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• W2129733758 abstract "Purpose/Objective(s)The Strut Adjusted Volume Implant (SAVITM) applicator is an HDR device used for accelerated partial breast irradiation (APBI). It is designed with multiple catheters, or struts, forming an ellipsoid around a central lumen. Occasionally the applicator may not open completely or symmetrically resulting in inverted or splayed struts. To investigate the resulting dosimetric consequences, we have run plans which simulate these abnormalities.Materials/MethodsA CT scan was performed on all four sizes of the SAVITM applicator. In each case the PTV was defined as the volume extending from the periphery of the applicator to 1.0 cm from the ellipsoid formed by the fully opened struts; the prescription dose of 3.40 Gy was prescribed to the outer edge of the PTV. Three plans were run off of each scan. The first plan was for the complete and symmetric opening of the struts. The second plan excluded one of the struts in the dose optimization simulating an inverted or splayed strut. The third plan excluded 2 adjacent struts, thus simulating two struts splayed away from each other. For each plan, the following 8 parameters were studied: the maximum dose encompassing the PTV (D100), V100, V150, V200, V250, V300, V350, and the volume outside the PTV receiving at least the prescribed dose (Vout).ResultsD100 was greatest for each applicator when it opened symmetrically, ranging between 93.2% and 98.8% of the prescribed dose. When a single strut was excluded from the plan, D100 decreased to between 90.6% and 93.2% of the prescribed dose. D100 remained unchanged when the second strut was removed from the plan except for the largest applicator where it fell to 87% of the prescribed dose. V100 ranged from 96.7% to 99.8% of the PTV over all 12 plans with less than 2% variation observed as asymmetry was added. V150 and V200 were maximized when the applicator opened symmetrically and decreased as the asymmetry in each applicator increased. For the largest applicator, these values fell from 49.8 cm3 to 45.4 cm3, and from 19.5 cm3 to 15.1 cm3, respectively. Of course, these values are lower for the smaller applicators. The V250, V300, and V350 values all showed the same pattern as asymmetry was introduced into the dosimetric optimization. Finally, Vout either decreased or remained the same as the asymmetry of the applicator increased, indicating that hotspots outside the PTV did not increase as the applicator became increasingly asymmetric.ConclusionsDue to the differential loading capability of the struts as well as the central lumen, no increase in hotspots either inside or outside the PTV are observed due to the introduction of applicator asymmetry. In fact, in all the cases studied, the hotspots were reduced in the asymmetrically optimized applicators while maintaining an acceptable dose to the PTV. Purpose/Objective(s)The Strut Adjusted Volume Implant (SAVITM) applicator is an HDR device used for accelerated partial breast irradiation (APBI). It is designed with multiple catheters, or struts, forming an ellipsoid around a central lumen. Occasionally the applicator may not open completely or symmetrically resulting in inverted or splayed struts. To investigate the resulting dosimetric consequences, we have run plans which simulate these abnormalities. The Strut Adjusted Volume Implant (SAVITM) applicator is an HDR device used for accelerated partial breast irradiation (APBI). It is designed with multiple catheters, or struts, forming an ellipsoid around a central lumen. Occasionally the applicator may not open completely or symmetrically resulting in inverted or splayed struts. To investigate the resulting dosimetric consequences, we have run plans which simulate these abnormalities. Materials/MethodsA CT scan was performed on all four sizes of the SAVITM applicator. In each case the PTV was defined as the volume extending from the periphery of the applicator to 1.0 cm from the ellipsoid formed by the fully opened struts; the prescription dose of 3.40 Gy was prescribed to the outer edge of the PTV. Three plans were run off of each scan. The first plan was for the complete and symmetric opening of the struts. The second plan excluded one of the struts in the dose optimization simulating an inverted or splayed strut. The third plan excluded 2 adjacent struts, thus simulating two struts splayed away from each other. For each plan, the following 8 parameters were studied: the maximum dose encompassing the PTV (D100), V100, V150, V200, V250, V300, V350, and the volume outside the PTV receiving at least the prescribed dose (Vout). A CT scan was performed on all four sizes of the SAVITM applicator. In each case the PTV was defined as the volume extending from the periphery of the applicator to 1.0 cm from the ellipsoid formed by the fully opened struts; the prescription dose of 3.40 Gy was prescribed to the outer edge of the PTV. Three plans were run off of each scan. The first plan was for the complete and symmetric opening of the struts. The second plan excluded one of the struts in the dose optimization simulating an inverted or splayed strut. The third plan excluded 2 adjacent struts, thus simulating two struts splayed away from each other. For each plan, the following 8 parameters were studied: the maximum dose encompassing the PTV (D100), V100, V150, V200, V250, V300, V350, and the volume outside the PTV receiving at least the prescribed dose (Vout). ResultsD100 was greatest for each applicator when it opened symmetrically, ranging between 93.2% and 98.8% of the prescribed dose. When a single strut was excluded from the plan, D100 decreased to between 90.6% and 93.2% of the prescribed dose. D100 remained unchanged when the second strut was removed from the plan except for the largest applicator where it fell to 87% of the prescribed dose. V100 ranged from 96.7% to 99.8% of the PTV over all 12 plans with less than 2% variation observed as asymmetry was added. V150 and V200 were maximized when the applicator opened symmetrically and decreased as the asymmetry in each applicator increased. For the largest applicator, these values fell from 49.8 cm3 to 45.4 cm3, and from 19.5 cm3 to 15.1 cm3, respectively. Of course, these values are lower for the smaller applicators. The V250, V300, and V350 values all showed the same pattern as asymmetry was introduced into the dosimetric optimization. Finally, Vout either decreased or remained the same as the asymmetry of the applicator increased, indicating that hotspots outside the PTV did not increase as the applicator became increasingly asymmetric. D100 was greatest for each applicator when it opened symmetrically, ranging between 93.2% and 98.8% of the prescribed dose. When a single strut was excluded from the plan, D100 decreased to between 90.6% and 93.2% of the prescribed dose. D100 remained unchanged when the second strut was removed from the plan except for the largest applicator where it fell to 87% of the prescribed dose. V100 ranged from 96.7% to 99.8% of the PTV over all 12 plans with less than 2% variation observed as asymmetry was added. V150 and V200 were maximized when the applicator opened symmetrically and decreased as the asymmetry in each applicator increased. For the largest applicator, these values fell from 49.8 cm3 to 45.4 cm3, and from 19.5 cm3 to 15.1 cm3, respectively. Of course, these values are lower for the smaller applicators. The V250, V300, and V350 values all showed the same pattern as asymmetry was introduced into the dosimetric optimization. Finally, Vout either decreased or remained the same as the asymmetry of the applicator increased, indicating that hotspots outside the PTV did not increase as the applicator became increasingly asymmetric. ConclusionsDue to the differential loading capability of the struts as well as the central lumen, no increase in hotspots either inside or outside the PTV are observed due to the introduction of applicator asymmetry. In fact, in all the cases studied, the hotspots were reduced in the asymmetrically optimized applicators while maintaining an acceptable dose to the PTV. Due to the differential loading capability of the struts as well as the central lumen, no increase in hotspots either inside or outside the PTV are observed due to the introduction of applicator asymmetry. In fact, in all the cases studied, the hotspots were reduced in the asymmetrically optimized applicators while maintaining an acceptable dose to the PTV." @default.
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• W2129733758 date "2009-11-01" @default.
• W2129733758 modified "2023-09-27" @default.
• W2129733758 title "Dosimetric Effects of Non-symmetric Openings of Multi-catheter Breast Brachytherapy Applicators" @default.
• W2129733758 doi "https://doi.org/10.1016/j.ijrobp.2009.07.1628" @default.
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