After the CT simulation, all CT images were registered in the Oncentra Master Plan (Elekta, Sweden) contouring system. The contouring was done by a single radiation oncologist. The clinical target volume (CTV) was defined as chest wall and mastectomy scar with locoregional lymph nodes. The planning treatment volume (PTV) was created by adding a 5-mm margin from CTV in all directions. The OARs consisting of the heart, left anterior descending artery (LAD), ipsilateral lung, contralateral lung and spinal cord were contoured according to the Breast Cancer Atlas for Radiation Therapy Planning: Consensus Definitions from Radiation Therapy Oncology Group [23 ]. The prescription dose to cover the PTV was 50 Gy in 25 fractions.
Oncentra masterplan
Manufactured by Elekta
Sourced in Sweden
Oncentra MasterPlan is a radiation treatment planning software designed for oncology clinics. It provides tools for creating and optimizing treatment plans for various cancer types. The software allows users to import patient data, define target volumes, and generate radiation dose distributions.
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Lab products found in correlation
6 protocols using oncentra masterplan
1
Radiotherapy Planning for Breast Cancer
2
Systematic Lymph Node Mapping for Radiation Therapy
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To allow a systematic topographic mapping of the lymph node locations, the cross-sectional nodal atlas published by Martinez-Monge et al. was used [7 (link)]. For each patient the number and location of the affected, PET-positive lymph nodes were documented. Beyond summarizing these data in a table, each single PET-positive lymph node was manually contoured in a “virtual” patient dataset to achieve a 3-D visualization of the cumulative PET positive lymph node distribution (Fig. 1a and b ). The Oncentra MasterPlan (Version 4.3, Elekta, Crawley, UK) planning system was used for contouring and generating 3-D images for the atlas. Moreover, the PET-positive lymph node location in each patient was assessed with regard to the existence of a potential geographic miss (i.e. PET-positive lymph nodes that would not have been treated adequately by the RTOG consensus on clinical target volume definition of pelvic lymph nodes [5 (link)]).![]()
3
Delineation and Dose Analysis of Pelvic OARs
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The treatment planning computed tomography scans from Helax-TMS were imported into the treatment planning system at the Department of Oncology, Skåne University Hospital (Oncentra MasterPlan, Elekta, Stockholm, Sweden) for structure delineation. The femoral heads, pubic arch, and sacrum were delineated according to predefined descriptions as organs at risk (OARs) by the same senior radiation therapist who had many years of experience in treatment planning (Fig 1 ). The following physical dose-volume descriptors were derived for the OARs: mean dose (Dmean), median dose (D50%), maximum dose (Dmax), near-maximum dose (D2%), and the fractional volume receiving at least dose D (VD [%], where D = 10-40 Gy in 10 Gy steps). In addition, equivalent doses, converted, voxel by voxel, to 2 Gy with α/β = 3 Gy (EQD2) were calculated. Because the treatment plans were symmetrical, the right and left femoral heads received similar dose distributions and were combined and analyzed as a single paired structure (Fig 1 ).
4
Detailed Organ Contouring Guidelines
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All manual contours were drawn by an experienced radiation oncologist following the guidelines of the RTOG [12 , 13 (link)] using Oncentra Masterplan by Elekta AB, Sweden. Lungs: All inflated and collapsed, fibrotic and emphysematic lungs were contoured including small vessels extending beyond the hilar regions; hilars and trachea/main bronchus were not included. Heart: Contoured along the pericardial sac. The superior aspect (base) began at the level of the inferior aspect of the pulmonary artery passing the midline and extend inferiorly to the apex of the heart. Bladder: Contoured inferiorly from its base, and superiorly to the dome. Rectum: Contouring ended inferiorly from the lowest level of the ischial tuberosities (right or left), and superiorly before the rectum lost its round shape in the axial plane and connected anteriorly with the sigmoid.
5
Systematic Topographic Mapping of PET-Positive Lymph Nodes
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To allow systematic topographic mapping, the cross-sectional nodal atlas published by Martinez-Monge et al. (25) with small modifications (Table 1) was used. For each patient, the number and location of the PET-positive LNs were documented. Beyond summarizing these data in a table, we manually contoured each LN in a virtual patient dataset to achieve a 3-dimensional visualization of the cumulative LN distribution (Fig. 1). The Oncentra MasterPlan (version 4.5.2; Elekta) planning system was used for contouring and generating 3-dimensional images for the atlas. Moreover, every lymphatic drainage region in each patient was assessed regarding a potential geographic miss by counting LNs that would not have been treated adequately by the 3 templates (Fig. 2).
A LN was considered covered if more than the half its volume was covered by the respective clinical target volume (RTOG, PIVOTAL, or NRG). Contouring was performed in accordance with the original publications (5, 6, 13) . Main differences between the templates are pointed out in Table 2.
For the assessment of geographic miss, distances to relevant anatomic structures (vessels, bone, muscle, bladder, bowel) were considered, as well as the craniocaudal position in relation to vessel bifurcations or bony landmarks.
A LN was considered covered if more than the half its volume was covered by the respective clinical target volume (RTOG, PIVOTAL, or NRG). Contouring was performed in accordance with the original publications (5, 6, 13) . Main differences between the templates are pointed out in Table 2.
For the assessment of geographic miss, distances to relevant anatomic structures (vessels, bone, muscle, bladder, bowel) were considered, as well as the craniocaudal position in relation to vessel bifurcations or bony landmarks.
6
Delineation of OARs in Radiation Oncology
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Three radiation oncologists manually delineated the eight OARs on 1340 non-enhanced and enhanced planning CT slices of 20 patients using an Oncentra MasterPlan (version 4.3, Elekta AB, Stockholm, Sweden) except for the lung delineation, for which the oncologists employed automatic segmentation tools available with the treatment planning system. The inter-observer variability was assessed, and the reference contour was defined as the baseline and obtained from the averages of the oncologists’ contours based on a method defined by Chalana and Kim [27] (link).
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