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Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer

The purpose was to report clinical experience of a video‐guided spirometry system in applying deep inhalation breath‐hold (DIBH) radiotherapy for left‐sided breast cancer, and to study the systematic and random uncertainties, intra‐ and interfraction motion and impact on cardiac dose associated with...

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Autores principales: Yang, Wensha, McKenzie, Elizabeth M., Burnison, Michele, Shiao, Stephen, Mirhadi, Amin, Hakimian, Behrooz, Reznik, Robert, Tuli, Richard, Sandler, Howard, Fraass, Benedick A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690070/
https://www.ncbi.nlm.nih.gov/pubmed/26103193
http://dx.doi.org/10.1120/jacmp.v16i2.5218
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author Yang, Wensha
McKenzie, Elizabeth M.
Burnison, Michele
Shiao, Stephen
Mirhadi, Amin
Hakimian, Behrooz
Reznik, Robert
Tuli, Richard
Sandler, Howard
Fraass, Benedick A.
author_facet Yang, Wensha
McKenzie, Elizabeth M.
Burnison, Michele
Shiao, Stephen
Mirhadi, Amin
Hakimian, Behrooz
Reznik, Robert
Tuli, Richard
Sandler, Howard
Fraass, Benedick A.
author_sort Yang, Wensha
collection PubMed
description The purpose was to report clinical experience of a video‐guided spirometry system in applying deep inhalation breath‐hold (DIBH) radiotherapy for left‐sided breast cancer, and to study the systematic and random uncertainties, intra‐ and interfraction motion and impact on cardiac dose associated with DIBH. The data from 28 left‐sided breast cancer patients treated with spirometer‐guided DIBH radiation were studied. Dosimetric comparisons between free‐breathing (FB) and DIBH plans were performed. The distance between the heart and chest wall measured on the digitally reconstructed radiographs (DRR) and MV portal images, d(DRR)(DIBH) and d(port)(DIBH), respectively, was compared as a measure of DIBH setup uncertainty. The difference ([Formula: see text]) between d(DRR)(DIBH) and d(port)(DIBH) was defined as the systematic uncertainty. The standard deviation of [Formula: see text] for each patient was defined as the random uncertainty. MV cine images during radiation were acquired. Affine registrations of the cine images acquired during one fraction and multiple fractions were performed to study the intra‐ and interfraction motion of the chest wall. The median chest wall motion was used as the metric for intra‐ and interfraction analysis. Breast motions in superior–inferior (SI) direction and “AP” (defined on the DRR or MV portal image as the direction perpendicular to the SI direction) are reported. Systematic and random uncertainties of 3.8 mm and 2 mm, respectively, were found for this spirometer‐guided DIBH treatment. MV cine analysis showed that intrafraction chest wall motions during DIBH were 0.3 mm in “AP” and 0.6 mm in SI. The interfraction chest wall motions were 3.6 mm in “AP” and 3.4 mm in SI. Utilization of DIBH with this spirometry system led to a statistically significant reduction of cardiac dose relative to FB treatment. The DIBH using video‐guided spirometry provided reproducible cardiac sparing with minimal intra‐ and interfraction chest wall motion, and thus is a valuable adjunct to modern breast treatment techniques. PACS number: 87.55.kh, 87.55.ne, 87.55.tg
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spelling pubmed-56900702018-04-02 Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer Yang, Wensha McKenzie, Elizabeth M. Burnison, Michele Shiao, Stephen Mirhadi, Amin Hakimian, Behrooz Reznik, Robert Tuli, Richard Sandler, Howard Fraass, Benedick A. J Appl Clin Med Phys Radiation Oncology Physics The purpose was to report clinical experience of a video‐guided spirometry system in applying deep inhalation breath‐hold (DIBH) radiotherapy for left‐sided breast cancer, and to study the systematic and random uncertainties, intra‐ and interfraction motion and impact on cardiac dose associated with DIBH. The data from 28 left‐sided breast cancer patients treated with spirometer‐guided DIBH radiation were studied. Dosimetric comparisons between free‐breathing (FB) and DIBH plans were performed. The distance between the heart and chest wall measured on the digitally reconstructed radiographs (DRR) and MV portal images, d(DRR)(DIBH) and d(port)(DIBH), respectively, was compared as a measure of DIBH setup uncertainty. The difference ([Formula: see text]) between d(DRR)(DIBH) and d(port)(DIBH) was defined as the systematic uncertainty. The standard deviation of [Formula: see text] for each patient was defined as the random uncertainty. MV cine images during radiation were acquired. Affine registrations of the cine images acquired during one fraction and multiple fractions were performed to study the intra‐ and interfraction motion of the chest wall. The median chest wall motion was used as the metric for intra‐ and interfraction analysis. Breast motions in superior–inferior (SI) direction and “AP” (defined on the DRR or MV portal image as the direction perpendicular to the SI direction) are reported. Systematic and random uncertainties of 3.8 mm and 2 mm, respectively, were found for this spirometer‐guided DIBH treatment. MV cine analysis showed that intrafraction chest wall motions during DIBH were 0.3 mm in “AP” and 0.6 mm in SI. The interfraction chest wall motions were 3.6 mm in “AP” and 3.4 mm in SI. Utilization of DIBH with this spirometry system led to a statistically significant reduction of cardiac dose relative to FB treatment. The DIBH using video‐guided spirometry provided reproducible cardiac sparing with minimal intra‐ and interfraction chest wall motion, and thus is a valuable adjunct to modern breast treatment techniques. PACS number: 87.55.kh, 87.55.ne, 87.55.tg John Wiley and Sons Inc. 2015-03-08 /pmc/articles/PMC5690070/ /pubmed/26103193 http://dx.doi.org/10.1120/jacmp.v16i2.5218 Text en © 2015 The Authors. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Radiation Oncology Physics
Yang, Wensha
McKenzie, Elizabeth M.
Burnison, Michele
Shiao, Stephen
Mirhadi, Amin
Hakimian, Behrooz
Reznik, Robert
Tuli, Richard
Sandler, Howard
Fraass, Benedick A.
Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
title Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
title_full Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
title_fullStr Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
title_full_unstemmed Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
title_short Clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
title_sort clinical experience using a video‐guided spirometry system for deep inhalation breath‐hold radiotherapy of left‐sided breast cancer
topic Radiation Oncology Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690070/
https://www.ncbi.nlm.nih.gov/pubmed/26103193
http://dx.doi.org/10.1120/jacmp.v16i2.5218
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