scholarly journals Multiple Breath-hold Volumetric Modulated Arc Therapy Under Fluoroscopic Image Guidance with an Implanted Fiducial Marker: An Advanced Technique

Cureus ◽  
2018 ◽  
Author(s):  
Tsuyoshi Takanaka ◽  
Yoko Taima ◽  
Yasushi Horichi ◽  
Yasuhiro Kawamori ◽  
Koji Nobata ◽  
...  
Keyword(s):  
Image Guidance ◽  
Volumetric Modulated Arc Therapy ◽  
Fiducial Marker ◽  
Breath Hold ◽  
Advanced Technique ◽  
Fluoroscopic Image ◽  
Arc Therapy

scholarly journals Epid‐based in vivo dose verification for lung stereotactic treatments delivered with multiple breath‐hold segmented volumetric modulated arc therapy

2019 ◽  
Vol 20 (3) ◽  
pp. 37-44 ◽  
Author(s):  
Savino Cilla ◽  
Anna Ianiro ◽  
Maurizio Craus ◽  
Pietro Viola ◽  
Francesco Deodato ◽  
...  
Keyword(s):  
Volumetric Modulated Arc Therapy ◽  
Breath Hold ◽  
Dose Verification ◽  
Arc Therapy

Which simultaneous-integrated boost (SIB) intensity-modulated radiotherapy (IMRT) technique is dosimetrically superior in the treatment of breast cancer; volumetric-modulated arc therapy (VMAT) or fixed field (ff) IMRT?

2017 ◽  
Vol 16 (3) ◽  
pp. 272-279
Author(s):  
Steven B. D. Murphy ◽  
Heather Drury-Smith
Keyword(s):  
Breast Cancer ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Breath Hold ◽  
Hybrid Technique ◽  
Fixed Field ◽  
Intensity Modulated ◽  
Concomitant Boost ◽  
Arc Therapy ◽  
Integrated Boost

AbstractBackground and purposeTo determine which concomitant boost technique is dosimetrically superior in the treatment of breast cancer; volumetric-modulated arc therapy (VMAT) or fixed field intensity-modulated radiotherapy (ff-IMRT).Materials and methodsIn total, 30 breast patients were re-planned with both VMAT and fixed field concomitant boost intensity-modulated radiotherapy techniques. A hybrid technique was used delivering 80% of the dose through tangential beams and 20% through an integrated boost. A two-tailed t-test sample for means was used to compare the dosimetric differences between the techniques.ResultsMaximum dose was statistically lower for VMAT; 103·2 versus 103·7% for ff-IMRT along with statistically lower V2 Gy doses to the contralateral lung (0·7 versus 1·6%) and heart for both left- (19·0%/22·6%), and right- (5·5%/8·8%) sided patients, respectively. ff-IMRT boasted significantly lower ipsilateral lung V20, V18 and V10 Gy (7·9/8·6/13·1 versus 8·1/8·8/13·4%) than VMAT, respectively. No differences were found with minimum coverage, mean dose and V5 Gy to all organs at risk (OARs).ConclusionVMAT and ff-IMRT techniques demonstrate excellent target coverage and OAR sparing facilitated by the hybrid planning technique and deep inspiration breath hold. There is no obvious dosimetrically superior option between the two techniques. Reduced treatment times with VMAT make it more desirable to implement clinically.

Is 5 mm breath-hold window (BHW) sufficient to treat carcinoma left breast patients post-conservative surgery: a comparative study using forward intensity-modulated radiotherapy (FIMRT) and volumetric modulated arc therapy (VMAT)

2020 ◽  
pp. 1-9
Author(s):  
Karthikeyan Kalyanasundaram ◽  
Subramani Vellaiyan
Keyword(s):  
Breathing Pattern ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Conservative Surgery ◽  
Target Volume ◽  
Left Breast ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Intensity Modulated ◽  
Arc Therapy

Abstract Purpose: The purpose of the study was to evaluate the impact of changes in breathing pattern inside the breath-hold window (BHW) during deep inspiration breath hold treatment for carcinoma left breast patients post-conservative surgery. Methods: Ten patients of carcinoma left breast post-conservative surgery were prospectively selected. Three sets of CT plain images were acquired, one with 5 mm deep inspiration BHW (DIBHR) and the other one with 1 mm BHW matching the lower threshold (DIBHL) and the third one with 1 mm BHW matching the upper threshold (DIBHH) as DIBHR. For all patients, forward intensity-modulated radiotherapy (FIMRT) and volumetric modulated arc therapy (VMAT) plans were generated in the 5 mm BHW CT series and the same plan being copy and pasted in other series. Target volume doses and critical structure doses were tabulated. Results: Planning target volume coverage was adequate and no significant differences were found in any CT series. Significant differences noted in average left lung V5%, V10% and V18% doses between DIBHR versus DIBHH (p values = 0·0461, 0·0283 and 0·0213, respectively) and DIBHL versus DIBHH (p values = 0·0434, 0·0484 and 0·0334, respectively) for FIMRT plans and V18% doses in DIBHR versus DIBHH (p = 0·0067) in VMAT. No differences in heart and apex of heart doses were found. Left anterior descending artery (LAD) mean doses were significant in DIBHL versus DIBHR, DIBHR versus DIBHH and DIBHL versus DIBHH (p = 0·0012, 0·0444 and 0·0048, respectively) series for FIMRT plans and DIBHR versus DIBHH and DIBHL versus DIBHH (p = 0·0341, 0·0001) for VMAT plans. Finding: The changes in the breathing pattern inside DIBH window level cause some variation in LAD doses and no other significant differences in any parameters noted, so care should be taken while treating patients with preexisting cardiac conditions.

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