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Diastolic and systolic doses to the heart, LADCA, and LMCA were analyzed using electrocardiogram-gated cardiac computed tomography images from 15 women. Radiation therapy plans were created for a total dose of 50\u00a0Gy in 25 fractions. Parameters assessed included volume, D\n                    <jats:sub>mean<\/jats:sub>\n                    , D\n                    <jats:sub>2%<\/jats:sub>\n                    , V\n                    <jats:sub>5Gy<\/jats:sub>\n                    , V\n                    <jats:sub>10Gy<\/jats:sub>\n                    , V\n                    <jats:sub>20Gy<\/jats:sub>\n                    , and V\n                    <jats:sub>25Gy<\/jats:sub>\n                    for the heart; D\n                    <jats:sub>mean<\/jats:sub>\n                    , D\n                    <jats:sub>2%<\/jats:sub>\n                    , V\n                    <jats:sub>5Gy<\/jats:sub>\n                    , V\n                    <jats:sub>10Gy<\/jats:sub>\n                    , and V\n                    <jats:sub>20Gy<\/jats:sub>\n                    for the LADCA; and D\n                    <jats:sub>mean<\/jats:sub>\n                    and D\n                    <jats:sub>2%<\/jats:sub>\n                    for the LMCA. The D\n                    <jats:sub>mean<\/jats:sub>\n                    of the heart was 5.10\u2009\u00b1\u20093.04\u00a0Gy and 5.03\u2009\u00b1\u20093.05\u00a0Gy for diastole and systole, respectively (mean\u2009\u00b1\u20091 standard deviation), and D\n                    <jats:sub>2%<\/jats:sub>\n                    was 37.44\u2009\u00b1\u200916.03\u00a0Gy and 36.15\u2009\u00b1\u200916.76\u00a0Gy. Statistically significant differences were found in the D\n                    <jats:sub>mean<\/jats:sub>\n                    . LADCA doses showed no significant differences, possibly due to anatomical variations. The D\n                    <jats:sub>mean<\/jats:sub>\n                    of the LMCA was 1.88\u2009\u00b1\u20090.23\u00a0Gy and 2.02\u2009\u00b1\u20090.28\u00a0Gy for diastole and systole, and D\n                    <jats:sub>2%<\/jats:sub>\n                    was 2.05\u2009\u00b1\u20090.28\u00a0Gy and 2.21\u2009\u00b1\u20090.30\u00a0Gy, with both parameters being statistically significantly higher during systole. Although small, cardiac-phase-dependent dose variations under DIBH were statistically significant, confirming that current non-ECG-gated DIBH remains adequate for cardiac dose management.\n                  <\/jats:p>","DOI":"10.1007\/s12194-026-01016-2","type":"journal-article","created":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T10:02:56Z","timestamp":1770544976000},"page":"313-320","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robustness of heart dose against cardiac cycle in breast cancer radiotherapy with deep inspiration breath-hold"],"prefix":"10.1007","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7924-845X","authenticated-orcid":false,"given":"Yuya","family":"Yanagi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Monzen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Harada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Ohashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Kosaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harumi","family":"Iguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"issue":"4","key":"1016_CR1","doi-asserted-by":"publisher","first-page":"5748","DOI":"10.18632\/aging.202502","volume":"13","author":"J Huang","year":"2021","unstructured":"Huang J, Chan PS, Lok V, et al. 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Informed consent was obtained using an opt-out approach, whereby participants were provided with an opportunity to decline inclusion. All supporting documentation concerning ethical review and informed consent is available upon request.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study involved human participants. No animals were involved in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}}]}}