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Original Articles

Reduced lung dose and improved inspiration level reproducibility in visually guided DIBH compared to audio coached EIG radiotherapy for breast cancer patients

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Pages 1458-1463 | Received 03 May 2013, Accepted 02 Jun 2013, Published online: 19 Aug 2013

Figures & data

Figure 1. Patient flow in the study. One patient was only scanned in EIG because she was not able to perform a 15 s long stable DIBH. The three patients who were scanned in free breathing (FB) only did not comply with either EIG or DIBH.

Figure 1. Patient flow in the study. One patient was only scanned in EIG because she was not able to perform a 15 s long stable DIBH. The three patients who were scanned in free breathing (FB) only did not comply with either EIG or DIBH.

Figure 2. Respiration curves collected during the one minute of audio-coached EIG (A) and the subsequent treatment in DIBH with visual feedback (B). The red circles in (A) shows the extracted maxima for the EIG curve and the red squares in (B) shows the interval from which the mean inspiration level for a breath hold is calculated. The arrows indicate the inspiration level extracted for the analysis. The inspiration level was found for all enhanced inspirations and all breath holds). The dotted line is the baseline of the respiration. These curves were obtained for the same patient at the same treatment session (22nd fraction).

Figure 2. Respiration curves collected during the one minute of audio-coached EIG (A) and the subsequent treatment in DIBH with visual feedback (B). The red circles in (A) shows the extracted maxima for the EIG curve and the red squares in (B) shows the interval from which the mean inspiration level for a breath hold is calculated. The arrows indicate the inspiration level extracted for the analysis. The inspiration level was found for all enhanced inspirations and all breath holds). The dotted line is the baseline of the respiration. These curves were obtained for the same patient at the same treatment session (22nd fraction).

Table I. Results of the treatment planning analysis. The bold type indicates where a statistical significant difference was found (p < 0.05).

Table II. Results of the reproducibility analysis. The differences between EIG and DIBH were found to be statistically significant with the Wilcoxon sign rank test (p < 0.05). The reported mean is the average of the mean inspiration levels for all respiration curves.

Supplemental material

Supplementary Appendix 1–2

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