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Title: Assessment of Intrafraction Breathing Motion on Left Anterior Descending Artery Dose During Left-Sided Breast Radiation Therapy

Abstract

Purpose: To use 4-dimensional computed tomography (4D-CT) imaging to predict the level of uncertainty in cardiac dose estimates of the left anterior descending artery that arises due to breathing motion during radiation therapy for left-sided breast cancer. Methods and Materials: The fast helical CT (FH-CT) and 4D-CT of 30 left-sided breast cancer patients were retrospectively analyzed. Treatment plans were created on the FH-CT. The original treatment plan was then superimposed onto all 10 phases of the 4D-CT to quantify the dosimetric impact of respiratory motion through 4D dose accumulation (4D-dose). Dose-volume histograms for the heart, left ventricle (LV), and left anterior descending (LAD) artery obtained from the FH-CT were compared with those obtained from the 4D-dose. Results: The 95% confidence interval of 4D-dose and FH-CT differences in mean dose estimates for the heart, LV, and LAD were ±0.5 Gy, ±1.0 Gy, and ±8.7 Gy, respectively. Conclusion: Fast helical CT is a good approximation for doses to the heart and LV; however, dose estimates for the LAD are susceptible to uncertainties that arise due to intrafraction breathing motion that cannot be ascertained without the additional information obtained from 4D-CT and dose accumulation. For future clinical studies, we suggest the use of 4D-CT–derived dose-volume histograms formore » estimating the dose to the LAD.« less

Authors:
 [1];  [2];  [3];  [1];  [2];  [1];  [2];  [2]
  1. Department of Medical Biophysics, University of Western Ontario, London, Ontario (Canada)
  2. (Canada)
  3. Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada)
Publication Date:
OSTI Identifier:
22648722
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 95; Journal Issue: 3; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The 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; ARTERIES; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; DOSES; GY RANGE 01-10; HEART; MAMMARY GLANDS; NEOPLASMS; RADIOTHERAPY; RESPIRATION

Citation Formats

El-Sherif, Omar, E-mail: Omar.ElSherif@lhsc.on.ca, Department of Physics, London Regional Cancer Program, London, Ontario, Yu, Edward, Xhaferllari, Ilma, Department of Physics, London Regional Cancer Program, London, Ontario, Gaede, Stewart, Department of Physics, London Regional Cancer Program, London, Ontario, and Department of Radiation Oncology, London Regional Cancer Program, London, Ontario. Assessment of Intrafraction Breathing Motion on Left Anterior Descending Artery Dose During Left-Sided Breast Radiation Therapy. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.02.026.
El-Sherif, Omar, E-mail: Omar.ElSherif@lhsc.on.ca, Department of Physics, London Regional Cancer Program, London, Ontario, Yu, Edward, Xhaferllari, Ilma, Department of Physics, London Regional Cancer Program, London, Ontario, Gaede, Stewart, Department of Physics, London Regional Cancer Program, London, Ontario, & Department of Radiation Oncology, London Regional Cancer Program, London, Ontario. Assessment of Intrafraction Breathing Motion on Left Anterior Descending Artery Dose During Left-Sided Breast Radiation Therapy. United States. doi:10.1016/J.IJROBP.2016.02.026.
El-Sherif, Omar, E-mail: Omar.ElSherif@lhsc.on.ca, Department of Physics, London Regional Cancer Program, London, Ontario, Yu, Edward, Xhaferllari, Ilma, Department of Physics, London Regional Cancer Program, London, Ontario, Gaede, Stewart, Department of Physics, London Regional Cancer Program, London, Ontario, and Department of Radiation Oncology, London Regional Cancer Program, London, Ontario. Fri . "Assessment of Intrafraction Breathing Motion on Left Anterior Descending Artery Dose During Left-Sided Breast Radiation Therapy". United States. doi:10.1016/J.IJROBP.2016.02.026.
@article{osti_22648722,
title = {Assessment of Intrafraction Breathing Motion on Left Anterior Descending Artery Dose During Left-Sided Breast Radiation Therapy},
author = {El-Sherif, Omar, E-mail: Omar.ElSherif@lhsc.on.ca and Department of Physics, London Regional Cancer Program, London, Ontario and Yu, Edward and Xhaferllari, Ilma and Department of Physics, London Regional Cancer Program, London, Ontario and Gaede, Stewart and Department of Physics, London Regional Cancer Program, London, Ontario and Department of Radiation Oncology, London Regional Cancer Program, London, Ontario},
abstractNote = {Purpose: To use 4-dimensional computed tomography (4D-CT) imaging to predict the level of uncertainty in cardiac dose estimates of the left anterior descending artery that arises due to breathing motion during radiation therapy for left-sided breast cancer. Methods and Materials: The fast helical CT (FH-CT) and 4D-CT of 30 left-sided breast cancer patients were retrospectively analyzed. Treatment plans were created on the FH-CT. The original treatment plan was then superimposed onto all 10 phases of the 4D-CT to quantify the dosimetric impact of respiratory motion through 4D dose accumulation (4D-dose). Dose-volume histograms for the heart, left ventricle (LV), and left anterior descending (LAD) artery obtained from the FH-CT were compared with those obtained from the 4D-dose. Results: The 95% confidence interval of 4D-dose and FH-CT differences in mean dose estimates for the heart, LV, and LAD were ±0.5 Gy, ±1.0 Gy, and ±8.7 Gy, respectively. Conclusion: Fast helical CT is a good approximation for doses to the heart and LV; however, dose estimates for the LAD are susceptible to uncertainties that arise due to intrafraction breathing motion that cannot be ascertained without the additional information obtained from 4D-CT and dose accumulation. For future clinical studies, we suggest the use of 4D-CT–derived dose-volume histograms for estimating the dose to the LAD.},
doi = {10.1016/J.IJROBP.2016.02.026},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 95,
place = {United States},
year = {Fri Jul 01 00:00:00 EDT 2016},
month = {Fri Jul 01 00:00:00 EDT 2016}
}