dr. Michael Stouthandel (PhD)
Postdoctoral researcher - Radiotherapy and experimental cancer research (Faculty of Medicine and Health Sciences, UGent)
(Principal Investigator: prof. Liv Veldeman)
To improve radiotherapy treatment for breast cancer patients, our department recently developed a new and improved treatment position (prone crawl position) where the patient is in prone position with the arm on the treated side alongside the body and the contralateral arm extended above the head. Preliminary data using the prone crawl position confirmed lower radiation doses for lungs, thyroid, oesophagus and contralateral breast, while at the same time improving dose homogeneity for whole breast and lymph node targets, compared to the regularly used supine position. After confirming the applicability and the potential of this new treatment position, it is important to optimize it for widespread use in the clinic. An important step to standardise treatment in a new treatment position is the development of position specific delineation guidelines. During my PhD I developed new delineation guidelines for the lymphatic target volumes in prone crawl position, with the help of MRI and CT data and anatomical experiments. Apart from making new guidelines, a big part of my PhD revolved around mapping the lymphatic system. Experiments included the development of several methodologies for retrograde lymphatic injection to fill the lymphatics with contrast agent. Contrast filled lymphatics will show up on CT scans, so their position can be related to the surrounding anatomical structures that are used as reference structures for guideline application.
For the continuation of my research I will now focus on long deep inspiration breath holds in prone crawl position. By helping the patient perform a breath hold of several minutes, aided by hyperventilation and oxygen administration, radiotherapy can be administered with minimal movement of the internal organs during treatment. By limiting this movement of internal organs during treatment, radiation exposure to organs at risk (heart and lungs) is expected to be lower compared to treatment during free breathing. If radiation doses to organs at risk can be limited, side effects of the treatment can further be reduced. My role in this project will be to analyse the anatomical data and quantify organ movement in different scenarios, which in turn could provide further refinement of the breath hold technique in prone crawl position.