Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Evaluation of the heart and lung dosimetric parameters in deep inspiration breath hold using 3D Slicer

  • Eskandari, Azam (Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Science) ;
  • Nasseri, Shahrokh (Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Science) ;
  • Gholamhosseinian, Hamid (Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Science) ;
  • Hosseini, Sare (Cancer Research Center, Mashhad University of Medical Sciences) ;
  • Farzaneh, Mohammad Javad Keikhai (Department of Medical Physics, Faculty of Medicine, Zahedan University of Medical Sciences) ;
  • Keramati, Alireza (Student Research Committee, Mashhad University of Medical Sciences) ;
  • Naji, Maryam (Department of Radiation Oncology, Imam Reza Hospital, Mashhad University of Medical Sciences) ;
  • Rostami, Atefeh (Department of Medical Physics and Radiological Sciences, Sabzevar University of Medical Sciences) ;
  • Momennezhad, Mehdi (Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Science)
  • Received : 2019.12.27
  • Accepted : 2020.03.06
  • Published : 2020.03.31
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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.

Keywords

References

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