The role of intraoperative ultrasound in improving quality and reducing risk in breast IOERT

We started using intraoperative electron radiation therapy (IOERT) as a boost during breast conserving surgery in June 2012. The risk assessment was carried out before starting clinical trials and was integrated with a predictive matrix risk analysis (FMECA). Even after the introduction of corrective actions, the highest score was attributed to the misalignment of the internal shield which was used to protect the underlying normal tissues. In November 2014, we began using the new HIOB protocol (IOERT 11,1 Gy, WBERT 2,7 Gy in 15 fractions) and at the same time Intraoperative ultrasonography (IOUS) was introduced based on the recommendation of HIOB protocol in order to accurately measure depth of target and accordingly selection of the proper electron energy. The aim of this study is to evaluate the role of intraoperative ultrasonography in reducing risk and improving quality of breast IOERT