Evaluation of an in-house self-held respiration monitoring device for deep inspiration breath hold techniques for radiotherapy of patients with cancer of the left breast

Background: An in-house self-held respiration monitoring device (SHRMD) was developed for providing deep inspiration breath hold (DIBH) radiotherapy. The use of SHRMD is evaluated in terms of reproducibility, stability and heart dose reduction. Methods and materials: Sixteen patients receiving radiotherapy of left breast cancer were planned for treatment with both a free breathing (FB) scan and a DIBH scan. Both FB and DIBH plans were generated for comparison of the heart, left anterior descending (LAD) artery and lung dose. All patients received their treatments with DIBH using SHRMD. Megavoltage cine images were acquired during treatments for evaluating the reproducibility and stability of treatment position using SHRMD. Results: Compared with FB plans, the maximum dose to the heart by DIBH technique with SHRMD was reduced by 29 center dot 9 +/- 15 center dot 6%; and the maximum dose of the LAD artery was reduced by 41 center dot 6 +/- 18 center dot 3%. The inter-fractional overall mean error was 0 center dot 01 cm and the intra-fractional overall mean error was 0 center dot 04 cm. Conclusion: This study demonstrated the potential benefits of using the SHRMD for DIBH to reduce the heart and LAD dose. The patients were able to perform stable and reproducible DIBHs.