Abstract # 2441 Left Anterior Descending Coronary Artery Motion in Deep Inspiration Breath-Hold and Free Breathing using 4D-CT Scanning: Potential Impact on Left-Sided Breast Cancer Radiotherapy

Presenter: Jarvis, Lesley

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Results:
Evaluation of 4-D CT scans revealed that the cardiac contour elongated and became caudally and posteriorly displaced during inspiration and especially DIBH as compared to expiration in all patients. These cardiac shifts were associated with a displacement of the LAD away from the chest wall that was greater with DIBH in 5 of 6 patients compared to expiration. In DIBH, the mean posterior displacement of the proximal 1/3 of the artery was 6.3 mm +/- 3.7 mm (range 0.0 to 12.2 mm), the mean displacement of the middle 1/3 of the artery was 4.1 mm +/- 4.2 mm (range 0.0 to 4.6 mm), and the distal 1/3 was 1.8 mm +/- 1.5 mm (range 0.0 to 2.0 mm). During inspiration phase of FB, the mean posterior displacement of the proximal 1/3 of the artery was 3.4 mm +/- 2.3 mm, the mean displacement of the middle 1/3 was 2.2 mm +/- 1.3 mm, and the distal 1/3 was 0.5 mm +/- 0.5 mm. A tangent field treatment plan showed a mean LAD dose of 36.7% PD on expiration (range 2.4-93.5 %), 31.4% PD on inspiration (range 2.5-92.8 %) and 9.4% PD during DIBH (range 2.7-30.4 %).






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