PMID- 36875326
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230307
IS  - 2405-6316 (Electronic)
IS  - 2405-6316 (Linking)
VI  - 25
DP  - 2023 Jan
TI  - A method for beam's eye view breath-hold monitoring during breast volumetric 
      modulated arc therapy.
PG  - 100419
LID - 10.1016/j.phro.2023.100419 [doi]
LID - 100419
AB  - BACKGROUND AND PURPOSE: Deep inspiration breath-hold (DIBH) is a technique that 
      is widely utilised to spare the heart and lungs during breast radiotherapy. In 
      this study, a method was developed to validate directly the intrafraction 
      accuracy of DIBH during breast volumetric modulated arc therapy (VMAT) via 
      internal chest wall (CW) monitoring. MATERIALS AND METHODS: In-house software was 
      developed to automatically extract and compare the treatment position of the CW 
      in cine-mode electronic portal image device (EPID) images with the planned CW 
      position in digitally reconstructed radiographs (DRR) for breast VMAT treatments. 
      Feasibility of this method was established by evaluating the percentage of total 
      dose delivered to the target volume when the CW was sufficiently visible for 
      monitoring. Geometric accuracy of the approach was quantified by applying known 
      displacements to an anthropomorphic thorax phantom. The software was used to 
      evaluate (offline) the geometric treatment accuracy for ten patients treated 
      using real-time position management (RPM)-guided DIBH. RESULTS: The CW could be 
      monitored within the tangential sub-arcs which delivered a median 89% (range 73% 
      to 97%) of the dose to target volume. The phantom measurements showed a geometric 
      accuracy within 1 mm, with visual inspection showing good agreement between the 
      software-derived and user-determined CW positions. For the RPM-guided DIBH 
      treatments, the CW was found to be within +/-5 mm of the planned position in 97% of 
      EPID frames in which the CW was visible. CONCLUSION: An intrafraction monitoring 
      method with sub-millimetre accuracy was successfully developed to validate target 
      positioning during breast VMAT DIBH.
CI  - (c) 2023 The Authors.
FAU - Carr, M A
AU  - Carr MA
AD  - Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South 
      Wales, Australia.
AD  - Institute of Medical Physics, School of Physics, The University of Sydney, 
      Sydney, New South Wales, Australia.
FAU - Gargett, M
AU  - Gargett M
AD  - Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South 
      Wales, Australia.
AD  - School of Health Sciences, Faculty of Medicine and Health, The University of 
      Sydney, Sydney, New South Wales, Australia.
FAU - Stanton, C
AU  - Stanton C
AD  - Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South 
      Wales, Australia.
FAU - Zwan, B
AU  - Zwan B
AD  - Central Coast Cancer Centre, Gosford Hospital, Gosford, New South Wales, 
      Australia.
FAU - Byrne, H L
AU  - Byrne HL
AD  - ACRF Image-X Institute, Faculty of Medicine and Health, The University of Sydney, 
      Sydney, New South Wales, Australia.
FAU - Booth, J T
AU  - Booth JT
AD  - Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South 
      Wales, Australia.
AD  - Institute of Medical Physics, School of Physics, The University of Sydney, 
      Sydney, New South Wales, Australia.
LA  - eng
PT  - Journal Article
DEP - 20230125
PL  - Netherlands
TA  - Phys Imaging Radiat Oncol
JT  - Physics and imaging in radiation oncology
JID - 101704276
PMC - PMC9975298
OTO - NOTNLM
OT  - BEV monitoring
OT  - Breast VMAT
OT  - Chest wall
OT  - Cine EPID
OT  - DIBH
OT  - Deep inspiration breath-hold
OT  - Electronic portal imaging device
OT  - Intrafraction motion
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2023/03/07 06:00
MHDA- 2023/03/07 06:01
PMCR- 2023/01/25
CRDT- 2023/03/06 04:08
PHST- 2022/09/08 00:00 [received]
PHST- 2023/01/19 00:00 [revised]
PHST- 2023/01/20 00:00 [accepted]
PHST- 2023/03/06 04:08 [entrez]
PHST- 2023/03/07 06:00 [pubmed]
PHST- 2023/03/07 06:01 [medline]
PHST- 2023/01/25 00:00 [pmc-release]
AID - S2405-6316(23)00010-6 [pii]
AID - 100419 [pii]
AID - 10.1016/j.phro.2023.100419 [doi]
PST - epublish
SO  - Phys Imaging Radiat Oncol. 2023 Jan 25;25:100419. doi: 
      10.1016/j.phro.2023.100419. eCollection 2023 Jan.