Assessment of deep inspiration breath hold (DIBH) amplitude and reduction in cardiac dose in left breast cancer patients

LEDSOM, Dawn, REILLY, Andrew J and PROBST, Heidi (2017). Assessment of deep inspiration breath hold (DIBH) amplitude and reduction in cardiac dose in left breast cancer patients. Radiography. (In Press)

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Link to published version:: 10.1016/j.radi.2017.11.005

Abstract

Introduction The primary aim of this study was to examine the impact of deep inspiration breath-hold (DIBH) amplitude on subsequent mean heart dose and V30 during radiotherapy. The secondary aim was to investigate if patient age influenced DIBH amplitude. Method A retrospective study of 30 patients with left-sided breast cancer was completed. Patient were randomly selected from the total number of patients dual scanned in free breathing (FB) and DIBH over a 2-year period. Plans were retrospectively virtually simulated and statistical analysis performed. Results All patients achieved decreased V30 and mean cardiac dose using DIBH. A positive correlation was found between DIBH amplitude and cardiac V30 dose reduction (p=0.007, R=0.48). Ratio of amplitude increase from FB to DIBH and cardiac V30 reduction was positively correlated and statistically significant (p=0.04, R=0.38); Ratio of amplitude increase of at least 15 times FB achieved 100% V30 dose reduction, however this was also achieved with ratio increase as low as 6.25 times FB. A statistically significant positive correlation was identified between DIBH amplitude and mean cardiac dose reduction (p=0.003, R=0.523). No correlation was found between patient age and amplitude ratio increase (p=0.602, R=-0.099) Conclusion A 100% reduction in cardiac V30 can be achieved with a DIBH amplitude increase of 15 times FB. A full reduction can also be achieved at much lower levels (6.25 times FB in current study); however there appears to be no pre-determining patient factors to identify this. DIBH amplitudes of 1cm-4cm reduce cardiac mean dose by at least 50%.

Item Type: Article
Research Institute, Centre or Group: Centre for Pedagogic Research and Innovation
Departments: Health and Well-being > Allied Health Professions
Identification Number: 10.1016/j.radi.2017.11.005
Depositing User: Heidi Probst
Date Deposited: 14 Dec 2017 12:22
Last Modified: 13 Jan 2018 20:22
URI: http://shura.shu.ac.uk/id/eprint/17588

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