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Reproducibility of mammary gland structure during repeat setups in a supine position
Author(s) -
Klein Zeggelink William F. A.,
Deurloo Eline E.,
Muller Sara H.,
Schultze Kool Leo J.,
Gilhuijs Kenneth G. A.
Publication year - 2002
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.1500766
Subject(s) - supine position , reproducibility , medicine , fiducial marker , breast mri , magnetic resonance imaging , breast tissue , nuclear medicine , radiology , position (finance) , mammary gland , mammography , breast cancer , surgery , chemistry , cancer , finance , chromatography , economics
Purpose : In breast conserving therapy, complete excision of the tumor with an acceptable cosmetic outcome depends on accurate localization in terms of both the position of the lesion and its extent. We hypothesize that preoperative contrast‐enhanced magnetic resonance (MR) imaging of the patient in a supine position may be used for accurate tumor localization and marking of its extent immediately prior to surgery. Our aims in this study are to assess the reproducibility of mammary gland structure during repeat setups in a supine position, to evaluate the effect of a breast immobilization device, and to derive reproducibility margins that take internal tissue shifts into account occurring between repeat setups. Materials & Methods : The reproducibility of mammary gland structure during repeat setups in a supine position is estimated by quantification of tissue shifts in the breasts of healthy volunteers between repeat MR setups. For each volunteer fiducials are identified and registered with their counter locations in corresponding MR volumes. The difference in position denotes the shift of breast tissue. The dependence on breast volume and the part of the breast, as well as the effect of a breast immobilization cast are studied. Results : The tissue shifts are small with a mean standard deviation on the order of 1.5 mm, being slightly larger in large breasts ( V > 1000 cm 3) , and in the posterior part (toward the pectoral muscle) of both small and large breasts. The application of a breast immobilization cast reduces the tissue shifts in large breasts. A reproducibility margin on the order of 5 mm will take the internal tissue shifts into account that occur between repeat setups. Conclusion : The results demonstrate a high reproducibility of mammary gland structure during repeat setups in a supine position.