT and US, respectively, with significant value of p =0.02, whereas the anterior–posterior was −0.07, −0.15 and −0.09 cm, p -value=0.45 and the medio–lateral was 0.4, −0.13 and 0.09 cm, p =0.60. Conclusion Significant differences in shifts and indices were detected between each of modalities compared with surgical clips. Thus, in the setting of oncoplastic breast surgery, surgical clips should be routinely used for TB localisation. In view of the larger volumes of breast tissue excised and the extensive remodelling that are inherent to oncoplastic procedures, the concept of TB boost irradiation should be re-challenged.
Author Listing: Radwa Fawzy;Shaimaa Lasheen;Maha Kamaleldin;Rasha Wessam;Emad Khallaf;Mohamed Moussa
Volume: 18
Pages: 63-69
DOI: 10.1017/S1460396918000389
Language: English
Journal: Journal of Radiotherapy in Practice

Journal of Radiotherapy in Practice

J RADIOTHER PRACT

影响因子:0.5
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ISSN:1460-3969
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收录数据库:ESCI/Scopus收录
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出版社:Cambridge University Press

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年发文量 28
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偏重研究方向 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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(2021-2022年最新版)
RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q4

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