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Dosimetric Impact of Deep Inspiration Breath Hold (DIBH) Technique in Right-Sided Breast Cancer Radiotherapy: A Retrospective Analysis

oncology
radiology-and-medical-imaging

Abstract

Background and Purpose: While deep-inspiration breath hold (DIBH) is widely used to reduce cardiac dose in left-sided breast cancer radiotherapy, its dosimetric benefits for right-sided cases remain underexplored. This study evaluates DIBH’s impact on target volumes and organs at risk (OARs) in right-sided breast cancer, and investigates associations between dose-volume changes, lung volume, and anthropometric indices.

Methods: We retrospectively analyzed 33 right-sided breast cancer patients treated with DIBH. Seventeen received whole-breast (WB) irradiation post-breast-conserving surgery, and sixteen received chest wall (CW) plus internal mammary node (IMN) and supraclavicular (SC) irradiation post-mastectomy. CT scans acquired under free breathing (FB) and DIBH were used to generate separate treatment plans. We compared dose-volume parameters for target and OARs, and analyzed correlations between FB-to-DIBH changes and body mass index (BMI) and body surface area (BSA).

Results: Compared to FB, DIBH significantly reduced doses to the right lung, heart, right coronary artery (RCA), and liver (all P<0.05), while PTV D mean and contralateral lung V 5 showed no significant differences. WB patients had greater dose reductions than those receiving nodal irradiation. BMI was positively correlated with liver dose reduction (r = 0.544) and negatively with FB right-lung volume (r = −0.404); BSA showed no significant associations.

Conclusion: DIBH effectively reduces OAR doses in right-sided breast cancer radiotherapy and may improve long-term outcomes. Notably, patients with higher BMI benefit more from liver sparing, suggesting BMI-informed selection may enhance DIBH utility.

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