{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:01:46Z","timestamp":1790564506973,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1181","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100013845","name":"Foundation against Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013845","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Translational and Clinical","award":["2022-160"],"award-info":[{"award-number":["2022-160"]}]},{"name":"Fund for Innovation and Clinical Research of Ghent University Hospital"},{"name":"Liv Veldeman holds a Clinical Mandate of Foundation against Cancer"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Deep inspiration breath-hold (DIBH) is commonly used in breast cancer radiotherapy to reduce radiation exposure to the heart and lungs. Recent techniques incorporating oxygen supplementation and hyperventilation have enabled DIBHs exceeding 2.5\u2009minutes. However, data on internal organ stability during prolonged breath-holds (L-DIBH) remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational physiological study, 10 healthy female volunteers performed 2 L-DIBHs (2\u2009minutes 8\u2009seconds each) in both prone and supine positions, following a validated hyperventilation and oxygenation protocol. Serial 3D MRI scans were acquired every 16\u2009seconds during each L-DIBH to assess positional stability of the heart, lungs, and left-sided breast. Cumulative distance-volume histograms (cDiVHs) were used to evaluate spatial relationships between organs and quantify internal displacement over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 319 high-quality 3D MRI series were analysed. cDiVHs demonstrated consistent organ positions across timepoints and sessions. While left breast position remained stable throughout all L-DIBHs, minor but statistically significant heart displacement was observed during each L-DIBH increasing over time, more pronounced in the prone position than supine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>L-DIBHs of 2\u2009minutes and 8\u2009seconds are achievable and demonstrate stability in left breast positioning, with minimal movement of adjacent internal organs. Small but progressive shifts of the portion of the heart nearest the breast were detected, particularly in prone positioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>To account for these minimal displacements during L-DIBH, asymmetrical safety margins around the heart of 3\u2009mm in prone and 2\u2009mm in supine positions may be appropriate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag018","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T04:07:25Z","timestamp":1769227645000},"page":"898-905","source":"Crossref","is-referenced-by-count":1,"title":["MRI-based analysis of organ at risk stability during prolonged voluntary deep inspiration breath-hold in prone and supine breast cancer 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Ghent University , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Speleers","sequence":"additional","affiliation":[{"name":"Department of Human Structure and Repair, Ghent University , Gent 9000,","place":["Belgium"]},{"name":"Department of Radiation Oncology, Ghent University Hospital , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4276-8926","authenticated-orcid":false,"given":"Michael","family":"Stouthandel","sequence":"additional","affiliation":[{"name":"Department of Human Structure and Repair, Ghent University , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4343-2407","authenticated-orcid":false,"given":"Hans","family":"Van Hulle","sequence":"additional","affiliation":[{"name":"Department of Human Structure and Repair, Ghent University , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Pomm\u00e9","sequence":"additional","affiliation":[{"name":"Department of Human Structure and Repair, Ghent University , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Vanhoutte","sequence":"additional","affiliation":[{"name":"Department of Human Structure and Repair, Ghent University , Gent 9000,","place":["Belgium"]},{"name":"Department of Radiation Oncology, Ghent University Hospital , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5148-9237","authenticated-orcid":false,"given":"Wilfried","family":"De Neve","sequence":"additional","affiliation":[{"name":"Department of Human Structure and Repair, Ghent University , Gent 9000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2151-9253","authenticated-orcid":false,"given":"Fran\u00e7oise","family":"Kayser","sequence":"additional","affiliation":[{"name":"Departement of Radiology, CHU UCL Namur , Namur 5000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Pellegrin","sequence":"additional","affiliation":[{"name":"Departement of Radiology, CHU UCL Namur , Namur 5000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7545-5307","authenticated-orcid":false,"given":"Marc","family":"Coppens","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Ghent University Hospital , Gent 9000,","place":["Belgium"]},{"name":"Department of Basic and Applied Medical Sciences, Ghent University , Gent 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