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Discuss cardiac sparing for left breast patients with SGRT.
By ragu_tirukonda
We are kind of new to VisionRT, and our physician wants to use DIBH for Rt Cheswall (if nodes are involved). From what I heard, DIBH is not recommended for rt chestwalls. If you guys are doing DIBH for RT chestwall, please let me know, what is the criteria?
By amnavora
We do breath hold for Right Sided patients with IMN nodes if they can tolerate breathold and IMN then it will be planned as such
By ben_allen
We use it for all of our breast cancer radiotherapy patients including chest walls. The only think to consider is the topography of a chest wall can have a limited variation in the sup/inf direction which can confuse AlignRT when it tries to fix the position (can almost see the chest as a 'tube' with no contours to differentiate anything). This is not the case for all chest walls, only some. If we are concerned or have poor verification images, we will extend the ROI to include some more variation in topography such as taking the ROI over midline to include some of the contralateral breast to aid positioning. For bilateral mastectomy patients we will consider an ROI that wraps around the whole chest as a band and this will also give the system extra information to aid positioning.

Hope this helps,