A randomized control trial evaluating fluorescent ink versus dark ink tattoos for breast radiotherapy.
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<h4>Objective</h4>The purpose of this UK study was to evaluate interfraction reproducibility and body image score when using ultraviolet (UV) tattoos (not visible in ambient lighting) for external references during breast/chest wall radiotherapy and compare with conventional dark ink.<h4>Methods</h4>In this non-blinded, single-centre, parallel group, randomized control trial, patients were allocated to receive either conventional dark ink or UV ink tattoos using computer-generated random blocks. Participant assignment was not masked. Systematic (∑) and random (σ) setup errors were determined using electronic portal images. Body image questionnaires were completed at pre-treatment, 1 month and 6 months to determine the impact of tattoo type on body image. The primary end point was to determine that UV tattoo random error (σ<sub>setup</sub>) was no less accurate than with conventional dark ink tattoos, i.e. <2.8 mm.<h4>Results</h4>46 patients were randomized to receive conventional dark or UV ink tattoos. 45 patients completed treatment (UV: n = 23, dark: n = 22). σ<sub>setup</sub> for the UV tattoo group was <2.8 mm in the u and v directions (p = 0.001 and p = 0.009, respectively). A larger proportion of patients reported improvement in body image score in the UV tattoo group compared with the dark ink group at 1 month [56% (13/23) vs 14% (3/22), respectively] and 6 months [52% (11/21) vs 38% (8/21), respectively].<h4>Conclusion</h4>UV tattoos were associated with interfraction setup reproducibility comparable with conventional dark ink. Patients reported a more favourable change in body image score up to 6 months following treatment. Advances in knowledge: This study is the first to evaluate UV tattoo external references in a randomized control trial.
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Reproducibility of Results
Clinical Trials & Statistics Unit
Breast Cancer Radiotherapy
Translational Breast Radiobiology
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The British journal of radiology, 2016, 89 (1068), pp. 20160288 - ?