{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:50:56Z","timestamp":1792450256827,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the clinical value of thermo-optical surface monitoring + X-ray guidance system(ExacTrac Dynamic, ETD) in assessing inter-fraction setup accuracy and intra-fraction motion monitoring during deep inspiration breath-hold (DIBH) radiotherapy after breast-conserving surgery for breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data were collected from 31 female patients with breast cancer who had undergone breast\u2212conserving surgery. Cone\u2212beam computed tomography (CBCT) was used to verify inter\u2212fraction setup during the first three treatment fractions, as well as the 6th, 9th, 12th, and 15th fractions. Triple thermo\u2212optical surface tracking, intra\u2212fraction CBCT, and X\u2212ray imaging were employed to monitor intra\u2212fraction motion. Setup errors and treatment duration were recorded. Linear mixed\u2212effects models were applied to analyze inter\u2212fraction setup errors derived from CBCT and intra\u2212fraction errors measured by X\u2212ray.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After X-ray correction, mean setup errors in all dimensions were not significantly different from zero (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt;0.05) and were independent of breast volume. Treatment duration had no significant impact on intra-fraction deviations. Surface monitoring detected mid-treatment drift, which was corrected by X-ray guidance, keeping all values within clinical tolerance. The radiation dose from X-ray planar imaging was substantially lower than from CBCT. Calculated planning target volume (PTV) margins (van Herk formula) were 5.10\u00a0mm (lateral), 5.22\u00a0mm (longitudinal), and 5.78\u00a0mm (vertical).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ETD provides setup accuracy comparable to CBCT with lower radiation dose, making it appropriate for inter\u2212fraction verification. It allows stable real\u2212time intra\u2212fraction monitoring and can enhance treatment precision with mid\u2212treatment X\u2212ray correction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1880922","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:22:29Z","timestamp":1783398149000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Study on the application of thermo-optical surface monitoring + X-ray guidance system in DIBH for breast cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Tian","family":"Tian","sequence":"first","affiliation":[{"name":"Tumor Center, Affiliated Hospital of Jiangsu University","place":["Zhenjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jicheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Tumor Center, Affiliated Hospital of Jiangsu 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