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https://www.readbyqxmd.com/read/28333011/utility-of-deep-inspiration-breath-hold-for-left-sided-breast-radiation-therapy-in-preventing-early-cardiac-perfusion-defects-a-prospective-study
#1
Timothy M Zagar, Orit Kaidar-Person, Xiaoli Tang, Ellen E Jones, Jason Matney, Shiva K Das, Rebecca L Green, Arif Sheikh, Amir H Khandani, William H McCartney, Jorge Daniel Oldan, Terence Z Wong, Lawrence B Marks
PURPOSE: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). METHODS AND MATERIALS: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK)...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28297275/how-dose-sparing-of-cardiac-structures-correlates-with-in-field-heart-volume-and-sternal-displacement
#2
Taeho Kim, Kelli Reardon, Daniel M Trifiletti, Constance Geesey, Kaitlyn Sukovich, Edwin Crandley, Paul W Read, Krishni Wijesooriya
Cardiac irradiation increases the risk of coronary artery disease in patients with left-sided breast cancer. Techniques exist to reduce cardiac irradiation, but the optimum technique depends on individual patient anatomy and physiology. We investigated the correlation of delta heart volume in field (dHVIF) and sternal excursion with dose sparing in heart and left anterior descending artery (LAD) to develop quantitative predictive models for expected dose to heart and LAD. A treatment planning study was performed on 97 left-breast cancer patients who underwent whole breast radiotherapy (prescription dose = 50 Gy) under deep inspiratory breath hold (DIBH)...
November 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28296326/evaluation-of-target-and-cardiac-position-during-visually-monitored-deep-inspiration-breath-hold-for-breast-radiotherapy
#3
Leigh Conroy, Rosanna Yeung, Elizabeth Watt, Sarah Quirk, Karen Long, Alana Hudson, Tien Phan, Wendy L Smith
A low-resource visually monitored deep inspiration breath-hold (VM-DIBH) technique was successfully implemented in our clinic to reduce cardiac dose in left-sided breast radiotherapy. In this study, we retrospectively characterized the chest wall and heart positioning accuracy of VM-DIBH using cine portal images from 42 patients. Central chest wall position from field edge and in-field maximum heart distance (MHD) were manually measured on cine images and compared to the planned positions based on the digitally reconstructed radiographs (DRRs)...
July 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28291926/development-of-a-deep-inspiration-breath-hold-system-for-radiotherapy-utilizing-a-laser-distance-measurer
#4
Christer Andre Jensen, Nils Skottner, Jomar Frengen, Jo-Åsmund Lund
Deep inspiration breath-hold (DIBH) is a technique for treating left-sided breast cancer (LSBC). In modern radiotherapy, one of the main aims is to exclude the heart from the beam aperture with an individualized beam design for LSBC. A deep inhalation will raise the chest wall while the volume of the lungs increase, this will again push the heart away from the breast to be treated. There are a few commercial DIBH systems, both invasive and noninvasive. We present an alternative noninvasive DIBH system based upon an industrial laser distance measurer...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28281859/geometrical-uncertainty-of-heart-position-in-deep-inspiration-breath-hold-radiotherapy-of-left-sided-breast-cancer-patients
#5
Tuomas Koivumäki, Juuso Tujunen, Tuomas Virén, Janne Heikkilä, Jan Seppälä
BACKGROUND: This study aimed to determine the geometrical uncertainty of the position of the heart with daily cone beam computed tomography (CBCT) during deep-inspiration breath-hold (DIBH) treatment of the left breast. MATERIAL AND METHODS: A visually guided optical respiratory monitoring system was used in DIBH treatment of 15 breast cancer patients. Heart position was determined in relation to the planning target volume (PTV) in 225 fractions in which daily low-dose CBCT images were compared with planning CT images...
March 10, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28274398/lower-mean-heart-dose-with-deep-inspiration-breath-hold-whole-breast-irradiation-compared-with-brachytherapy-based-accelerated-partial-breast-irradiation-for-women-with-left-sided-tumors
#6
Emma B Holliday, Steve M Kirsner, Howard D Thames, Bryan E Mason, Christopher L Nelson, Elizabeth S Bloom
PURPOSE: For left-sided breast cancer, radiation to the heart is a concern. We present a comparison of mean heart and coronary artery biologically effective dose (BED) between accelerated partial breast irradiation (APBI) and whole breast irradiation with deep inspiration breath-hold technique (DIBH-WBI). METHODS AND MATERIALS: A total of 100 patients with left-sided, early-stage breast cancer were identified. Fifty underwent single-entry catheter-based APBI and 50 underwent DIBH-WBI...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28245908/target-position-uncertainty-during-visually-guided-deep-inspiration-breath-hold-radiotherapy-in-locally-advanced-lung-cancer
#7
Jonas Scherman Rydhög, Steen Riisgaard de Blanck, Mirjana Josipovic, Rasmus Irming Jølck, Klaus Richter Larsen, Paul Clementsen, Thomas Lars Andersen, Per Rugaard Poulsen, Gitte Fredberg Persson, Per Munck Af Rosenschold
PURPOSE: The purpose of this study was to estimate the uncertainty in voluntary deep-inspiration breath-hold (DIBH) radiotherapy for locally advanced non-small cell lung cancer (NSCLC) patients. METHODS: Perpendicular fluoroscopic movies were acquired in free breathing (FB) and DIBH during a course of visually guided DIBH radiotherapy of nine patients with NSCLC. Patients had liquid markers injected in mediastinal lymph nodes and primary tumours. Excursion, systematic- and random errors, and inter-breath-hold position uncertainty were investigated using an image based tracking algorithm...
February 25, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28203163/is-the-deep-inspiration-breath-hold-technique-superior-to-the-free-breathing-technique-in-cardiac-and-lung-sparing-while-treating-both-left-sided-post-mastectomy-chest-wall-and-supraclavicular-regions
#8
Anupama Darapu, Rajesh Balakrishnan, Patricia Sebastian, Mohamathu Rafic Kather Hussain, Paul Ravindran, Subhashini John
AIMS: To evaluate the efficacy of the deep inspirational breath-hold (DIBH) technique and its dosimetric advantages over the free breathing (FB) technique in cardiac (heart and left anterior descending artery [LAD]) and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. MATERIALS AND METHODS: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28188697/a-case-study-evaluating-deep-inspiration-breath-hold-and-intensity-modulated-radiotherapy-to-minimise-long-term-toxicity-in-a-young-patient-with-bulky-mediastinal-hodgkin-lymphoma
#9
Jonathan M Tomaszewski, Sarah Crook, Kenneth Wan, Lucille Scott, Farshad Foroudi
Radiotherapy plays an important role in the treatment of early-stage Hodgkin lymphoma, but late toxicities such as cardiovascular disease and second malignancy are a major concern. Our aim was to evaluate the potential of deep inspiration breath-hold (DIBH) and intensity-modulated radiotherapy (IMRT) to reduce cardiac dose from mediastinal radiotherapy. A 24 year-old male with early-stage bulky mediastinal Hodgkin lymphoma received involved-site radiotherapy as part of a combined modality programme. Simulation was performed in free breathing (FB) and DIBH...
March 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28179347/dose-sparing-potential-of-deep-inspiration-breath-hold-technique-for-left-breast-cancer-radiotherapy-organs-at-risk
#10
Gavin Lawler, Michelle Leech
BACKGROUND/AIM: To assess if deep inspiration breath-hold (DIBH) technique achieved dose sparing for organs-at-risk in left breast radiotherapy patients in order to reduce long-term complications. PATIENTS AND METHODS: DIBH and Free-breathing (FB) as a control, CT planning scans obtained for 28 left breast/chest wall (+/- supraclavicular field) patients treated January 2008-December 2013 were retrospectively re-contoured and re-planned. Organs-at-risk examined: lungs, left lung, heart and left anterior descending coronary artery (LADCA)...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28139381/assessment-of-upfront-selection-criteria-to-prioritise-patients-for-breath-hold-left-sided-breast-radiotherapy
#11
N Tanna, R McLauchlan, S Karis, C Welgemoed, D M Gujral, S J Cleator
AIMS: Deep inspiratory breath-hold (DIBH) techniques for left breast and chest wall radiotherapy can reduce cardiac dose. We investigated the use of 'upfront selection' criteria for DIBH based on tumour bed position and whether cardiac shielding was used. MATERIALS AND METHODS: Four methods of selecting patients for DIBH were assessed retrospectively in a cohort of left breast and chest wall treatments. These were: (1) free breathing scan on all patients, selecting DIBH treatment for those with a predicted mean heart dose ≥3 Gy; (2) selective DIBH for those with maximum heart depth (MHD) on free breathing scan ≥1 cm; (3) use of an 'upfront selection process' using tumour bed position as initial selection and measurement of MHD on those not selected upfront; (4) DIBH on all...
January 27, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28089480/deep-inspiration-breath-hold-produces-a-clinically-meaningful-reduction-in-ipsilateral-lung-dose-during-locoregional-radiation-therapy-for-some-women-with-right-sided-breast-cancer
#12
Jessica L Conway, Leigh Conroy, Lindsay Harper, Marie Scheifele, Haocheng Li, Wendy L Smith, Tannis Graham, Tien Phan, Ivo A Olivotto
PURPOSE: The goal of the work described here was to determine whether deep inspiration breath-hold (DIBH) produces a clinically meaningful reduction in pulmonary dose compared with free breathing (FB) during locoregional radiation for right-sided breast cancer. METHODS AND MATERIALS: Four-field, modified-wide tangent plans with full nodal coverage were developed for 30 consecutive patients on paired DIBH and FB CT scans. Nodes were contoured according to European Society for Radiotherapy and Oncology guidelines...
October 19, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28048814/su-f-j-123-ct-based-determination-of-dibh-variability-and-its-dosimetric-impact-on-post-mastectomy-plus-regional-nodal-radiation-therapy
#13
M Malin, H Kang, K Tatebe, Y Hasan, S Chmura, H Al-Hallaq
PURPOSE: Breast cancer radiotherapy delivered using voluntary deep inspiration breath-hold (DIBH) requires reproducible breath holds, particularly when matching supraclavicular fields to tangential fields. We studied the impact of variation in DIBHs on CTV and OAR dose metrics by comparing the dose distribution computed on two DIBH CT scans taken at the time of simulation. METHODS: Ten patients receiving 50Gy in 25 fractions to the left chestwall and regional lymph nodes were studied...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048808/su-f-j-19-robust-region-of-interest-roi-for-consistent-registration-on-deteriorated-surface-images
#14
H Kang, M Malin, S Chmura, Y Hasan, H Al-Hallaq
PURPOSE: For African-American patients receiving breast radiotherapy with a bolus, skin darkening can affect the surface visualization when using optical imaging for daily positioning and gating at deep-inspiration breath holds (DIBH). Our goal is to identify a region-of-interest (ROI) that is robust against deteriorating surface image quality due to skin darkening. METHODS: We study four patients whose post-mastectomy surfaces are imaged daily with AlignRT (VisionRT, UK) for DIBH radiotherapy and whose surface image quality is degraded toward the end of treatment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048736/su-f-j-55-feasibility-of-supraclavicular-field-treatment-by-investigating-variation-of-junction-position-between-breast-tangential-and-supraclavicular-fields-for-deep-inspiration-breath-hold-dibh-left-breast-radiation
#15
H Zhao, V Sarkar, A Paxton, P Rassiah-Szegedi, Y Huang, M Szegedi, L Huang, F Su, B Salter
PURPOSE: To explore the feasibility of supraclavicular field treatment by investigating the variation of junction position between tangential and supraclavicular fields during left breast radiation using DIBH technique. METHODS: Six patients with left breast cancer treated using DIBH technique were included in this study. AlignRT system was used to track patient's breast surface. During daily treatment, when the patient's DIBH reached preset AlignRT tolerance of ±3mm for all principle directions (vertical, longitudinal, and lateral), the remaining longitudinal offset was recorded...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048690/su-f-j-22-lung-volumevariability-assessed-by-bh-cbct-in-3d-surface-image-guided-deep-inspirationbreath-hold-dibh-radiotherapy-for-left-sided-breast-cancer
#16
A Gutierrez, D Stanley, N Papanikolaou, R Crownover
PURPOSE: With the increasing use of DIBH techniques for left-sided breast cancer, 3D surface-image guided DIBH techniques have improved patient setup and facilitated DIBH radiation delivery. However, quantification of the daily separation between the heart and left breast still presents a challenge. One method of assuring separation is to ensure consistent left lung filling. With this in mind, the aim of this study is to retrospectively quantify left lung volume from weekly breath hold-CBCTs (bh-CBCT) of left-sided breast patients treated using a 3D surface imaging system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048390/su-f-t-415-differences-in-lung-sparing-in-deep-inspiration-breath-hold-and-free-breathing-breast-plans-calculated-in-pinnacle-and-monaco
#17
D Saenz, S Stathakis
PURPOSE: Deep inspiration breath-hold (DIBH) is used for left-sided breast radiotherapy to spare the heart and lung. The magnitude of sparing has been shown to be significant. Monte Carlo, furthermore, has the potential to calculate most accurately the dose in the heterogeneous lung medium at the interface with the lung wall. The lung dose was investigated in Monaco to determine the level of sparing relative to that calculated in Pinnacle(3) . METHODS: Five patients undergoing DIBH radiotherapy on an Elekta Versa HD linear accelerator in conjunction with the Catalyst C-RAD surface imaging system were planned using Phillips Pinnacle(3) ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048276/su-f-t-525-monitordeep-inspiratory-breathhold-with-a-laser-sensor-for-radiation-therapy-of-left-breast-cancer
#18
A Tai, D J Li, A Currey, X Allen Li
PURPOSE: Radiation therapy (RT) of left sided breast cancers with deep-inspiratory breathhold (DIBH) can reduce the dose to heart. The purpose of this study is to develop and test a new laser-based tool to improve ease of RT delivery using DIBH. METHODS: A laser sensor together with breathing monitor device (Anzai Inc., Japan) was used to record the surface breathing motion of phantom/volunteers. The device projects a laser beam to the chestwall and the reflected light creates a focal spot on a light detecting element...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047823/we-de-209-00-practical-implementation-of-deep-inspiration-breath-hold-techniques-for-breast-radiation-therapy
#19
Rebecca Howell
Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047632/we-de-209-03-spirometric-motion-management-system
#20
S Hadley
Breast radiation therapy is associated with some risk of lung toxicity as well as cardiac toxicity for left-sided cases. Radiation doses to the lung and heart can be reduced by using the deep inspiration breath hold (DIBH) technique, in which the patient is simulated and treated during the deep inspiration phase of the breathing cycle. During DIBH, the heart is usually displaced posteriorly, inferiorly, and to the right, effectively expanding the distance between the heart and the breast/chest wall. As a result, the distance between the medial treatment field border and heart/lung is increased...
June 2016: Medical Physics
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