gms | German Medical Science

48th Meeting of the Particle Therapy Co-Operative Group

Particle Therapy Co-Operative Group (PTCOG)

28.09. - 03.10.2009, Heidelberg

Negative Pressure Breast Stabilization Device (BSD) for Proton Partial Breast Irradiation

Meeting Abstract

  • J. Jesseph - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA
  • K. Hahn - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA
  • R. Jesseph - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA
  • J. Jesseph - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA
  • K. McFall - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA
  • L. Taylor - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA
  • N. Schreuder - ProCure Treatment Centers, Inc., Bloomington, Indiana, USA

PTCOG 48. Meeting of the Particle Therapy Co-Operative Group. Heidelberg, 28.09.-03.10.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09ptcog097

DOI: 10.3205/09ptcog097, URN: urn:nbn:de:0183-09ptcog0977

Published: September 24, 2009

© 2009 Jesseph et al.
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Outline

Text

Background: All methods of irradiation of the breast are limited in their precision by difficulties with immobilization. Partial breast irradiation using protons appears promising, but practical clinical applications remain largely untested. This technology is limited by the lack of reliable immobilization of the breast as well.

Materials/methods: With IRB oversight, we are conducting a preclinical feasibility study of a negative pressure breast stabilization device (BSD) to: 1) determine the optimal configuration and application of the device, 2) measure parameters and tolerances of negative pressure, 3) determine the effects of negative pressure on breast morphology and 4) demonstrate the reproducibility of positioning with MRI imaging and surface morphometry.

Results: To date, we have enrolled twenty-five females who have undergone plaster chest wall molding. These molds were used to guide construction of prototype devices (BSD) for each subject. Molds were imaged by CT scanning for further morphometric analysis. Fifteen of the twenty-five subjects have, thus far, undergone device testing with determination of negative pressure tolerances. All fifteen subjects have had MRI imaging (1.5 tesla) showing breast and chest morphology without negative pressure and in two separate scans with negative pressure to show reproducibility. All subjects have tolerated -20 inches of water in supine position for up to ten minutes with no reports of discomfort. When the device is adequately sealed, all subjects have demonstrated clearly reproducible expansion and configuration of the breast on MRI with the BSD. The largest single measured deviation of nipple position under suction in a large breast at -20 cm was 1.7 mm.

Conclusions: Our preliminary findings show that reproducible negative pressure breast stabilization is possible in the supine position. Developments and refinements continue. The BSD empowers more sophisticated and precise breast treatments with proton radiotherapy. In addition, this method could find many other applications in breast imaging and intervention.