The development of new delineation guidelines for the lymphatic system for radiotherapy treatment of breast cancer in prone crawl position.
Belgium (BeMSA) - Ghent University, Ghent
Department of Human Structure and Repair
Michael Stouthandel (daily supervisor)
Tom Van Hoof (anatomy expert), Liv Veldeman (radiotherapy/clinical expert)
English, Dutch
4 weeks
Cities/Months Jan Feb Mar Apr May Jun Jul Augt Sep Oct Nov Dec
No No No No No No Yes Yes No No No No
Type of Research Project
- Basic science
What is the background of the project?
Breast cancer is the most common type of cancer in women, with well over 1.5 million new patients a year. Tumor recurrence and breast cancer mortality can be reduced by locoregional radiation therapy. The use of radiation comes at the expense of acute and long-term side effects, however. These radiation-induced side effects can include heart disease, lung cancer and cancer of the non-treated breast. To limit these radiation-induced side-effects, it is of paramount importance to avoid irradiation of organs at risk, while at the same time still achieving the required radiation dose in the target tissue. Delineation guidelines, used for treatment planning, help in this process and they are available for the supine position (standard position). Our department recently found that the prone crawl position that we developed showed fewer side effects compared to the standard treatment position. The change in arm position that occurs between the 2 positions will change the location of the lymphatic system. As such, delineation guidelines specific for the lymphatic targets in prone crawl position are needed to further optimize the treatment for widespread clinical use. New delineation guidelines will be developed by using a combination of medical imaging, 3D reconstruction, and dissection validation, making use of anatomical specimens (embalmed human cadaveric specimens).
What is the aim of the project?
Making new delineation guidelines for the lymphatic system for radiotherapy treatment of breast cancer in prone crawl position.
What techniques and methods are used?
- A small literature search regarding the current topic to see if the relevant articles can be found. (There are approximately 5 key articles that will give the student a solid basis to start the project with. Any of these articles that are not found will be provided by the tutor in the first week.) - Anatomical dissection of the target area on an embalmed human cadaveric specimen to help visualize the structures and facilitate 3D reconstructions of medical imaging data. - 3D reconstruction of medical imaging data from Computational Tomography (CT) and Magnetic Resonance Imaging (MRI) using Mimics software. The scan data will be available when the student starts. (Depending on the time planning, the student can participate in a scanning session with a cadaveric specimen) - All the steps required to overlap a CT and an MRI dataset of the same specimen in the reconstruction software will be explained and all necessary operations for segmenting the datasets will be taught. Reconstructions will be double checked by the tutor and additional feedback will be given.
What is the role of the student?
- If the project includes “lab work”
- the student will take active part in the practical aspect of the project
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
- Small literature search for key papers, explain the literature search strategy and summarize the key papers - Anatomical dissection of the subclavian region, learning dissection skills - Identification of the structures of interest during the dissection - Use of the anatomical knowledge to segment CT and MRI scans - Overlapping of a CT and MRI dataset of the same body in reconstruction software - Indication of the structures of interest on the CT and MRI fused dataset - Evaluation of the 3D reconstructions of the reconstructed CT and MRI scans with the goal of guideline development in mind - Presentation of the results of the internship during a departmental meeting
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
- Based on the literature search, various search strategies will be explained by the tutor. - The tutor will explain the relevance of the project and why the current approach was chosen. - The tutor will explain the basics of radiotherapy and the other disciplines involved in the project. - During the dissection, the tutor will show the dissection techniques and the anatomy in the target region will be discussed during the dissection. - All technical procedures related to the digital reconstructions will be explained by the tutor. - The PowerPoint for the presentation of the internship results will be checked before the presentation and tips for making a presentation will be given by the tutor.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a presentation
- The student’s name will be mentioned in a future publication
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
- Dissection skills and experience with medical imaging processing would be a plus, but these are not required, as they will be taught during the internship. - High level of English communication skills - Prior knowledge of anatomy and medical imaging data processing is a plus
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts:
- Medical students
- Graduated students (less than 6 months)
- Pre-Medical students from the American-British system
- Students in biomedical fields
- Call for a Multidisciplinary Effort to Map the Lymphatic System with Advanced Medical Imaging Techniques: A Review of the Literature and Suggestions for Future Anatomical Research. Stouthandel MEJ; Veldeman L; Van Hoof T. Anat Rec (Hoboken). 2019 Oct;302(10):1681-1695. doi: 10.1002/ar.24143. Epub 2019 May 23. Review.