Application of surface image guided radiotherapy (SIGRT) for deep inspiration breath-hold and free breathing gating technique in Pantai Hospital Kuala Lumpur

Abstract

Abstract Pantai Hospital Kuala Lumpur (PHKL) has integrated Surface Image Guided Radiotherapy (SIGRT), C-RAD Catalyst HD camera in radiotherapy treatment over the 12 months. It eases us in setting up patients before treatment, monitoring intrafraction treatment and allows Deep Inspiration Breath-Hold (DIBH) treatment delivery. Positioning patients using Catalyst gives correctable error in 6-dimension and the shifts were small and acceptable. However, C-RAD is not the gold standard for positioning compared to CBCT but it has the advantage in terms of monitoring patient surface motion during treatment especially DIBH treatments. Target volume coverage for DIBH plan is improved by 0.6% to 1.8% compared to FB plan. This study also compare dose to the heart using DIBH technique over the free breathing (FB) technique for left breast cases. Maximum dose to the heart in DIBH is reduced by 18% compared to FB. Treatment of left breast with DIBH results in significant reductions in doses to the heart, since the distance between the target and the heart is increase compare to FB technique.