Ceramic and polymeric devices for breast brachytherapy - Mammographic and CT response

The present research investigates the radiological visibility of ceramic and polymeric devices implanted in breast phantom (in vitro) for future applications in brachytherapy treatments. The main research goal is to investigate the viability of monitoring ceramic and polymeric devices, in vitro based on simple methods of radiological diagnostic, maintaining the easiest access to the population, represented by the conventional X-ray and mammography. The methodology involves the processing of ceramic devices constituted by bioglasses of Sm, SmBa, Ho, HoBa and the production of polymeric devices, such as polymeric membranes incorporating Ho e HoBa. Contrast agent of Barium was introduced in the syntheses of those devices to improve the radiological visibility in breast equivalent-tissue (TE) phantom. The breast phantom is constituted of glandular, adipose and skin TE, reproducing a 5 cm compressed real breast. In the compressed breast phantom, all types of ceramic and polymeric devices were implanted side by side. Radiological images were generated through X-ray equipment, mammography and computerized tomography (TC), for the samples implanted in the compressed breast phantom. The results show that SmBa and HoBa seeds on breast phantom presented suitable radiological visibility, on all the radiological diagnostic methods. However, the X-rays radiological visibility of Sm seeds without contrast was discreet. On mammography and TC images, it was not possible to identify those seeds, because the same ones were degraded after two months immersed in the glandular TE, after placed on the phantom. The Ho seeds were identified on all radiological diagnostic images, although non contrast agent in its constitution was added. However, the holmium polymeric membranes in direct contact with TE did not show Xray radiological visibility. However, the polymeric membranes of HoBa in the same conditions presented efficient X-rays radiological response. For mammography and TC methods, all membranes, with or without contrast, could be identified on the images. In all the radiological investigation, the implanted devices present enough response for visual clinical identification. However, the radiological gray-level density varied according to the method chosen. As conclusion, X-rays and mammography radiological diagnostic methods can be used to monitor implants on compressed breast, identifying the ceramic and polymeric devices in quantity and position on the implants. (author)