{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:37:17Z","timestamp":1789663037738,"version":"4.0.1"},"reference-count":21,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardioprotection is valued in radiotherapy for patients with left-sided breast cancer. Deep inspiration breath-hold (DIBH) technique can achieve cardioprotection well. However, during DIBH, the extent to which the heart enters the radiation field is affected by the movement of the thorax and diaphragm. The aim of this study was to analyze the correlation between the maximum distance of the heart entering the field (maximum heart distance, MHD) and thoracic diameter changes and diaphragmatic descent in left-sided breast cancer patients during DIBH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Ninety-eight patients with left-sided breast cancer were included in this retrospective study. They performed simulation in Sentinel-guided DIBH, and two sets of CT images were collected under both free breathing (FB) and DIBH, and diaphragm positions, anteroposterior thoracic diameter (ATD), transverse thoracic diameter (TTD), gating window level (GWL), and MHD were measured, and the change (\u0394) of each parameter in DIBH relative to that in FB were calculated. Pearson or Spearman test were used to analyze the correlation between \u0394MHD and the changes in other parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For all patients with DIBH, the average of \u0394MHD was \u22128.3 mm, and the average of \u0394ATD and \u0394TTD were 11.0 and 8.6 mm, and the median of both left diaphragmatic descent (LDD) and right diaphragmatic descent (RDD) were 35.0 mm, and the median of GWL was 11.1 mm. The correlation coefficients between MHD decrease (\u0394MHD) and LDD, RDD, and \u0394TTD were \u22120.430 (p = 0.000), \u22120.592 (p = 0.000) and 0.208 (p = 0.040), respectively, but not significantly correlated with \u0394ATD or GWL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The MHD decrease showed a moderate correlation with diaphragmatic descent In Sentinel-guided DIBH for patients with left-sided breast cancer, while there was a weak or no correlation with thoracic diameter changes or GWL. Abdominal breathing can lower diaphragm more and may be more beneficial to the heart stay away from tangential field.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2023-0053","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T13:08:07Z","timestamp":1701695287000},"page":"530-537","source":"Crossref","is-referenced-by-count":3,"title":["Correlation between maximum heart distance and thoracic diameter changes and diaphragmatic descent in left-sided breast cancer patients during deep inspiration breath-hold (DIBH)"],"prefix":"10.2478","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7050-0209","authenticated-orcid":false,"given":"He-Gou","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Shenzhen People's Hospital , The Second Clinical Medical College of Jinan University , Shenzhen , Guangdong , People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang-Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shenzhen People's Hospital , The Second Clinical Medical College of Jinan University , Shenzhen , Guangdong , People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shenzhen People's Hospital , The Second Clinical Medical College of Jinan University , Shenzhen , Guangdong , People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Guo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shenzhen People's Hospital , The Second Clinical Medical College of Jinan University , Shenzhen , Guangdong , People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Hui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shenzhen People's Hospital , The Second Clinical Medical College of Jinan University , Shenzhen , Guangdong , People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"2026071211422125695_j_raon-2023-0053_ref_001","doi-asserted-by":"crossref","unstructured":"Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Br\u00f8nnum D, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med 2013; 368: 987\u201398. doi: 10.1056\/NEJMoa1209825","DOI":"10.1056\/NEJMoa1209825"},{"key":"2026071211422125695_j_raon-2023-0053_ref_002","doi-asserted-by":"crossref","unstructured":"Stranzl H, Zurl B. Postoperative irradiation of left-sided breast cancer patients and cardiac toxicity. Does deep inspiration breath-hold (DIBH) technique protect the heart? Strahlenther Onkol 2008; 184: 354\u20138. doi: 10.1007\/s00066-008-1852-0","DOI":"10.1007\/s00066-008-1852-0"},{"key":"2026071211422125695_j_raon-2023-0053_ref_003","doi-asserted-by":"crossref","unstructured":"Sch\u00f6necker S, Walter F, Freislederer P, Marisch C, Scheithauer H, Harbeck N, et al. Treatment planning and evaluation of gated radiotherapy in left-sided breast cancer patients using the CatalystTM\/SentinelTMsystem for deep inspiration breath-hold (DIBH). 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