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British Journal of Radiology (2006) 79, 734-739
© 2006 British Institute of Radiology
doi: 10.1259/bjr/80814021
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What is the optimum breast plan: a study based on the START trial plans

K Venables, PhD, MIPEM1, E A Miles, MPhil, DCR(T)1, E G A Aird, PhD, FIPEM2 and P J Hoskin, FCRP, FRCR1

1 Marie Curie Research Wing, 2 Medical Physics Department, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK


Figure 1
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  		Figure 1. Box plot illustrating variation in lung depthvs centre.

 

Figure 2
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  		Figure 2. Energy used for treatment(n = 1488).

 

Figure 3
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  		Figure 3. Association between energy used for treatment and average patient separation. Lines give the range of patient separations treated at each energy.

 

Figure 4
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  		Figure 4. Relationship between dose gradient(%) and breast depth.

 

Figure 5
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  		Figure 5. Relationship between dose gradient and separation. Data for 6 MV have been excluded from the graph to allow the trends for other energies to be seen.

 

Figure 6
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  		Figure 6. Correlation between wedge angle and breast shape(max. distance from post edge to skin/patient separation) for centre 12. This was a large centre with a wide range of planning staff, but with rigid guidelines on the final distribution (r = –0.81 p<0.001, n = 44).

 

Figure 7
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  		Figure 7. Correlation between wedge angle and breast shape for all patients in the trialr = –0.39, p<0.001. Note the wide spread in breast shapes for the fixed wedge angles 0°, 15°, 30°, 45° and 60°.

 

Figure 8
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  		Figure 8. Box plot showing difference in dose gradient for different centres using the same planning system and same nominal machine energy. Circles represent outliers.

 

Figure 9
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  		Figure 9. Definitions used for points of the breast.

 




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