title: Reproducibility of deep inspiration breath hold for prone left-sided whole breast irradiation.
abstract: BACKGROUND
  Investigating reproducibility and instability of deep inspiration breath hold (DIBH) in the prone position to reduce heart dose for left-sided whole breast irradiation.
  
  
  METHODS
  Thirty patients were included and underwent 2 prone DIBH CT-scans during simulation. Overlap indices were calculated for the ipsilateral breast, heart and lungs to evaluate the anatomical reproducibility of the DIBH maneuver. The breathing motion of 21 patients treated with prone DIBH were registered using magnetic probes. These breathing curves were investigated to gain data on intra-fraction reproducibility and instability of the different DIBH cycles during treatment.
  
  
  RESULTS
  Overlap index was 0.98 for the ipsilateral breast and 0.96 for heart and both lungs between the 2 prone DIBH-scans. The magnetic sensors reported population amplitudes of 2.8 ± 1.3 mm for shallow breathing and 11.7 ± 4.7 mm for DIBH, an intra-fraction standard deviation of 1.0 ± 0.4 mm for DIBH, an intra-breath hold instability of 1.0 ± 0.6 mm and a treatment time of 300 ± 69 s.
  
  
  CONCLUSIONS
  Prone DIBH can be accurately clinically implemented with acceptable reproducibility and instability.
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. thomas.mulliez@uzgent.be.|Department of Radiotherapy, Clinique et Maternité Sainte-Elisabeth, Place Louise Godin 16, 5000, Namur, Belgium. thomas.mulliez@uzgent.be.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mulliez
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. liv.veldeman@uzgent.be.
authors.forename: Liv
authors.initials: L
authors.lastname: Veldeman
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. tom.vercauteren@uzgent.be.
authors.forename: Tom
authors.initials: T
authors.lastname: Vercauteren
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. werner.degersem@ugent.be.
authors.forename: Werner
authors.initials: W
authors.lastname: De Gersem
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. bruno.speleers@ugent.be.
authors.forename: Bruno
authors.initials: B
authors.lastname: Speleers
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. annick.vangreveling@uzgent.be.
authors.forename: Annick
authors.initials: A
authors.lastname: Van Greveling
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. dieter.berwouts@uzgent.be.
authors.forename: Dieter
authors.initials: D
authors.lastname: Berwouts
authors.affiliation: Department of Radiotherapy, Clinique et Maternité Sainte-Elisabeth, Place Louise Godin 16, 5000, Namur, Belgium. vincent.remouchamps@cmsenamur.be.
authors.forename: Vincent
authors.initials: V
authors.lastname: Remouchamps
authors.affiliation: Department of Gynaecology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. rudy.vandenbroecke@uzgent.be.
authors.forename: Rudy
authors.initials: R
authors.lastname: Van den Broecke
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. wilfried.deneve@uzgent.be.
authors.forename: Wilfried
authors.initials: W
authors.lastname: De Neve
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D062485:Breath Holding; D005240:Feasibility Studies; D005260:Female; D006321:Heart / Q000528:radiation effects; D006801:Humans; D001239:Inhalation; D008168:Lung / Q000528:radiation effects; D008875:Middle Aged; D011379:Prognosis; D016684:Prone Position; D011446:Prospective Studies; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed