Doctoral fellow - 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, esophagus 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. Delineation guidelines for the lymphatic system in prone crawl position were extrapolated from guidelines for the regularly used supine position for these preliminary data. However, the change in position is expected to affect the position of the lymphatic areas and the existing guidelines are based on expert opinion and planning CT images that do not clearly show the soft tissue, making it difficult to obtain accurate delineations.
My research aims to further reduce the radiation dose on organs at risk by making new guidelines for lymphatic area delineation. These new guidelines will be based on CT images, overlapped with MRI images obtained from human cadaveric specimens fixed in the same scanning position. After scanning and digital reconstruction, the results will be veryfied by anatomical dissection. Multiple datasets will then be overlapped to incorporate anatomical varieties in the lymphatics within a minimal area. This area will then be used to postulate new anatomically validated guidelines for lymphatic system delineation, ultimately leading to a reduction in radiation-induced side effects. Once the guidelines for prone crawl position are in place, the same approach can be used to optimize guidelines for the regularly used supine position.