Evidence map›Paper›PMID 30102019›Full record

Trial reportJournal of medical imaging and radiation oncology2018

Utility of CT imaging in a novel form of high-dose-rate intraoperative breast radiation therapy.

Taryn E Hassinger, Timothy N Showalter, Anneke T Schroen, David R Brenin, Adam C Berger, Bruce Libby, Shayna L Showalter

Abstract readClinical Trial
In one paragraph

Trial report in Journal of medical imaging and radiation oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Taryn E HassingerDivision of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.ORCID http://orcid.org/0000-0003-3015-4126
Timothy N ShowalterDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Anneke T SchroenDivision of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
David R BreninDivision of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Adam C BergerSection of Surgical Oncology, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Bruce LibbyDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Shayna L ShowalterDivision of Surgical Oncology, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.

Funding

Postdoctoral Training Grant for MDs in Surgical Oncology ResearchT32CA163177 · NCI · UNIVERSITY OF VIRGINIA · PI Craig Lee Slingluff, Allan Tsung · 2011 to 2026
$4.6M
Evaluation of image-guided, conformal, high-dose intraoperative radiation therapy (Precision Breast IORT) for early stage breast cancerR01CA214594 · NCI · UNIVERSITY OF VIRGINIA · PI SHOWALTER, SHAYNA LEFRAK, SHOWALTER, TIMOTHY NORMAN · 2018 to 2022
$1.9M
American Cancer Society 144372NCI NIH HHS R01 CA214594NCI NIH HHS T32 CA163177NIH HHS T32CA163177
6 · The paper itself

Abstract

introductionIntraoperative radiation therapy (IORT) is an alternative to whole breast radiation following breast conserving surgery. Conventional breast IORT is limited by lack of cross-sectional imaging. In response, our institution developed Precision Breast IORT (PB-IORT) which utilizes intraoperative computed tomography (CT) images for confirmation of brachytherapy applicator placement and for treatment planning. The purpose of this study was to determine the utility of CT imaging in PB-IORT in the first 103 patients treated in two prospective clinical trials.

methodsWe retrospectively reviewed the first 103 patients treated with PB-IORT. All patients underwent breast surgery and placement of a multi-lumen brachytherapy applicator. Patients had a CT scan followed by high-dose-rate (HDR) brachytherapy. Endpoints were the number of patients having more than one CT during PB-IORT and the number of treatment plans having image-based modifications.

resultsAfter initial CT scan, 27 patients (26.2%) had findings prompting surgical applicator adjustment. One patient underwent an additional scan to localize a biopsy clip and aid in excision to negative margin. Eighty-one patients (78.6%) had dosimetry modifications based on CT findings with 36 plans (35.0%) adjusted to protect the skin or chest wall and 45 plans (43.7%) to protect both the skin and chest wall.

conclusionsComputed tomography findings prompted treatment alterations in the majority of patients treated with PB-IORT to enhance tissue conformity and to sculpt the radiation dose away from normal tissues. CT imaging is unique to PB-IORT. These findings suggest the potential clinical superiority of PB-IORT given its allowance for patient-specific alterations.

Indexed as

AgedBrachytherapyBreast NeoplasmsCombined Modality TherapyFemaleHumansIntraoperative CareMastectomy, SegmentalMiddle AgedRadiotherapy DosageRetrospective StudiesTomography, X-Ray ComputedTreatment Outcomebreast conservation therapybreast neoplasmsintraoperative careradiotherapyradiotherapy, image-guided

Identifiers

PMID30102019
PMCPMC6283680

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.