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Detection of Intrafractional Set-Up Errors Using Electronic Portal Imaging Device-based in vivo Dosimetry in Deep-inspiration Breath-hold Irradiation for Left Breast Cancer

Year: 2025
Type: article
Study design: Observational Study
Abstract: Aim: dosimetry (IVD) analysis and intrafractional set-up errors (SEs) to determine the criteria for detecting intra-fractional SEs of 3 mm. Methods: Fifteen patients undergoing deep-inspiration breath-hold (DIBH) irradiation for left breast cancer were included in the study. The prescribed dose and fraction size were 50 Gy for six patients, and 42.56 Gy for nine patients. Visual coaching devices were used to improve the reproducibility of deep inspiration states. For IVD, integrated electronic portal imaging device (EPID) images were obtained using treatment beams. Intra-fractional SEs were detected, and gamma analysis was performed on these images. Receiver-operating characteristic curves were calculated to assess the accuracy of the detection of the intrafractional SEs for each criterion. Results: -direction, and three dimensional (3D) vectors of intra-fractional SEs were 1.9 ± 1.5 mm, 1.8 ± 1.6 mm, and 2.9 ± 1.8 mm, respectively. The mean γ-pass rates in each criterion were 90.6% ± 10.4%, 89.6% ± 10.8%, 92.7% ± 9.7%, 94.8% ± 8.3%, and 94.4% ± 8.3% for 2% 3 mm, 3% 2 mm, 3% 3 mm, 3% 4 mm, and 4% 3 mm, respectively. The correlation coefficients between the SEs in the 3D vector and each γ value ranged from 0.6 to 0.8. Conclusions: In IVD with EPIDs for DIBH irradiation, the optimal γ-analysis index for intrafractional SEs detection >3 mm is 3% 3 mm.
Language: English
Subfield: Radiation
Open Access status: diamond
OpenAlex ID: W7117696299
FWCI: 0.635
Cites: 19
Cited by: 1
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