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Correlation between maximum heart distance and thoracic diameter changes and diaphragmatic descent in left-sided breast cancer patients during deep inspiration breath-hold (DIBH) Cover

Correlation between maximum heart distance and thoracic diameter changes and diaphragmatic descent in left-sided breast cancer patients during deep inspiration breath-hold (DIBH)

Radiology and Oncology
Volume 57 (2023): Issue 4 (December 2023)
By: He-Gou Wu,  Guang-Wei Zhang,  Jian-Feng Liu,  Jun-Guo Yang and  Xiao-Hui Su  
Open Access
|Nov 2023

Figures & Tables

FIGURE 1.

Parameter measurement diagram. For each patient, at the height of the vertebral body corresponding to the right diaphragm top during free breathing, anteroposterior thoracic diameter (ATD), transverse thoracic diameter (TTD) and maximum heart distance (MHD) were measured on free breathing CT images and deep inspiration breath-hold CT images respectively. Point A at the center of the sternum, and point B at the center of the medulla, the line AB was constructed as the ATD. Through the center of the line AB at M, a second line was constructed perpendicular to AB reaching the lateral edge of the lung at C and D, and the line CD was the TTD. The line AD approximates the direction of the tangential field, and the maximum distance from the left edge of the heart to AD is taken as the MHD.
Parameter measurement diagram. For each patient, at the height of the vertebral body corresponding to the right diaphragm top during free breathing, anteroposterior thoracic diameter (ATD), transverse thoracic diameter (TTD) and maximum heart distance (MHD) were measured on free breathing CT images and deep inspiration breath-hold CT images respectively. Point A at the center of the sternum, and point B at the center of the medulla, the line AB was constructed as the ATD. Through the center of the line AB at M, a second line was constructed perpendicular to AB reaching the lateral edge of the lung at C and D, and the line CD was the TTD. The line AD approximates the direction of the tangential field, and the maximum distance from the left edge of the heart to AD is taken as the MHD.

FIGURE 2.

Correlation between ΔMHD and left diaphragmatic descent, right diaphragmatic descent [r: Spearman rank correlation coefficient; p: p-value (2-tailed)].ΔMHD = maximum heart distance in deep inspiration breath-hold minus maximum heart distance in free breathing
Correlation between ΔMHD and left diaphragmatic descent, right diaphragmatic descent [r: Spearman rank correlation coefficient; p: p-value (2-tailed)].ΔMHD = maximum heart distance in deep inspiration breath-hold minus maximum heart distance in free breathing

The values of respiratory characteristic parameters in free breathing (FB) and/or deep inspiration breath holding (DIBH), and the differences in the values of some respiratory characteristic parameters between DIBH and FB (N = 98)

ParametersFBDIBHΔ
MHD (mm)26.8 (±5.1)18.4(±7.5)−8.3 (±5.9)
ATD (mm)127. 0(±11.6)139.0(±11.6)11.0 (±3.8)
TTD (mm)227.0 (±10.6)235.6(±10.4)8.6 (±4.4)
RDD (mm) 35.0(0.0 – 60.0)
LDD (mm) 35.0(0.0 – 55.0)
GWL (mm) 11.1(4.6 – 20.7)

Correlation between dosimetric parameters and geometric parameters

ΔDmeanΔHVIFΔV10ΔV5
ΔMHDr0.4680.4640.4810.484
p< 0.001< 0.001< 0.001< 0.001
LDDr− 0.340− 0.365− 0.382− 0.373
p= 0.001< 0.001< 0.001< 0.001
RDDr− 0.439− 0.449− 0.462− 0.458
p< 0.001< 0.001< 0.001< 0.001
ΔATDr0.0070.0440.0260.008
p0.9430.6690.8010.935
ΔTTDr0.0120.0550.0620.065
P0.9060.5930.5450.527

Comparison of the mean of parameters in ΔATDlow (n = 46) and ΔATDhigh (n = 52) and in ΔTTDlow (n = 51) and ΔTTDhigh (n = 47)

LDDRDDΔATDΔTTDΔMHD
ΔATDlow (mm)32.234.07.77.5−7.0
ΔATDhigh (mm)34.235.413.89.6−9.5
Increase of ΔATDhigh (mm)2.01.46.12.1−2.5
Increase of ΔATDhigh (%)6.2%4.1%78.9%27.9%36.5%
ΔTTDlow(mm)35.337.110.55.4−9.7
ΔTTDhigh (mm)31.132.211.412.0−6.9
Increase of ΔTTDhigh (mm)−4.2−4.90.86.62.8
Increase of ΔTTDhigh (%)−12.0%−13.2%7.9%122.2%−29.3%
DOI: https://doi.org/10.2478/raon-2023-0053 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 530 - 537
Submitted on: Apr 13, 2023
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Accepted on: Aug 28, 2023
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Published on: Nov 30, 2023
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
left-sided breast cancer,
maximum heart distance,
thoracic diameter,
diaphragmatic descent,
deep inspiration breath-hold
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2023 He-Gou Wu, Guang-Wei Zhang, Jian-Feng Liu, Jun-Guo Yang, Xiao-Hui Su, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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