Research Article
Impact of DIBH Technique on Dosimetric Parameters of LAD and Its Segments During Left-Sided Breast Cancer Radiotherapy
Mukesh Meshram
,
Sameer Chandorkar,
Himanshu Kumbhare,
Arpit Gite,
Appaso Bandgar,
Siddesh Kalbut,
Sabheen Bushra,
Jayesh Dherange,
Jayant Nardekar
Issue:
Volume 14, Issue 3, September 2026
Pages:
75-83
Received:
4 August 2026
Accepted:
18 August 2026
Published:
11 September 2026
Abstract: Deep inspiration breath hold (DIBH) technique plays significant role in reducing the mean heart and LAD doses, however the potential dosimetric impact of DIBH on LAD segments has not been studied in left-sided breast cancer. This study aimed to analyse the potential dosimetric impact of DIBH technique on LAD and its individual segments during breast cancer radiotherapy. This study also investigated the potential correlation of changes in lung volume, changes in heart volume, and patients body mass index with the dose indices of different LAD segments. This study retrospectively included a set of data of thirty female patients who underwent radiation therapy for left breast cancer. Treatment plans were generated on both FB and DIBH CT-dataset for each patient. For comparative analysis, following dosimetric parameters were analysed to evaluate the potential dosimetric impact of DIBH technique; ipsilateral lung [Dmean, volume receiving 17Gy, 8Gy, 4Gy]. Heart [Dmean, volume receiving V17Gy, 35Gy, V8Gy], LAD and its segments-proximal, middle, and distal [Dmean, Dmax, volume receiving 15Gy]. Analysis revealed that the DIBH technique results in significant reduction in all segmented LAD dose indices. The study evaluated that the DIBH resulted in significant reduction with average value of -31.76%, -16.16% and -24.84% in the Dmean, Dmax and V15Gy of total LAD, respectively. All LAD segments showed variable reduction in dose indices, particularly, the distal LAD segment presented a maximum reduction in Dmean and Dmax dose indices compared to other LAD segments. The analysis demonstrated a negative correlation between changes in lung volume, patient BMI, and all dosimetric indices of the LAD segments. A statistically significant moderate negative correlation was observed between changes in lung volume and the Dmean and V15Gy of the proximal LAD segment and V15Gy of distal LAD segments. There is also a positive correlation between change in heart volume and the change in all dose parameters of LAD segments with significant value for Dmean of distal LAD segment (r = 0.462; p < 0.05). The study demonstrated that the DIBH technique resulted in significant reduction in dose parameters for whole LAD as well as its three segments. The study found that the distal LAD segment showed a maximum reduction in Dmean and Dmax dose indices compared to other segments. The study also revealed significant correlations between changes in lung volume, heart volume, and segmented LAD dose parameters.
Abstract: Deep inspiration breath hold (DIBH) technique plays significant role in reducing the mean heart and LAD doses, however the potential dosimetric impact of DIBH on LAD segments has not been studied in left-sided breast cancer. This study aimed to analyse the potential dosimetric impact of DIBH technique on LAD and its individual segments during breas...
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