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(Radiology. 2001;219:203-206.)
© RSNA, 2001

Radiation Oncology

Breast Electron Boost Planning: Comparison of CT and US1

Melanie C. Smitt, MD, Robyn L. Birdwell, MD and Don R. Goffinet, MD

1 From the Departments of Radiation Oncology (M.C.S., D.R.G.) and Diagnostic Radiology (R.L.B.), Stanford Hospital, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305. Received September 20, 1999; revision requested October 20; final revision received August 1, 2000; accepted September 6. Address correspondence to M.C.S. (e-mail: melanies@reyes.stanford.edu).

PURPOSE: To compare computed tomography (CT) with ultrasonography (US) for depiction of the biopsy cavity.

MATERIALS AND METHODS: Thirty-two consecutive patients who underwent radiation therapy following lumpectomy with a planned electron boost were examined. At the time of simulation for whole-breast radiation therapy, all patients underwent planning CT (CT 1) at 3-mm section intervals. At the time of electron boost simulation, US was performed to define the biopsy cavity. In 17 cases, a second CT examination (CT 2) was performed at the time of electron boost simulation. CT and US studies were reviewed jointly and assigned a cavity visualization score (CVS) of 1 (cavity not visualized) to 5 (all cavity margins clearly defined).

RESULTS: The median CVS at CT 1 was 5; at CT 2, 4; and at US, 4. For patients who underwent all three studies, the median CVS at CT 1 was 5; at CT 2, 4; and at US, 4. Factors related to CVS at CT 1 were homogeneous versus heterogeneous appearance (score, 5 vs 4), surgery-to-CT interval (<=30 days, 5; 31–60 days, 4; >60 days, 4), and cavity size (>15 cm3, 5; <15 cm3, 4). In all cases, cavity volume decreased somewhat during the CT 1–to–CT 2 interval.

CONCLUSION: CT performed at the time of whole-breast simulation can be used to plan electron boost fields, with cavity visualization similar to that at US.

Index terms: Breast, CT, 00.1211 • Breast, US, 00.12986, 00.12989 • Breast neoplasms, 00.32 • Breast neoplasms, therapeutic radiology