Short-Term Displacement and Reproducibility of the Breast and Nodal Targets Under Active Breathing Control

Jean M. Moran*, James M. Balter, Merav A. Ben-David, Robin B. Marsh, Marcel Van Herk, Lori J. Pierce

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

Purpose: The short-term displacement and reproducibility of the breast or chest wall, and the internal mammary (IM), infraclavicular (ICV), and supraclavicular (SCV) nodal regions have been assessed as a function of breath-hold state using an active breathing control (ABC) device for patients receiving loco-regional breast radiation therapy. Methods and Materials: Ten patients underwent computed tomographic scanning using an ABC device at breath-hold states of end-exhale and 20%, 40%, 60%, and 80% of vital capacity (VC). Patients underwent scanning before treatment and at one third and two thirds of the way through treatment. A regional registration was performed for each target using a rigid-body transformation with mutual information as a metric. Results: Between exhale and 40% of VC, the mean displacement was 0.27/0.34, 0.24/0.31, 0.22/0.19, and 0.13/0.19 cm anterior/superior for the breast or chest wall, and IM, ICV, and SCV nodes, respectively. At 80% of VC, the mean displacement from exhale was 0.84/.88, 0.76/.79, 0.70/0.79, and 0.54/0.56 cm anterior/superior for the breast or chest wall, and IM, ICV, and SCV nodes, respectively. The short-term reproducibility (standard deviation) was <0.3 and ≤0.4 cm for 40% and 80% of VC, respectively. Displacements up to 1.9 cm were observed for individual patients. Conclusions: The short-term reproducibility of target position is ≤0.4 cm using ABC for all structures for all breath-hold states. This information can be used to guide treatment planning optimization studies that consider the effect of motion on target and normal tissue doses with and without active breathing control.

Original languageEnglish
Pages (from-to)541-546
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume68
Issue number2
DOIs
StatePublished - 1 Jun 2007
Externally publishedYes

Keywords

  • Active breathing control
  • Breast cancer
  • Heart
  • Radiation planning
  • Short-term reproducibility

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