scholarly journals Dosimetric comparison of normal breathing and deep inspiration breath hold technique for synchronous bilateral breast cancer using 6MV flattened beam and flattening filter free beam

2021 ◽  
Author(s):  
Suresh Tamilarasu ◽  
Madeswaran Saminathan
Keyword(s):  
Breast Cancer ◽  
Bilateral Breast Cancer ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Normal Breathing ◽  
Flattening Filter Free ◽  
Synchronous Bilateral Breast Cancer ◽  
Flattening Filter ◽  
Free Beam

scholarly journals Dosimetric comparison of deep inspiration breath hold and free breathing technique in stereotactic body radiotherapy for localized lung tumor using Flattening Filter Free beam

2018 ◽  
Vol 24 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Karthick Raj Mani ◽  
Md. Anisuzzaman Bhuiyan ◽  
Md. Mahbub Alam ◽  
Sharif Ahmed ◽  
Mostafa Aziz Sumon ◽  
...  
Keyword(s):  
Lung Tumor ◽  
Free Breathing ◽  
Target Volume ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Ipsilateral Lung ◽  
Flattening Filter Free ◽  
Flattening Filter ◽  
The Mean

Abstract Aim: To compare the dosimetric advantage of stereotactic body radiotherapy (SBRT) for localized lung tumor between deep inspiration breath hold technique and free breathing technique. Materials and methods: We retrospectively included ten previously treated lung tumor patients in this dosimetric study. All the ten patients underwent CT simulation using 4D-CT free breathing (FB) and deep inspiration breath hold (DIBH) techniques. Plans were created using three coplanar full modulated arc using 6 MV flattening filter free (FFF) bream with a dose rate of 1400 MU/min. Same dose constraints for the target and the critical structures for a particular patient were used during the plan optimization process in DIBH and FB datasets. We intend to deliver 50 Gy in 5 fractions for all the patients. For standardization, all the plans were normalized at target mean of the planning target volume (PTV). Doses to the critical structures and targets were recorded from the dose volume histogram for evaluation. Results: The mean right and left lung volumes were inflated by 1.55 and 1.60 times in DIBH scans compared to the FB scans. The mean internal target volume (ITV) increased in the FB datasets by 1.45 times compared to the DIBH data sets. The mean dose followed by standard deviation (x̄ ± σx̄) of ipsilateral lung for DIBH-SBRT and FB-SBRT plans were 7.48 ± 3.57 (Gy) and 10.23 ± 4.58 (Gy) respectively, with a mean reduction of 36.84% in DIBH-SBRT plans. Ipsilateral lung were reduced to 36.84% in DIBH plans compared to FB plans. Conclusion: Significant dose reduction in ipsilateral lung due to the lung inflation and target motion restriction in DIBH-SBRT plans were observed compare to FB-SBRT. DIBH-SBRT plans demonstrate superior dose reduction to the normal tissues and other critical structures.

scholarly journals Using flattening filter free beams in electronic tissue compensation whole breast irradiation with deep inspiration breath hold

2020 ◽  
Vol 21 (12) ◽  
pp. 280-287
Author(s):  
Sarah B. Wisnoskie ◽  
Xiaoying Liang ◽  
Andrew O. Wahl ◽  
Nathan R. Bennion ◽  
Andrew D. Granatowicz ◽  
...  
Keyword(s):  
Breath Hold ◽  
Whole Breast Irradiation ◽  
Deep Inspiration ◽  
Breast Irradiation ◽  
Deep Inspiration Breath Hold ◽  
Flattening Filter Free ◽  
Flattening Filter

Dosimetric comparison of flattened and flattening filter-free beams for liver stereotactic body irradiation in deep inspiration breath hold, and free breathing conditions

2019 ◽  
Vol 18 (02) ◽  
pp. 169-174
Author(s):  
N. Munirathinam ◽  
P. N. Pawaskar
Keyword(s):  
Free Breathing ◽  
Target Volume ◽  
Conformity Index ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Flattening Filter Free ◽  
Treatment Plans ◽  
Flattening Filter ◽  
Prescription Dose

AbstractAimThe aim of this study is to evaluate the influence of flattened and flattening filter-free (FFF) beam 6 MV photon beam for liver stereotactic body radiation therapy by using volumetric modulated arc therapy (VMAT) technique in deep inspiration breath hold (DIBH) and free breathing condition.Materials and methodsEight liver metastasis patients (one to three metastasis lesions) were simulated in breath hold and free breathing condition. VMAT-based treatment plans were created for a prescription dose of 50 Gy in 10 fractions, using a 230° coplaner arc and 60° non-coplanar arc for both DIBH and free breathing study set. Treatment plans were evaluated for planning target volume (PTV) dose coverage, conformity and hot spots. Parallel and serial organs at risk were compared for average and maximum dose, respectively. Dose spillages were evaluated for different isodose volumes from 5 to 80%.ResultMean D 98% (dose received by 98% target volume) for FFF in DIBH, flattened beam in DIBH, FFF in free breathing and flatten beam in free breathing dataset were 48·9, 47·81, 48·5 and 48·3 Gy, respectively. D 98% was not statistically different between FFF and flatten beam (p = 0·34 and 0·69 for DIBH and free breathing condition). PTV V 105% (volume receiving 105% dose) for the same set were 3·76, 0·25, 1·2 and 0·4%, respectively. Mean heterogeneity index for all study sets and beam models varies between 1·05 and 1·07. Paddik conformity index using unflattened and flattened beam in DIBH at 98% prescription dose were 0·91 and 0·79, respectively. Maximum variation of isodose volume was observed for I-5%, which was ranging between 2288·8 and 2427·2 cm3. Increase in isodose value shows a diminishing difference in isodose volumes between different techniques. DIBH yields a significant reduction in the chest wall dose compared with free breathing condition. Average monitor units for FFF beam in DIBH, flattened beam in DIBH, FFF beam in free breathing CT dataset and flattened beam in free breathing CT dataset were 1318·6 ± 265·1, 1940·3 ± 287·6, 1343·3 ± 238·1 and 2192·5 ± 252·6 MU.ConclusionDIBH and FFF is a good combination to reduce the treatment time and to achieve better tumour conformity. No other dosimetric gain was observed for FFF in either DIBH or free breathing condition.

PD-0180: Interim Report from the SAVE HEART Study: deep inspiration breath-hold in left-sided breast cancer

2020 ◽  
Vol 152 ◽  
pp. S88
Author(s):  
S. Schönecker ◽  
A. Gaasch ◽  
M. Pazos ◽  
D. Reitz ◽  
M. Braun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Interim Report ◽  
Deep Inspiration Breath Hold ◽  
Heart Study

Deep-inspiration breath hold radiotherapy in patients with left-sided breast cancer after partial mastectomy

2021 ◽  
Vol 100 (4) ◽  
Keyword(s):  
Breast Cancer ◽  
Radiation Dose ◽  
Organs At Risk ◽  
Left Lung ◽  
Free Breathing ◽  
Partial Mastectomy ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Dose Volume Histograms

Introduction: The purpose of this study was to compare the radiation dose to organs at risk for deep-inspiration breath hold (DIBH) and free-breathing (FB) radiotherapy in patients with lef-sided breast cancer undergoing adjuvant radiotherapy after partial mastectomy. Methods: One hundred patients with left-sided breast cancer underwent DIBH and FB planning computed tomography scans, and the 2 techniques were compared. Dose-volume histograms were analyzed for heart, left anterior descending coronary artery (LAD), and left lung. Results: Radiation dose to heart, LAD, and left lung was significantly lower for DIBH than for free breathing plans. The median mean heart dose for DIBH technique in comparison with FB was 1.21 Gy, and 3.22 Gy respectively; for LAD, 4.67 versus 24.71 Gy; and for left lung 8.32 Gy versus 9.99 Gy. Conclusion: DIBH is an effective technique to reduce cardiac and lung radiation exposure.

Deep inspiration breath-hold for patients with left-sided breast cancer – A one fits all approach? A prospective analysis of patient selection using dosimetrical and practical aspects

2021 ◽  
pp. 20210295
Author(s):  
Christina Schröder ◽  
Sebastian Kirschke ◽  
Eyck Blank ◽  
Sophia Rohrberg ◽  
Robert Förster ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Left Lung ◽  
Free Breathing ◽  
Lymphatic Drainage ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Patient Preparation ◽  
Treatment Plans ◽  
Planning Ct

Objective: To prospectively analyze the feasibility of an algorithm for patient preparation, treatment planning and selection for deep inspiration breath-hold (DIBH) treatment of left-sided breast cancer. Methods: From 02/2017 to 07/2019, 135 patients with left-sided breast cancer were selected and prepared for radiotherapy in DIBH. 99 received radiotherapy for the breast alone and 36 for the breast including the lymphatic drainage (RNI). Treatment plans DIBH and free breathing (FB) were calculated. Dosimetrical analyses were performed and criteria were defined to assess whether a patient would dosimetrically profit from DIBH. Results: Of the 135 patients, 97 received a DIBH planning CT and 72 were selected for treatment in DIBH according to predefined criteria. When using DIBH there was a mean reduction of the DmeanHeart of 2.8 Gy and DmeanLAD of 4.2 Gy. seven patients did not benefit from DIBH regarding DmeanHeart, 23 regarding DmeanLAD. For the left lung the V20Gy was reduced by 4.9%, the V30Gy by 2.7% with 15 and 29 patients not benefitting from DIBH, respectively. In the 25 patients treated in FB, the benefit of DIBH would have been lower than for patients treated with DIBH (ΔDmeanHeart0.7 Gy vs 3.4 Gy). Conclusion: Dosimetrically, DIBH is no “one fits all” approach. However, there is a statistically significant benefit when looking at a larger patient population. DIBH should be used for treatment of left-sided breast cancer in patients fit for DIBH. Advances in knowledge: This analysis offers a well-designed dosimetrical analysis in patients treated with DIBH radiotherapy in an “every day” cohort.

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