Reproducibility of chestwall and heart position using surface-guided versus RPM-guided DIBH radiotherapy for left breast cancer Journal Article
| Authors: | Lu, W.; Li, G.; Hong, L.; Yorke, E.; Tang, X.; Mechalakos, J. G.; Zhang, P.; Cerviño, L. I.; Powell, S.; Berry, S. L. |
| Article Title: | Reproducibility of chestwall and heart position using surface-guided versus RPM-guided DIBH radiotherapy for left breast cancer |
| Abstract: | This study compared the reproducibility of chestwall and heart position using surface-guided versus RPM (real-time position management)-guided deep inspiration breath hold (DIBH) radiotherapy for left sided breast cancer. Forty DIBH patients under either surface-guided radiotherapy (SGRT) or RPM guidance were studied. For patients treated with tangential fields, reproducibility was measured as the displacements in central lung distance (CLD) and heart shadow to field edge distance (HFD) between pretreatment MV (megavoltage) images and planning DRRs (digitally reconstructed radiographs). For patients treated with volumetric modulated arc therapy (VMAT), sternum to isocenter (ISO) distance (StID), spine to rib edge distance (SpRD), and heart shadow to central axis (CAX) distance (HCD) between pretreatment kV images and planning DRRs were measured. These displacements were compared between SGRT and RPM-guided DIBH. In tangential patients, the mean absolute displacements of SGRT versus RPM guidance were 0.19 versus 0.23 cm in CLD, and 0.33 versus 0.62 cm in HFD. With respect to planning DRR, heart appeared closer to the field edge by 0.04 cm with surface imaging versus 0.62 cm with RPM. In VMAT patients, the displacements of surface imaging versus RPM guidance were 0.21 versus 0.15 cm in StID, 0.24 versus 0.19 cm in SpRD, and 0.72 versus 0.41 cm in HCD. Heart appeared 0.41 cm further away from CAX with surface imaging, whereas 0.10 cm closer to field CAX with RPM. None of the differences between surface imaging and RPM guidance was statistically significant. In conclusion, the displacements of chestwall were small and were comparable with SGRT- or RPM-guided DIBH. The position deviations of heart were larger than those of chestwall with SGRT or RPM. Although none of the differences between SGRT and RPM guidance were statistically significant, there was a trend that the position deviations of heart were smaller and more favorable with SGRT than with RPM guidance in tangential patients. © 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine. |
| Keywords: | reproducibility; reproducibility of results; breast cancer; radiotherapy dosage; diagnostic imaging; breast neoplasms; breast tumor; radiotherapy planning, computer-assisted; breath holding; thorax wall; heart; thoracic wall; procedures; humans; human; female; radiotherapy planning system; comparison; unilateral breast neoplasms; deep inspiration breath hold; surface imaging; real-time position management |
| Journal Title: | Journal of Applied Clinical Medical Physics |
| Volume: | 24 |
| Issue: | 1 |
| ISSN: | 1526-9914 |
| Publisher: | American College of Medical Physics |
| Date Published: | 2023-01-01 |
| Start Page: | e13755 |
| Language: | English |
| DOI: | 10.1002/acm2.13755 |
| PUBMED: | 35993318 |
| PROVIDER: | scopus |
| PMCID: | PMC9859984 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK authors: Wei Lu -- Source: Scopus |
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175Zhang -
98Li -
164Mechalakos -
450Yorke -
58Tang -
70Lu -
135Cervino Arriba
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