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Updated: May 15, 2025
Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
Published on: July 3, 2014
Automated Deep Inspiration Breath-Hold (DIBH) in breast radiotherapy: A comprehensive assessment of the VitalHold
Paul Retif1, Abdourahamane Djibo Sidikou2, Julien Gribelbauer2
1Medical Physics Unit, CHR Metz-Thionville, Metz, France; Université de Lorraine, CNRS, CRAN, F-54000 Nancy, France.
Purpose:
To evaluate the performance of the VitalHold module for automated Deep Inspiration Breath-Hold (DIBH) treatment on the Radixact platform, focusing on its dosimetric accuracy, responsiveness to respiratory motion and system latency.
Materials And Methods:
A Delta4 Phantom+ system with customized 3D-printed breast add-ons was used to simulate a clinically relevant setup for DIBH. A treatment plan was created with 40 Gy in 15 fractions using TomoDirect. The Phantom was coupled with the HexaMotion motion platform to to simulate simple (tested with various amplitude, periods and gating thresholds) and complex respiratory patterns, including irregular breathing, patient-specific motion, and baseline shifts. Respiratory motion was analyzed, and dose distributions were measured using gamma analysis with varying criteria. System latency was evaluated following TG-147 guidelines.
Results:
The measured simple respiratory curve closely matched the simulated motion, with amplitude differences under 0.1 mm and cycle variations of 0.1 s. Gamma pass rates for 2-5 mm gating tolerances were ≥95 %, indicating high system accuracy. Complex motion scenarios showed average measured amplitude deviations below 0.1 mm. The system exhibited a mean latency of 4.3 ms.
Conclusions:
The VitalHold module on the Radixact platform demonstrates strong potential for automated DIBH treatment, providing precise and reliable beam control across both simple and complex respiratory patterns and exhibiting minimal latency. This study supports the integration of automated breath-hold techniques in clinical practice.
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