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Title: Respiratory Motion of The Heart and Positional Reproducibility Under Active Breathing Control

Abstract

Purpose: To reduce cardiotoxicity from breast radiotherapy (RT), innovative techniques are under investigation. Information about cardiac motion with respiration and positional reproducibility under active breathing control (ABC) is necessary to evaluate these techniques. Methods and Materials: Patients requiring loco-regional RT for breast cancer were scanned by computed tomography using an ABC device at various breath-hold states, before and during treatment. Ten patients were studied. For each patient, 12 datasets were analyzed. Mutual information-based regional rigid alignment was used to determine the magnitude and reproducibility of cardiac motion as a function of breathing state. For each scan session, motion was quantified by evaluating the displacement of a point along the left anterior descending artery (LAD) with respect to its position at end expiration. Long-term positional reproducibility was also assessed. Results: Displacement of the LAD was greatest in the inferior direction, moderate in the anterior direction, and lowest in the left-right direction. At shallow breathing states, the average displacement of LAD position was up to 6 mm in the inferior direction. The maximum displacement in any patient was 2.8 cm in the inferior direction, between expiration and deep-inspiration breath hold. At end expiration, the long-term reproducibility (SD) of the LAD position wasmore » 3 mm in the A-P, 6 mm in the S-I, and 4 mm in the L-R directions. At deep-inspiration breath hold, long-term reproducibility was 3 mm in the A-P, 7 mm in the S-I, and 3 mm in the L-R directions. Conclusions: These data demonstrate the extent of LAD displacement that occurs with shallow breathing and with deep-inspiration breath hold. This information may guide optimization studies considering the effects of respiratory motion and reproducibility of cardiac position on cardiac dose, both with and without ABC.« less

Authors:
 [1];  [1];  [1];  [1];  [1];  [2]
  1. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)
  2. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States). E-mail: ljpierce@umich.edu
Publication Date:
OSTI Identifier:
20951640
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 68; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.12.058; PII: S0360-3016(06)03671-6; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ALIGNMENT; ARTERIES; BREATH; COMPUTERIZED TOMOGRAPHY; HEART; INFORMATION; MAMMARY GLANDS; NEOPLASMS; OPTIMIZATION; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY; RESPIRATION

Citation Formats

Jagsi, Reshma, Moran, Jean M., Kessler, Marc L., Marsh, Robin B. C, Balter, James M., and Pierce, Lori J. Respiratory Motion of The Heart and Positional Reproducibility Under Active Breathing Control. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.12.058.
Jagsi, Reshma, Moran, Jean M., Kessler, Marc L., Marsh, Robin B. C, Balter, James M., & Pierce, Lori J. Respiratory Motion of The Heart and Positional Reproducibility Under Active Breathing Control. United States. doi:10.1016/j.ijrobp.2006.12.058.
Jagsi, Reshma, Moran, Jean M., Kessler, Marc L., Marsh, Robin B. C, Balter, James M., and Pierce, Lori J. Tue . "Respiratory Motion of The Heart and Positional Reproducibility Under Active Breathing Control". United States. doi:10.1016/j.ijrobp.2006.12.058.
@article{osti_20951640,
title = {Respiratory Motion of The Heart and Positional Reproducibility Under Active Breathing Control},
author = {Jagsi, Reshma and Moran, Jean M. and Kessler, Marc L. and Marsh, Robin B. C and Balter, James M. and Pierce, Lori J.},
abstractNote = {Purpose: To reduce cardiotoxicity from breast radiotherapy (RT), innovative techniques are under investigation. Information about cardiac motion with respiration and positional reproducibility under active breathing control (ABC) is necessary to evaluate these techniques. Methods and Materials: Patients requiring loco-regional RT for breast cancer were scanned by computed tomography using an ABC device at various breath-hold states, before and during treatment. Ten patients were studied. For each patient, 12 datasets were analyzed. Mutual information-based regional rigid alignment was used to determine the magnitude and reproducibility of cardiac motion as a function of breathing state. For each scan session, motion was quantified by evaluating the displacement of a point along the left anterior descending artery (LAD) with respect to its position at end expiration. Long-term positional reproducibility was also assessed. Results: Displacement of the LAD was greatest in the inferior direction, moderate in the anterior direction, and lowest in the left-right direction. At shallow breathing states, the average displacement of LAD position was up to 6 mm in the inferior direction. The maximum displacement in any patient was 2.8 cm in the inferior direction, between expiration and deep-inspiration breath hold. At end expiration, the long-term reproducibility (SD) of the LAD position was 3 mm in the A-P, 6 mm in the S-I, and 4 mm in the L-R directions. At deep-inspiration breath hold, long-term reproducibility was 3 mm in the A-P, 7 mm in the S-I, and 3 mm in the L-R directions. Conclusions: These data demonstrate the extent of LAD displacement that occurs with shallow breathing and with deep-inspiration breath hold. This information may guide optimization studies considering the effects of respiratory motion and reproducibility of cardiac position on cardiac dose, both with and without ABC.},
doi = {10.1016/j.ijrobp.2006.12.058},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 68,
place = {United States},
year = {Tue May 01 00:00:00 EDT 2007},
month = {Tue May 01 00:00:00 EDT 2007}
}