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Discuss cardiac sparing for left breast patients with SGRT.
By sam_wolting New Caledonia flag
Hello all,

I was wondering if you could please share your experience of ABC compared to SGRT (such as Align-RT) for breast patient with Elekta machines. I understand breath-hold CBCT is very difficult with SGRT due to the panels obstructing the view but would be interested to hear your pros vs cons!

Many thanks,

By david_nguyen
Hi Sam,

We conventionally use 3D-CRT for breast patients but from time to time, have had VMAT breast patients which require CBCT daily. We use Elekta machines, planned on Raystation and use DIBH with RTC. If it's a right breast case for example, we would use a 'Chest Right F0S20' CBCT in which the gantry starts from 180 and finishes around 20 degrees.
For the CBCT we manually count 20 seconds for example to give the patient a break to breathe. With the KV-panel and source extended we experience camera blockages at around 300-320 degrees so we are mindful to let the patient have a break before the gantry/panel/kv source blocks the camera. This would otherwise cause the patient and staff not being to read the values and continue with the scan.
We also educate the patient that there are times which the RTC reading disappears from the screen and we tell them to keep holding their breath and ignore the screen during those brief moments of disrupted readings.
Otherwise it is very much achievable with a bit of knowledge knowing which angles are affecting the reading. The CBCTs quality have been pretty good.

Hope this helps,