Spatial orientation of coronary arteries and its implication for breast and thoracic radiotherapy—proposing “coronary strip” as a new organ at risk

Objectives Radiotherapy for breast cancer has been associated with various side effects including cardiac sequelae. Our study aimed to define the spatial arc of spread of coronary vessels in a radian angle. Materials and methods We analysed the records of 51 CT coronary angiographies done in our hos...

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Bibliographic Details
Published in:Strahlentherapie und Onkologie 2018-08, Vol.194 (8), p.711-718
Main Authors: Munshi, Anusheel, Khataniar, Nilaxi, Sarkar, Biplab, Bera, Moti Lal, Mohanti, Bidhu Kalyan
Format: Article
Language:English
Subjects:
Arteries
Blood vessels
Breast cancer
Cancer
Confidence intervals
Coronary vessels
Medicine
Medicine & Public Health
Oncology
Original Article
Patients
Radiation therapy
Radiotherapy
Side effects
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Summary:Objectives Radiotherapy for breast cancer has been associated with various side effects including cardiac sequelae. Our study aimed to define the spatial arc of spread of coronary vessels in a radian angle. Materials and methods We analysed the records of 51 CT coronary angiographies done in our hospital from January 2016 to July 2016. Left anterior descending (LAD) and right coronary (RC) were contoured for each patient. In each axial section, the radial spread of each artery was noted. A 5 mm brush tool was used to join the start and stop angles for making the summated “coronary strips”. Results Start and end angle of LAD with 95% confidence interval (CI) (in clockwise direction) were 23.9 ± 4° and 79.0 ± 6.6°, respectively. Mean LAD arc length ± SD (standard deviation) noted was 55.1° ± 7.7° (95% CI). For RC the smallest start angle and the largest end angle in all patients was 297.6° and 322.6°, respectively. RC start angle, end angle and arc length for 95% confidence interval were 322.2 ± 6.1°, 292.4 ± 11.6° and 29.8 ± 13.1°, respectively. Conclusions Our study provides a measure of the radial spread of the coronary arteries, especially from the perspective of breast radiotherapy. We have proposed a new organ at risk (OAR) of coronary strip. This should provide an easy and cost-effective way to delineate the coronary vasculature in breast cancer patients undergoing radiotherapy.
ISSN:0179-7158
1439-099X
DOI:10.1007/s00066-018-1299-x