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Surface guided ring gantry radiotherapy in deep inspiration breath hold for breast cancer patients

Kadhim, Mustafa LU ; Haraldsson, André LU ; Kügele, Malin LU orcid ; Enocson, Hedda LU ; Bäck, Sven LU and Ceberg, Sofie LU (2024) In Journal of Applied Clinical Medical Physics 25(10).
Abstract

Purpose: This study investigated the use of surface guided radiotherapy (SGRT) in combination with a tomotherapy treatment mode using discrete delivery angles for deep inspiration breath hold (DIBH) treatments of breast cancer (bc). We aimed to assess the feasibility and dosimetric advantages of this approach. Materials and methods: We evaluated camera occlusion in the Radixact treatment system bore and the stability of DIBH signals during couch movement. The SGRT system's ability to maintain signal and surface image accuracy was analyzed at different depths within the bore. Dosimetric parameters were compared and measured for 20 left-sided bc patients receiving TomoDirect (TD) tangential radiotherapy in both DIBH and free breathing... (More)

Purpose: This study investigated the use of surface guided radiotherapy (SGRT) in combination with a tomotherapy treatment mode using discrete delivery angles for deep inspiration breath hold (DIBH) treatments of breast cancer (bc). We aimed to assess the feasibility and dosimetric advantages of this approach. Materials and methods: We evaluated camera occlusion in the Radixact treatment system bore and the stability of DIBH signals during couch movement. The SGRT system's ability to maintain signal and surface image accuracy was analyzed at different depths within the bore. Dosimetric parameters were compared and measured for 20 left-sided bc patients receiving TomoDirect (TD) tangential radiotherapy in both DIBH and free breathing (FB). Results: The SGRT system maintained surface coverage and precise DIBH-signal at depths up to 40 cm beyond the treatment center. Camera occlusion occurred in the clavicular and neck regions due to the patient's morphology and gantry geometry. Nonetheless, the system accurately detected respiratory motion for all measurements. The DIBH plans significantly (p < 0.001) reduced mean heart and left anterior descending artery (LAD) radiation doses by up to 40%, with a 50% reduction in near-maximum heart and LAD doses, respectively. No significant dosimetric differences between DIBH and FB were observed in other investigated parameters and volumes. Conclusions: Camera occlusion and couch movement minimally impacted the real-time surface image accuracy needed for DIBH treatments of bc. DIBH reduced heart and LAD radiation doses significantly compared to FB, indicating the feasibility and dosimetric benefits of combining these modalities.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
DIBH, SGRT, tomotherapy, VitalHold
in
Journal of Applied Clinical Medical Physics
volume
25
issue
10
publisher
American College of Medical Physics
external identifiers
  • pmid:39138877
  • scopus:85201097360
ISSN
1526-9914
DOI
10.1002/acm2.14463
language
English
LU publication?
yes
id
0ef61b98-3323-4191-ab82-f40814a2affc
date added to LUP
2024-10-14 14:16:29
date last changed
2025-07-08 12:47:12
@article{0ef61b98-3323-4191-ab82-f40814a2affc,
  abstract     = {{<p>Purpose: This study investigated the use of surface guided radiotherapy (SGRT) in combination with a tomotherapy treatment mode using discrete delivery angles for deep inspiration breath hold (DIBH) treatments of breast cancer (bc). We aimed to assess the feasibility and dosimetric advantages of this approach. Materials and methods: We evaluated camera occlusion in the Radixact treatment system bore and the stability of DIBH signals during couch movement. The SGRT system's ability to maintain signal and surface image accuracy was analyzed at different depths within the bore. Dosimetric parameters were compared and measured for 20 left-sided bc patients receiving TomoDirect (TD) tangential radiotherapy in both DIBH and free breathing (FB). Results: The SGRT system maintained surface coverage and precise DIBH-signal at depths up to 40 cm beyond the treatment center. Camera occlusion occurred in the clavicular and neck regions due to the patient's morphology and gantry geometry. Nonetheless, the system accurately detected respiratory motion for all measurements. The DIBH plans significantly (p &lt; 0.001) reduced mean heart and left anterior descending artery (LAD) radiation doses by up to 40%, with a 50% reduction in near-maximum heart and LAD doses, respectively. No significant dosimetric differences between DIBH and FB were observed in other investigated parameters and volumes. Conclusions: Camera occlusion and couch movement minimally impacted the real-time surface image accuracy needed for DIBH treatments of bc. DIBH reduced heart and LAD radiation doses significantly compared to FB, indicating the feasibility and dosimetric benefits of combining these modalities.</p>}},
  author       = {{Kadhim, Mustafa and Haraldsson, André and Kügele, Malin and Enocson, Hedda and Bäck, Sven and Ceberg, Sofie}},
  issn         = {{1526-9914}},
  keywords     = {{DIBH; SGRT; tomotherapy; VitalHold}},
  language     = {{eng}},
  number       = {{10}},
  publisher    = {{American College of Medical Physics}},
  series       = {{Journal of Applied Clinical Medical Physics}},
  title        = {{Surface guided ring gantry radiotherapy in deep inspiration breath hold for breast cancer patients}},
  url          = {{http://dx.doi.org/10.1002/acm2.14463}},
  doi          = {{10.1002/acm2.14463}},
  volume       = {{25}},
  year         = {{2024}},
}