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J Korean Soc Ther Radiol Oncol > Volume 24(3); 2006 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2006;24(3): 192-200.
Analysis of the Movement of Surgical Clips Implanted in Tumor Bed during Normal Breathing for Breast Cancer Patients
Rena Lee, Eunah Chung, HyunSuk Suh, Kyung ja Lee, Jihye Lee
1Department of Radiation Oncology, Ewha Womans University College of Medicine, Korea. renalee@ewha.ac.kr
2Department of Physics, Ewha Womans University, Seoul, Korea.
To evaluate the movement of surgical clips implanted in breast tumor bed during normal breathing.
Seven patients receiving breast post-operative radiotherapy were selected for this study. Each patient was simulated in a common treatment position. Fluoroscopic images were recorded every 0.033 s, 30 frames per 1 second, for 10 seconds in anterior to posterior (AP), lateral, and tangential direction except one patient's images which were recorded as a rate of 15 frames per second. The movement of surgical clips was recorded and measured, thereby calculated maximal displacement of each clip in AP, lateral, tangential, and superior to inferior (SI) direction. For the comparison, we also measured the movement of diaphragm in SI direction.
From AP direction's images, average movement of surgical clips in lateral and SI direction was 0.8+/-0.5 mm and 0.9+/-0.2 mm and maximal movement was 1.9 mm and 1.2 mm. Surgical clips in lateral direction's images were averagely moved 1.3+/-0.7 mm and 1.3+/-0.5 mm in AP and SI direction with 2.6 mm and 2.6 mm maximal movement in each direction. In tangential direction's images, average movement of surgical clips and maximal movement was 1.2+/-0.5 mm and 2.4 mm in tangential direction and 0.9+/-0.4 mm and 1.7 mm in SI direction. Diaphragm was averagely moved 14.0+/-2.4 mm and 18.8 mm maximally in SI direction.
The movement of clips caused by breathing was not as significant as the movement of diaphragm. And all surgical clip movements were within 3 mm in all directions. These results suggest that for breast radiotherapy, it may not necessary to use breath-holding technique or devices to control breath.
Key Words: Breast cancer, Radiotherapy, Surgical clips
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