Automatização da Determinação dos Campos na Radioterapia de Mama: Desenvolvimento e Comparação entre Dois Algoritmos

Giulianne Rivelli Rodrigues Zaratim; Leonardo Bicudo dos Santos; Ricardo Gomes dos Reis; Luis Felipe Oliveira e Silva

doi:10.29384/rbfm.2023.v17.19849001720

Authors

Giulianne Rivelli Rodrigues Zaratim Universidade de Brasília
Leonardo Bicudo dos Santos
Ricardo Gomes dos Reis
Luis Felipe Oliveira e Silva

DOI:

https://doi.org/10.29384/rbfm.2023.v17.19849001720

Keywords:

Medical Physics, Radiation Oncology, Breast Cancer

Abstract

In breast cancer radiotherapy, with two oblique tangential fields, the manual selection of the gantry angles considers the volume of irradiated healthy tissue. The goal of this work was to develop, validate and compare two algorithms to automate the selection of the tangent fields angles. One of the algorithms selects the tangent angles with the smallest area of the planning target volume in the beam eye view projection (Script_PTV), while the other (Script_PULMAO) selects the angles with the smallest intersection area of the target volume with the ipsilateral lung. These areas were calculated using the Gauss Method. We retrospectively analyzed 55 plans for the treatment of breast cancer without nodal irradiation, 31 for the left side and 24 for the right side. The absolute deviations to the angles obtained manually were different (z = -5.267, p < 0.001). For the Script_PTV, the median, the first and third quartiles were, respectively, 2.50, 1.00 and 4.50 degrees. For Script_PULMAO these results were, respectively, 1.35, 0.50 and 2.50 degrees. The proportion of incidences in the contralateral breast in the group with absolute deviations greater than or equal to 4 degrees was greater than in the group in which the differences were less than 4 degrees (p < 0.001). This highlights the relevance of taking into account the beam incidence on the contralateral breast in the automated selection of gantry angles. Furthermore, the smaller differences and dispersion to the manual determination of gantry angles obtained with Script_PULMAO suggests that this approach is more suitable dosimetrically than that of Script_PTV.

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