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Evaluation of the heart and lung dosimetric parameters in deep inspiration breath hold using 3D Slicer

Radiation Oncology Journal 2020년 38권 1호 p.68 ~ 76
Eskandari Azam, Nasseri Shahrokh, Gholamhosseinian Hamid, Hosseini Sare, Farzaneh Mohammad Javad Keikhai, Keramati Alireza, Naji Maryam, Rostami Atefeh, Momennezhad Mehdi,
소속 상세정보
 ( Eskandari Azam ) - Mashhad University of Medical Sciences Faculty of Medicine Department of Medical Physics
 ( Nasseri Shahrokh ) - Mashhad University of Medical Sciences Faculty of Medicine Department of Medical Physics
 ( Gholamhosseinian Hamid ) - Mashhad University of Medical Sciences Faculty of Medicine Department of Medical Physics
 ( Hosseini Sare ) - Mashhad University of Medical Sciences Faculty of Medicine Cancer Research Center
 ( Farzaneh Mohammad Javad Keikhai ) - Zahedan University of Medical Sciences Faculty of Medicine Department of Medical Physics
 ( Keramati Alireza ) - Mashhad University of Medical Sciences Student Research Committee
 ( Naji Maryam ) - Mashhad University of Medical Sciences Imam Reza Hospital Department of Radiation Oncology
 ( Rostami Atefeh ) - Sabzevar University of Medical Sciences Department of Medical Physics and Radiological Sciences
 ( Momennezhad Mehdi ) - Mashhad University of Medical Sciences Faculty of Medicine Department of Medical Physics

Abstract


Purpose: The present study was conducted to compare dosimetric parameters for the heart and left lung between free breathing (FB) and deep inspiration breath hold (DIBH) and determine the most important potential factors associated with increasing the lung dose for left-sided breast radiotherapy using image analysis with 3D Slicer software.

Materials and Methods: Computed tomography-simulation scans in FB and DIBH were obtained from 17 patients with left-sided breast cancer. After contouring, three-dimensional conformal plans were generated for them. The prescribed dose was 50 Gy to the clinical target volume. In addition to the dosimetric parameters, the irradiated volumes and both displacement magnitudes and vectors for the heart and left lung were assessed using 3D Slicer software.

Results: The average of the heart mean dose (Dmean) decreased from 5.97 to 3.83 Gy and V25 from 7.60% to 3.29% using DIBH (p < 0.001). Furthermore, the average of Dmean for the left lung was changed from 8.67 to 8.95 Gy (p = 0.389) and V20 from 14.84% to 15.44% (p = 0.387). Both of the absolute and relative irradiated heart volumes decreased from 42.12 to 15.82 mL and 8.16% to 3.17%, respectively (p < 0.001); however, these parameters for the left lung increased from 124.32 to 223.27 mL (p < 0.001) and 13.33% to 13.99% (p = 0.350). In addition, the average of heart and left lung displacement magnitudes were calculated at 7.32 and 20.91 mm, respectively.

Conclusion: The DIBH is an effective technique in the reduction of the heart dose for tangentially treated left sided-breast cancer patients, without a detrimental effect on the left lung.

키워드

Breath holding; Unilateral breast neoplasms; Heart; Radiotherapy; Conformal

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