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Towards MRI-guided radiation therapy of regional lymph nodes in breast cancer patients

Groot Koerkamp, M.L. (2017) Towards MRI-guided radiation therapy of regional lymph nodes in breast cancer patients.

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Abstract:Several subjects relevant for MRI-guided radiation therapy of regional lymph nodes in breast cancer patients were explored. Interfraction displacement of individual lymph nodes (LN) was measured. Differences in center of gravity (CoG) position up to 2.5mm were found for different anatomical LN levels. LNs moved independently from each other. Displacements were small, but local verification of target position is important. Intrafraction motion of individual LNs was studied using the cine MRIs. An optical flow algorithm showed maximum peak-to-peak amplitude ranging from 1.6-2.1mm. LN displacement was caused mainly by breathing motion, but some small baseline drifts were seen. Intrapatient contour propagation of LN delineations was investigated for recontouring of daily MRI scans. Mean distance between propagated and manual LN contours was 0.70mm (SD: 0.30mm) and 1.09mm (SD 0.60mm) between the CoGs. Median propagated LN volume was 11% smaller than the manual volume. Geometrical correctness and volumes of propagated contours have to be checked. Also patient experiences during MRI scanning were evaluated. Overall, patients indicated that they could well endure scanning. The subjects that have been investigated are important for workflow development of MRI-guided RT of individual regional LNs. An MRI-guided approach will improve LN targeting accuracy and thereby reduce treatment-induced toxicity.
Item Type:Essay (Master)
Clients:
UMC Utrecht
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:https://purl.utwente.nl/essays/73704
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