The aim of the study was to develop and assess a technique for the optimization of breast electronic tissue compensation (ECOMP) treatment plans based on the breast radius and separation.
Ten ECOMP plans for 10 breast cancer patients delivered at our institute were collected for this work. Pre-treatment CT-simulation images were anonymized and input to a framework for estimation of the breast radius and separation for each axial slice. Optimal treatment fluence was estimated based on the breast radius and separation, and a total beam fluence map for both medial and lateral fields was generated. These maps were then imported into the Eclipse Treatment Planning System and used to calculate a dose distribution. The distribution was compared to the original treatment hand-optimized by a medical dosimetrist. An additional comparison was performed by generating plans assuming a single tissue penetration depth determined by averaging the breast radius and separation over the entire treatment volume. Comparisons between treatment plans used the dose homogeneity index (HI; lower number is better).
HI was non-inferior between our algorithm (HI = 12.6) and the dosimetrist plans (HI = 9.9) (
This work indicates the potential clinical utility of a technique for the optimization of ECOMP breast treatments.