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Related Concept Videos

Computed Tomography01:10

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...

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Updated: Jul 16, 2026

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Quantitative Assessment of Respiratory-Induced Clinical Target Volume Motion During Postoperative Whole-Breast

Ji Hwan Jo1,2, Jeong Won Lee1,2, Ki Ho Seol1,2

  • 1Department of Radiation Oncology, Daegu Catholic University Medical Center, Daegu 42472, Republic of Korea.

Cancers
|July 15, 2026
PubMed
Summary

Respiratory motion during whole-breast radiotherapy after breast-conserving surgery is minimal, with anteroposterior motion being most significant. Standard planning margins are sufficient, potentially making routine motion management unnecessary.

Keywords:
4DCTCTV displacementbreast cancerbreast-conserving surgeryinternal marginpostoperative radiotherapyrespiratory motion

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Breast Cancer Treatment

Background:

  • Assessing respiratory-induced clinical target volume (CTV) motion is crucial for accurate radiotherapy planning.
  • Postoperative whole-breast radiotherapy (RT) after breast-conserving surgery (BCS) requires precise target delineation.
  • Understanding motion variability informs the adequacy of planning margins.

Purpose of the Study:

  • To quantitatively evaluate respiratory-induced CTV motion during whole-breast RT post-BCS.
  • To determine internal margins required to account for respiratory motion.
  • To assess the necessity of advanced motion management techniques.

Main Methods:

  • Utilized four-dimensional computed tomography (4DCT) in 100 patients undergoing whole-breast RT post-BCS.
  • Measured CTV center displacement in lateral, anteroposterior, and superoinferior directions across 10 respiratory phases.
  • Calculated internal margins using the Van Herk formula (2.5Σ + 0.7σ).

Main Results:

  • Mean CTV displacement was 0.94 mm (lateral), 1.29 mm (anteroposterior), and 1.00 mm (superoinferior).
  • Mean 3D motion magnitude was 1.99 mm, with anteroposterior motion being significantly greater.
  • Internal margins were approximately 1 mm in all directions; no patient exceeded 3 mm motion.

Conclusions:

  • Respiratory CTV motion in whole-breast RT post-BCS is generally small and predominantly in the anteroposterior direction.
  • Calculated internal margins suggest a conventional 5 mm CTV-to-planning target volume (PTV) margin is adequate.
  • Routine 4DCT or active respiratory motion management may not be necessary for ensuring target coverage in this patient population.